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No Spike in Overdoses With COVID-Era Expansion of Methadone Access

A new study led by researchers at Columbia University indicates that patients who receive methadone take-home doses—a protocol expanded during the COVID pandemic—are no more likely to overdose or drop out of care than those whose methadone is delivered at government‐​approved opioid treatment programs.
The findings, published Dec. 4 in Lancet Regional Health Americas, could eventually result in improving access to this proven, life-saving treatment and help close the gap in care.
There are currently 1,800 opioid treatment programs in the United States dispensing methadone to about 400,000 people annually, a fraction of those who report developing opioid use disorder (OUD) in a given year.

Arthur Robin Williams, MD

“The vast majority of people living with opioid use disorder are not receiving methadone, considered the gold standard of treatment,” said lead study author Arthur Robin Williams,  MD, MBE, assistant professor of clinical psychiatry at Columbia and a research scientist at New York State Psychiatric Institute. “Increasing take-home doses is one way to help reduce overdoses and deaths.”
Restrictive regulations
More than 107,000 Americans died of drug overdoses in 2021, a 15 percent increase from 2020, with deaths led by opioids, such as heroin and fentanyl. Despite the worsening of the opioid epidemic, patients in need of treatment must travel to government-approved opioid treatment programs (OTPs), where staff is required to observe them taking the medication. 
In March 2020, to reduce contact at clinics, the Substance Abuse and Mental Health Services Administration (SAMHSA) permitted OTPs, with state approval, to dispense a larger supply of methadone take-homes.  Patients deemed stable could take home a 28-day supply, akin to monthly pharmacy prescriptions; other patients received up to a 14-day supply.
To assess the impact of these reforms, the research team, which included investigators from the NYU Grossman School of Medicine, recruited 1,200 patients with OUD entering methadone maintenance programs.
The cohort comprised two study groups (n=600 each) based upon their methadone treatment periods: prior and post COVID pandemic. The investigators tracked electronic health records for patients newly entering methadone maintenance in 2020 and compared their clinical outcomes to control groups admitted in 2019.
“We primarily looked at retention in treatment; adverse events, such as overdose; and rates of drug use,” said senior investigator Edward V. Nunes, MD, professor of psychiatry and research scientist at Columbia.
First empirical study
Over a six-month period, the researchers found that adherence to methadone maintenance and adverse events were equivalent across groups despite higher rates of opioid and methamphetamine use in the 2020 cohort following regulatory reforms. 
They also discovered that more half of the sites barely increased their take-home schedules despite wide latitude to do so.
“There is currently a seismic debate at the federal level between health and law enforcement agencies about how to reform access to opioid use disorder treatment,” Dr. Williams said. “This is the first empirical study with electronic health records data in the U.S. that also has a control group. We hope that policymakers will take these findings into consideration when determining which reforms to keep in place versus rescind.”

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No Spike in Overdoses With COVID-Era Expansion of Methadone Access

A new study led by researchers at Columbia University indicates that patients who receive methadone take-home doses—a protocol expanded during the COVID pandemic—are no more likely to overdose or drop out of care than those whose methadone is delivered at government‐​approved opioid treatment programs.
The findings, published Dec. 4 in Lancet Regional Health Americas, could eventually result in improving access to this proven, life-saving treatment and help close the gap in care.
There are currently 1,800 opioid treatment programs in the United States dispensing methadone to about 400,000 people annually, a fraction of those who report developing opioid use disorder (OUD) in a given year.

Arthur Robin Williams, MD

“The vast majority of people living with opioid use disorder are not receiving methadone, considered the gold standard of treatment,” said lead study author Arthur Robin Williams,  MD, MBE, assistant professor of clinical psychiatry at Columbia and a research scientist at New York State Psychiatric Institute. “Increasing take-home doses is one way to help reduce overdoses and deaths.”
Restrictive regulations
More than 107,000 Americans died of drug overdoses in 2021, a 15 percent increase from 2020, with deaths led by opioids, such as heroin and fentanyl. Despite the worsening of the opioid epidemic, patients in need of treatment must travel to government-approved opioid treatment programs (OTPs), where staff is required to observe them taking the medication. 
In March 2020, to reduce contact at clinics, the Substance Abuse and Mental Health Services Administration (SAMHSA) permitted OTPs, with state approval, to dispense a larger supply of methadone take-homes.  Patients deemed stable could take home a 28-day supply, akin to monthly pharmacy prescriptions; other patients received up to a 14-day supply.
To assess the impact of these reforms, the research team, which included investigators from the NYU Grossman School of Medicine, recruited 1,200 patients with OUD entering methadone maintenance programs.
The cohort comprised two study groups (n=600 each) based upon their methadone treatment periods: prior and post COVID pandemic. The investigators tracked electronic health records for patients newly entering methadone maintenance in 2020 and compared their clinical outcomes to control groups admitted in 2019.
“We primarily looked at retention in treatment; adverse events, such as overdose; and rates of drug use,” said senior investigator Edward V. Nunes, MD, professor of psychiatry and research scientist at Columbia.
First empirical study
Over a six-month period, the researchers found that adherence to methadone maintenance and adverse events were equivalent across groups despite higher rates of opioid and methamphetamine use in the 2020 cohort following regulatory reforms. 
They also discovered that more half of the sites barely increased their take-home schedules despite wide latitude to do so.
“There is currently a seismic debate at the federal level between health and law enforcement agencies about how to reform access to opioid use disorder treatment,” Dr. Williams said. “This is the first empirical study with electronic health records data in the U.S. that also has a control group. We hope that policymakers will take these findings into consideration when determining which reforms to keep in place versus rescind.”

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Join us for El Niño: Nativity Reconsidered, on December 21 at 7:30pm! Tickets …

Join us for El Niño: Nativity Reconsidered, on December 21 at 7:30pm!

Tickets are available across many price ranges, but we hope you will consider purchasing a $125 ticket for this one-night-only performance, which includes access to reserved seating and a reception with the artists directly following the performance. By doing so, you’ll be supporting our commitment to offering accessible ticket pricing and ensuring El Niño is an experience available to everyone.

Credits: An AMOC* production of EL NIÑO: NATIVITY RECONSIDERED at the Cathedral of St. John the Divine in 2022.

#AMOC #stjohndivinenyc #cathedralchurch #cathedral #nyc #elniño #concert #musicconcert #thingstodo #thingstodonyc #nycthingstodo

📸: Nina Westervelt


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Chancellor Schwartz Shares Her Thoughts on the Passing of Rabbi David Ellenson (z”l)

Like so many in the community, I am heartbroken to learn of the death of Rabbi David Ellenson (z”l). Dr. Ellenson served as president and Chancellor Emeritus of Hebrew Union College – Jewish institute of Religion. He had the special ability to be both a profound scholar and an exceptional institutional leader. Internationally recognized for his scholarly work in the areas of Jewish religious thought, ethics, and modern Jewish history, he was also known for his devotion to sustaining HUC-JIR’s excellence.  

JTS was honored to work closely with Rabbi Ellenson throughout the years. Three successive JTS chancellors were blessed to call him both a colleague and a friend.  

I knew him as a true “Ohev Yisrael” and a staunch adherent of religious pluralism who believed in the power of each variety of Judaism to bring more people closer to God, Torah, and the people Israel. With his prodigious intellect, incisive thinking, and, most of all, his love for the Jewish people in all its variety, he inspired all those he encountered.  

As so many can attest, he was a marvelous human being, a trusted friend, and a wise counselor. I personally grew from every conversation I had with him, whether about our shared interests in 19th-century Wissenschaft scholarship, American Judaism, the future of American Jewry, or the unique challenges of institutional leadership.   

Chancellor Emeritus Eisen, who worked closely with Rabbi Ellenson, recalled that “David Ellenson was one of the wisest, kindest and most loving human beings I have known. It was a great privilege to be his friend—a privilege shared by so many in the Jewish world—and a special pleasure to have his companionship as I led JTS at the same time as he led HUC. There are not enough candles on all our hanukiyyot to make up for the light that has just left our world. Truly a man whose memory, like his life, is for blessing.” 

“I am deeply saddened by President Ellenson’s sudden death,” said Chancellor Emeritus Schorsch who also knew Rabbi Ellenson well. “I mourn along with the multitudes that he touched. He was a dear friend, an outstanding leader, and a tireless scholar.”   

Rabbi Ellenson received an honorary doctorate from JTS in 2014, a day that now holds added meaning in our community.



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Discrimination During Pregnancy May Alter Circuits in Infants’ Brains

Racial discrimination and bias are painful realities and increasingly recognized as detrimental to the health of adults and children.
These stressful experiences also appear to be transmitted from mother to child during pregnancy, altering the strength of infants’ brain circuits, according to a new study from researchers at Columbia, Yale, and Children’s Hospital of Los Angeles.
Read the paper“The effects of experience of discrimination and acculturation during pregnancy on the developing offspring brain” was published in the journal Neuropsychopharmacology on Nov. 15.
The study found similar brain changes in infants whose mothers experienced stress from adapting to a new culture during pregnancy.
“A leading hypothesis would be that the connectivity changes that we see could reduce one’s ability to regulate their emotions and increase risk for mental health disorders,” says the study’s lead author Marisa Spann, PhD, the Herbert Irving Associate Professor of Medical Psychology in the Department of Psychiatry at Columbia University Vagelos College of Physicians and Surgeons.
“It remains to be seen if the connectivity differences we found lead to long-term mental health outcomes in children. Our team and others in the field still have the opportunity to test this.”
Previous research by Spann and colleagues has documented the impact of various forms of prenatal distress—depression, stress, and anxiety—on the infant brain. “We work with vulnerable and underrepresented populations, and the experience of stigma and discrimination are distressingly common,” Spann says. “This naturally led to discussions about the impact of other stressors, like discrimination and acculturation, on the infant brain.”
In the new study, the researchers analyzed data collected from 165 young, mostly Hispanic women who had participated in an earlier study of teen pregnancy, stress, and nutrition by co-authors Catherine Monk, PhD, and Bradley Peterson, MD. The data included self-reported measures of discrimination and acculturation, along with measures of general stress, childhood trauma, depression, and socioeconomic status.
An analysis of the data showed that stress from discrimination and acculturation were separate and distinct from other types of stress and might have unique effects on the brain.
To look for these unique effects, the researchers compared the mothers’ discrimination and acculturation stress to the strength of their infants’ brain circuits, as measured with MRI scans. This analysis of 38 mother-infant pairs showed that infants of mothers who experienced discrimination generally had weaker connections between their amygdala and prefrontal cortex and infants of mothers who experienced acculturation stress had stronger connectivity between the amygdala and another brain region called the fusiform. 
The amygdala is an area of the brain associated with emotional processing that is altered in many mood disorders. It also may be involved in ethnic and racial processing, such as differentiating faces

Marisa Spann, PhD, is a clinical neuropsychologist whose research focuses on how prenatal exposure, such as maternal infection, medical conditions, and environmental stressors affect the fetal and infant brain and behavioral development. Her goal is to identify early immune, brain, and neuropsychological factors that increase childhood psychiatric risk to allow for earlier intervention for young children.

“The amygdala is very sensitive to other types of prenatal stress,” Spann says, “and our new findings suggest that the experience of discrimination and acculturation also influences amygdala circuitry, potentially across generations.”

The take-home message, Spann says, is that “how we treat and interact with people matters, especially during pregnancy—a critical time point where we can see the far-reaching effects on children.”
Spann adds that more research is needed to investigate the biological mechanisms that carry the experiences of adversity from parent to offspring as well as the long-term impact of these findings. She currently is leading a study—funded by the Community-Based Participatory Research program of Columbia’s Irving Institute for Clinical and Translational Research and in collaboration with the Northern Manhattan Perinatal Partnership—to examine the relationship between maternal experiences of discrimination and acculturative stress on the development of their infant’s racial processing.

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We are so grateful for all of givings throughout this season! Just one year ag…

We are so grateful for all of givings throughout this season!

Just one year ago our partnership with Coke began and we could not be more thankful! Over this past year and into this holiday season we have had refreshing cans for our pantry, lunch bags and to give away during our clothing closet. Cheers to a great year and the future!

Thank you to Theresa and Rahim Hollisi once again sponsoring our entire Thanksgiving Meal Service on Sunday Nov. 19th!

Thanks to Principal Corbin, Rev. Pat Williams, students and members of Mission Outreach for collecting a CUP OF LOVE (SOUP) for our pantry clients!

Thank you to Marie Del Tejo for her generous donation of brand-new hats, scarves and gloves!





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Edwidge Danticat, Once a Barnard Student, Is Now a Columbia Professor

Edwidge Danticat, who holds a B.A. in French Literature from Barnard, has returned to Morningside Heights this fall as the Wun Tsun Tam Mellon Professor of the Humanities in the Department of African American and African Diaspora Studies.

She is the author of 17 books, including the novels Breath, Eyes, Memory and The Farming of Bones, as well as the short story collection, Krik? Krak! She has written books for children and young adults; a travel narrative, After the Dance; and a collection of essays, Create Dangerously. Danticat’s memoir, Brother, I’m Dying, was a finalist for the National Book Award and a 2008 winner of the National Book Critics Circle Award for autobiography. Her story collection, Everything Inside, won the 2019 National Book Critics Circle Fiction Prize. She has received numerous other honors, including a MacArthur Fellowship and a Ford Foundation Art of Change fellowship.

Recently, Danticat discussed with Columbia News how it feels to be back on campus, as well as what she’s teaching this semester and how she manages two jobs at once—being a professor and a writer.

How is your first semester going teaching at Columbia—and being across Broadway from your alma mater, Barnard?

My semester is going well, thankfully. It’s hard not to feel like the 20-year-old version of myself walking around campus despite so much evidence to the contrary. The difference is that rather than being taught by great scholars and mentors on both sides of Broadway, they are now my colleagues. That still blows my mind and is taking some getting used to.

What are you teaching now?

I am teaching a Topics in the Black Experience graduate seminar, Writing in the Presence of Ancestors. It’s framed around Toni Morrison’s 1984 essay, “Rootedness: The Ancestor as Foundation,” in which she writes: “It seems to me interesting to evaluate Black literature on what the writer does with the presence of an ancestor.” We explore what we can create in the presence of ancestors by looking at what others, including scholars and creative writers, have also produced when hyper-aware of their ancestors. 

How does the intersection of teaching and writing affect you? Is there much of an overlap?

My writing projects often involve a lot of research, be it reading, interviews, or travel. Teaching also requires research, even as I read along with students, and learn and grow with them. Again, being here, where I started developing some of these skills, allows me to see what might be possible for students even a few years from now, because they are probably further along than I was at their age. I tried to wrap up two big projects before I got here because I knew it would take some time to find my rhythm to do both. Still, I know that what I’m reading for my classes and the discussions I’m having with students will undoubtedly expand my field of knowledge and make me a better writer.

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Union to Feature a Course on Jewish-Christian Relations in Spring 2024 – Union Theological Seminary

The complex and largely contentious history between Jews and Christians constitutes a significant dimension of current crises and conflicts—both abroad and here at home. Yet this difficult history isn’t the full story. Remarkable advances in understanding and collaboration reveal new hope in the possibilities of repairing and strengthening the bonds that link both traditions. In response to the relevance of the topic, Union is featuring  a course offered in the 2024 spring term, Studies in Jewish-Christian Relations, taught by Professor Mary Boys
This in-person course, offered to religiously diverse students from schools in the NY Metro area, will be offered weekly on Mondays (January 29-May 6 2024) from 9-11:50am on Union’s campus. The deadline to sign up for the course is January 11.
The standard audit fee is $600, but a reduced fee ($150) will be available by request to those for whom the higher fee would be a financial hardship. Please email David Gastwirth (dgastwirth@uts.columbia.edu) no later than January 4 with a reduced fee request (and prior to completing the sign up form) or any other questions about the course. Learners from all religious and spiritual backgrounds are encouraged to join.
Learn More:
PLEASE Join us for a brief overview of the course and some Q&A online on December 20, 5:30-6:30pm. Please register to attend on Zoom.
Course Information:
IE/RE 344 STUDIES IN JEWISH-CHRISTIAN RELATIONS
Jews and Christians have a long and complex relationship requiring us to grapple with what has been termed a “tormented” history. As “two nations in [one] womb” (Israel Jacob Yuval), our traditions experienced a protracted, complicated and often fractious process by which they ultimately emerged in relation to one another. Grappling with this history is essential to reimagining a relation in the present characterized by mutual respect and commitment to a peaceful and just world.
This course on Jewish-Christian relations engages us in two cases in interreligious/intercultural conflict and reconciliation. The first reveals how cultural and religious differences gave rise to disparagement of the other, and how power imbalances and societal tensions fueled binary oppositional identity, often with tragic consequences. This case involves delving into the origins and development of anti-Jewish teachings that became embedded in church life and contributed significantly to antisemitism. The second case, still very much in process, documents the developing—and somewhat marginal—transformation of relations between Jews and Christians in the past 60 years, not simply through the many instances of scholarly collaboration but also among those committed to interreligious/intercultural dialogue.
A course such as this would be inconceivable for most of the two millennia of relations between our traditions, so it is a sign of hope that Jews and Christians today can engage in learning in the presence of the other.
Course Goals:

To analyze key developments in Jewish-Christian relations, with emphasis on scholarship that presents an alternative to conventional understandings of the first centuries of the Common Era that serve as a resource to reorient thinking.
To draw upon the wealth of resources by Jewish and Christian scholars, including books, articles, open-access journals, encyclopedias, films, and lectures.
To engage participants in the issues involving Jews and Christians relevant to their own religious and cultural contexts, including the current war between Israel and Hamas.
To provide opportunities for participants to interact with one another and to collaborate so as to foster greater knowledge and understanding.

The post Union to Feature a Course on Jewish-Christian Relations in Spring 2024 appeared first on Union Theological Seminary.
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Research Collaborations Across Disciplines and Generations Can Help Reduce Gun Violence


When a Tucson, Ariz., gunman killed five people and wounded 14 others in 2011, TC doctoral student Dawn Myers was on duty as a paramedic. The tragedy, Myers said, remained “raw” in the desert community for long after. About 800 miles away and 11 years later, 19 children and two teachers were shot and killed at an elementary school in Uvalde, Texas. TC doctoral student Jenny Caruso, a classroom teacher at the time, would join millions of others in watching the aftermath unfold on the news. 
Both events would punctuate the journeys of Caruso and Myers, now scholars examining gun violence as a public health issue. As doctoral students in TC’s Health Education program, the two study and conduct research under the guidance of leading expert Sonali Rajan, the Inaugural President of the Research Society for the Prevention of Firearm-Related Harms, which was established late last year and recently hosted its national conference in Chicago that Caruso, Myers, and Rajan attended together along with their colleagues.



Caruso, Rajan and Myers. (Photos courtesy of those pictured)

“It was incredible to experience the breadth of work across so many different disciplines that approach gun violence from different perspectives,” said Caruso, who specifically studies school-based teacher trauma. “And have the opportunity to learn from them, and create opportunities to work alongside each other in the future.” 
Preparing the next wave of gun violence prevention scholars is part of what drove Rajan and her contemporaries to establish the national research society, a key milestone in any growing discipline, much less one that was barred from receiving federal funding for nearly 25 years and until relatively recently. But as the Washington Post editorial board wrote this month, the organization plays a distinct role from advocacy organizations working on the same issue by offering scientific findings that “speak for themselves.”  
“We are in this to fix this,” says Rajan. “Doing this kind of research is difficult and challenging, and it can be heartbreaking. To see so many people come together in such creative, collaborative and compassionate ways to do this work — which has incredible need and urgency — that is something I’m still reflecting on, absorbing, and taking in. For that I feel enormous gratitude.” 

Gun Violence by the Numbers

45,000+ firearm deaths each year
54% of gun-related deaths are from suicide
23% more gun deaths occurred in 2021 vs. 2019 

The development of new science alongside the immense amount of work required to establish, build and grow a research society is certainly a feat in itself, but how Rajan and her team have executed that work is just as significant. In just its second year, the conference ballooned to approximately 700 attendees across numerous fields and career points — a diversity that Rajan, her colleagues, and her students see as essential to the efficacy and scalability of this work. 
“The scope of the problem is so enormous,” Rajan says, “that it requires an ‘all hands on deck’ kind of effort.”
Reaching the full potential for such diverse collaboration remains an ever-moving target for Rajan and colleagues, including Myers, who suspects that they were one of the few attendees who conducts research in addition to teaching high school. 
“We’re in the trenches,” says Myers, who recently celebrated a decade in the classroom, and hopes to engage more educators and young people in research-driven violence reduction solutions throughout their career.
“We need to not just be willing to do the research, but to listen,” Myers explains. “What are teachers seeing and hearing? We need a connection with the kids and let them have a voice. They have a finger on the pulse of what is going on and where this is coming from…And how do we get youth involved to make those changes and make them feel safe to make those changes,  much less in underfunded and under-resourced schools?” 

The Conference by the Numbers

~700 conference attendees
333 scientific presentations
225 attendees were students, careers, and early-career scholars
210 unique institutions
20 different academic disciplines
39 states represented
4 countries represented 

Rajan, her students, and colleagues here via the Columbia Scientific Union for the Reduction of Gun Violence (SURGE) and at institutions across the country are exploring just that, among other questions — and while Rajan and her contemporaries have identified specific policies with promising indicators of success, researchers see a long road ahead in confronting the complexities of gun violence, which claims more than 45,000 lives each year in the U.S., many from suicide. In September, the White House launched the Office of Gun Violence Prevention, and recent research has also confirmed firearm injuries as the leading cause of death among children and teens in the U.S. 
“Every single year, gun violence claim the lives of over 40,000 Americans, with guns being the number one killer of kids nationwide. This is not only unacceptable, it is also preventable,” said Deputy Director for the White House Office of Gun Violence Prevention Rob Wilcox, who delivered remarks during the conference’s opening ceremony. “Research continues to show that proven prevention methods like red flag laws, secure gun storage, background checks and investing in community-based solutions reduce gun deaths and make communities safer. President Biden and this Administration will continue to follow the research on gun safety through implementing the historic Bipartisan Safer Communities Act, identifying new executive actions, building state and local partnerships, and coordinating the federal response to gun violence.”



Rajan and her colleagues, including TC’s Louis Klarevas and Charles Branas of Columbia’s Mailman School of Public Health. (Photo courtesy of Branas)

The White House’s efforts are among what experts see as a changing tide. “Dr. Rajan was already doing this work, which I’m really proud of and excited by as her colleague,” Myers says of Rajan, whose research on gun violence prevention dates back to 2014. It’s amazing to watch TC grow into such a prominent leader in this space.”
Leading critical research in a relatively new discipline while working closely with students, Rajan is giving them a front-seat to what it takes to pursue brave inquiry with the highest of measurable stakes amid an often heated political backdrop. But despite the tragedies tied to gun violence and the debates that follow, Rajan, her colleagues, and her students — who see themselves continuing in this field — remain focused on the research itself with clarity and precision. 
“Let’s leave the finger-pointing to the politicians,” Myers says from their classroom. “I don’t know if we could ever stop [gun violence], but maybe we could really make a difference.” 


NY1 and Sonali Rajan


— Morgan Gilbard

Published Thursday, Nov 16, 2023

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Wednesday Noonday Concerts return….September 13th at noon.

El Niño: Nativity Reconsidered: Audiences called it “thrilling” and “superb”! T…

El Niño: Nativity Reconsidered: Audiences called it “thrilling” and “superb”!

Thursday, December 21, 2023
7:30pm
Tickets: link in bio | Choose—What-You-Pay

Credits: Conductor Christian Reif and AMOC* members Bass-Baritone Davóne Tines, Soprano Julia Bullock and Countertenor Anthony Roth Costanzo in the AMOC* production EL NIÑO: NATIVITY RECONSIDERED with the Cathedral of St. John the Divine in 2022.

:

#AMOC #stjohndivinenyc #cathedralchurch #cathedral #nyc #elniño #concert #musicconcert
📸: Nina Westervelt





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No Spike in Overdoses With COVID-Era Expansion of Methadone Access

A new study led by researchers at Columbia University indicates that patients who receive methadone take-home doses—a protocol expanded during the COVID pandemic—are no more likely to overdose or drop out of care than those whose methadone is delivered at government‐​approved opioid treatment programs.
The findings, published Dec. 4 in Lancet Regional Health Americas, could eventually result in improving access to this proven, life-saving treatment and help close the gap in care.
There are currently 1,800 opioid treatment programs in the United States dispensing methadone to about 400,000 people annually, a fraction of those who report developing opioid use disorder (OUD) in a given year.

Arthur Robin Williams, MD

“The vast majority of people living with opioid use disorder are not receiving methadone, considered the gold standard of treatment,” said lead study author Arthur Robin Williams,  MD, MBE, assistant professor of clinical psychiatry at Columbia and a research scientist at New York State Psychiatric Institute. “Increasing take-home doses is one way to help reduce overdoses and deaths.”
Restrictive regulations
More than 107,000 Americans died of drug overdoses in 2021, a 15 percent increase from 2020, with deaths led by opioids, such as heroin and fentanyl. Despite the worsening of the opioid epidemic, patients in need of treatment must travel to government-approved opioid treatment programs (OTPs), where staff is required to observe them taking the medication. 
In March 2020, to reduce contact at clinics, the Substance Abuse and Mental Health Services Administration (SAMHSA) permitted OTPs, with state approval, to dispense a larger supply of methadone take-homes.  Patients deemed stable could take home a 28-day supply, akin to monthly pharmacy prescriptions; other patients received up to a 14-day supply.
To assess the impact of these reforms, the research team, which included investigators from the NYU Grossman School of Medicine, recruited 1,200 patients with OUD entering methadone maintenance programs.
The cohort comprised two study groups (n=600 each) based upon their methadone treatment periods: prior and post COVID pandemic. The investigators tracked electronic health records for patients newly entering methadone maintenance in 2020 and compared their clinical outcomes to control groups admitted in 2019.
“We primarily looked at retention in treatment; adverse events, such as overdose; and rates of drug use,” said senior investigator Edward V. Nunes, MD, professor of psychiatry and research scientist at Columbia.
First empirical study
Over a six-month period, the researchers found that adherence to methadone maintenance and adverse events were equivalent across groups despite higher rates of opioid and methamphetamine use in the 2020 cohort following regulatory reforms. 
They also discovered that more half of the sites barely increased their take-home schedules despite wide latitude to do so.
“There is currently a seismic debate at the federal level between health and law enforcement agencies about how to reform access to opioid use disorder treatment,” Dr. Williams said. “This is the first empirical study with electronic health records data in the U.S. that also has a control group. We hope that policymakers will take these findings into consideration when determining which reforms to keep in place versus rescind.”

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No Spike in Overdoses With COVID-Era Expansion of Methadone Access

A new study led by researchers at Columbia University indicates that patients who receive methadone take-home doses—a protocol expanded during the COVID pandemic—are no more likely to overdose or drop out of care than those whose methadone is delivered at government‐​approved opioid treatment programs.
The findings, published Dec. 4 in Lancet Regional Health Americas, could eventually result in improving access to this proven, life-saving treatment and help close the gap in care.
There are currently 1,800 opioid treatment programs in the United States dispensing methadone to about 400,000 people annually, a fraction of those who report developing opioid use disorder (OUD) in a given year.

Arthur Robin Williams, MD

“The vast majority of people living with opioid use disorder are not receiving methadone, considered the gold standard of treatment,” said lead study author Arthur Robin Williams,  MD, MBE, assistant professor of clinical psychiatry at Columbia and a research scientist at New York State Psychiatric Institute. “Increasing take-home doses is one way to help reduce overdoses and deaths.”
Restrictive regulations
More than 107,000 Americans died of drug overdoses in 2021, a 15 percent increase from 2020, with deaths led by opioids, such as heroin and fentanyl. Despite the worsening of the opioid epidemic, patients in need of treatment must travel to government-approved opioid treatment programs (OTPs), where staff is required to observe them taking the medication. 
In March 2020, to reduce contact at clinics, the Substance Abuse and Mental Health Services Administration (SAMHSA) permitted OTPs, with state approval, to dispense a larger supply of methadone take-homes.  Patients deemed stable could take home a 28-day supply, akin to monthly pharmacy prescriptions; other patients received up to a 14-day supply.
To assess the impact of these reforms, the research team, which included investigators from the NYU Grossman School of Medicine, recruited 1,200 patients with OUD entering methadone maintenance programs.
The cohort comprised two study groups (n=600 each) based upon their methadone treatment periods: prior and post COVID pandemic. The investigators tracked electronic health records for patients newly entering methadone maintenance in 2020 and compared their clinical outcomes to control groups admitted in 2019.
“We primarily looked at retention in treatment; adverse events, such as overdose; and rates of drug use,” said senior investigator Edward V. Nunes, MD, professor of psychiatry and research scientist at Columbia.
First empirical study
Over a six-month period, the researchers found that adherence to methadone maintenance and adverse events were equivalent across groups despite higher rates of opioid and methamphetamine use in the 2020 cohort following regulatory reforms. 
They also discovered that more half of the sites barely increased their take-home schedules despite wide latitude to do so.
“There is currently a seismic debate at the federal level between health and law enforcement agencies about how to reform access to opioid use disorder treatment,” Dr. Williams said. “This is the first empirical study with electronic health records data in the U.S. that also has a control group. We hope that policymakers will take these findings into consideration when determining which reforms to keep in place versus rescind.”

Source link

Join us for El Niño: Nativity Reconsidered, on December 21 at 7:30pm! Tickets …

Join us for El Niño: Nativity Reconsidered, on December 21 at 7:30pm!

Tickets are available across many price ranges, but we hope you will consider purchasing a $125 ticket for this one-night-only performance, which includes access to reserved seating and a reception with the artists directly following the performance. By doing so, you’ll be supporting our commitment to offering accessible ticket pricing and ensuring El Niño is an experience available to everyone.

Credits: An AMOC* production of EL NIÑO: NATIVITY RECONSIDERED at the Cathedral of St. John the Divine in 2022.

#AMOC #stjohndivinenyc #cathedralchurch #cathedral #nyc #elniño #concert #musicconcert #thingstodo #thingstodonyc #nycthingstodo

📸: Nina Westervelt


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Chancellor Schwartz Shares Her Thoughts on the Passing of Rabbi David Ellenson (z”l)

Like so many in the community, I am heartbroken to learn of the death of Rabbi David Ellenson (z”l). Dr. Ellenson served as president and Chancellor Emeritus of Hebrew Union College – Jewish institute of Religion. He had the special ability to be both a profound scholar and an exceptional institutional leader. Internationally recognized for his scholarly work in the areas of Jewish religious thought, ethics, and modern Jewish history, he was also known for his devotion to sustaining HUC-JIR’s excellence.  

JTS was honored to work closely with Rabbi Ellenson throughout the years. Three successive JTS chancellors were blessed to call him both a colleague and a friend.  

I knew him as a true “Ohev Yisrael” and a staunch adherent of religious pluralism who believed in the power of each variety of Judaism to bring more people closer to God, Torah, and the people Israel. With his prodigious intellect, incisive thinking, and, most of all, his love for the Jewish people in all its variety, he inspired all those he encountered.  

As so many can attest, he was a marvelous human being, a trusted friend, and a wise counselor. I personally grew from every conversation I had with him, whether about our shared interests in 19th-century Wissenschaft scholarship, American Judaism, the future of American Jewry, or the unique challenges of institutional leadership.   

Chancellor Emeritus Eisen, who worked closely with Rabbi Ellenson, recalled that “David Ellenson was one of the wisest, kindest and most loving human beings I have known. It was a great privilege to be his friend—a privilege shared by so many in the Jewish world—and a special pleasure to have his companionship as I led JTS at the same time as he led HUC. There are not enough candles on all our hanukiyyot to make up for the light that has just left our world. Truly a man whose memory, like his life, is for blessing.” 

“I am deeply saddened by President Ellenson’s sudden death,” said Chancellor Emeritus Schorsch who also knew Rabbi Ellenson well. “I mourn along with the multitudes that he touched. He was a dear friend, an outstanding leader, and a tireless scholar.”   

Rabbi Ellenson received an honorary doctorate from JTS in 2014, a day that now holds added meaning in our community.



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Discrimination During Pregnancy May Alter Circuits in Infants’ Brains

Racial discrimination and bias are painful realities and increasingly recognized as detrimental to the health of adults and children.
These stressful experiences also appear to be transmitted from mother to child during pregnancy, altering the strength of infants’ brain circuits, according to a new study from researchers at Columbia, Yale, and Children’s Hospital of Los Angeles.
Read the paper“The effects of experience of discrimination and acculturation during pregnancy on the developing offspring brain” was published in the journal Neuropsychopharmacology on Nov. 15.
The study found similar brain changes in infants whose mothers experienced stress from adapting to a new culture during pregnancy.
“A leading hypothesis would be that the connectivity changes that we see could reduce one’s ability to regulate their emotions and increase risk for mental health disorders,” says the study’s lead author Marisa Spann, PhD, the Herbert Irving Associate Professor of Medical Psychology in the Department of Psychiatry at Columbia University Vagelos College of Physicians and Surgeons.
“It remains to be seen if the connectivity differences we found lead to long-term mental health outcomes in children. Our team and others in the field still have the opportunity to test this.”
Previous research by Spann and colleagues has documented the impact of various forms of prenatal distress—depression, stress, and anxiety—on the infant brain. “We work with vulnerable and underrepresented populations, and the experience of stigma and discrimination are distressingly common,” Spann says. “This naturally led to discussions about the impact of other stressors, like discrimination and acculturation, on the infant brain.”
In the new study, the researchers analyzed data collected from 165 young, mostly Hispanic women who had participated in an earlier study of teen pregnancy, stress, and nutrition by co-authors Catherine Monk, PhD, and Bradley Peterson, MD. The data included self-reported measures of discrimination and acculturation, along with measures of general stress, childhood trauma, depression, and socioeconomic status.
An analysis of the data showed that stress from discrimination and acculturation were separate and distinct from other types of stress and might have unique effects on the brain.
To look for these unique effects, the researchers compared the mothers’ discrimination and acculturation stress to the strength of their infants’ brain circuits, as measured with MRI scans. This analysis of 38 mother-infant pairs showed that infants of mothers who experienced discrimination generally had weaker connections between their amygdala and prefrontal cortex and infants of mothers who experienced acculturation stress had stronger connectivity between the amygdala and another brain region called the fusiform. 
The amygdala is an area of the brain associated with emotional processing that is altered in many mood disorders. It also may be involved in ethnic and racial processing, such as differentiating faces

Marisa Spann, PhD, is a clinical neuropsychologist whose research focuses on how prenatal exposure, such as maternal infection, medical conditions, and environmental stressors affect the fetal and infant brain and behavioral development. Her goal is to identify early immune, brain, and neuropsychological factors that increase childhood psychiatric risk to allow for earlier intervention for young children.

“The amygdala is very sensitive to other types of prenatal stress,” Spann says, “and our new findings suggest that the experience of discrimination and acculturation also influences amygdala circuitry, potentially across generations.”

The take-home message, Spann says, is that “how we treat and interact with people matters, especially during pregnancy—a critical time point where we can see the far-reaching effects on children.”
Spann adds that more research is needed to investigate the biological mechanisms that carry the experiences of adversity from parent to offspring as well as the long-term impact of these findings. She currently is leading a study—funded by the Community-Based Participatory Research program of Columbia’s Irving Institute for Clinical and Translational Research and in collaboration with the Northern Manhattan Perinatal Partnership—to examine the relationship between maternal experiences of discrimination and acculturative stress on the development of their infant’s racial processing.

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We are so grateful for all of givings throughout this season! Just one year ag…

We are so grateful for all of givings throughout this season!

Just one year ago our partnership with Coke began and we could not be more thankful! Over this past year and into this holiday season we have had refreshing cans for our pantry, lunch bags and to give away during our clothing closet. Cheers to a great year and the future!

Thank you to Theresa and Rahim Hollisi once again sponsoring our entire Thanksgiving Meal Service on Sunday Nov. 19th!

Thanks to Principal Corbin, Rev. Pat Williams, students and members of Mission Outreach for collecting a CUP OF LOVE (SOUP) for our pantry clients!

Thank you to Marie Del Tejo for her generous donation of brand-new hats, scarves and gloves!





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