Context: The opioid epidemic is a major US public health crisis. Its scope prompted significant public outreach, but this response triggered a series of journalistic articles comparing the opioid epidemic to the crack cocaine epidemic. Some authors claimed that the political response to the crack cocaine epidemic was criminal justice rather than medical in nature, motivated by divergent racial demographics.
Methods: We examine these assertions by analyzing the language used in relevant newspaper articles. Using a national sample, we compare word frequencies from articles about crack cocaine in 1988–89 and opioids in 2016–17 to evaluate media framings. We also examine articles about methamphetamines in 1992–93 and heroin throughout the three eras to distinguish between narratives used to describe the crack cocaine and opioid epidemics.
Findings: We find support for critics' hypotheses about the differential framing of the two epidemics: articles on the opioid epidemic are likelier to use medical terminology than criminal justice terminology while the reverse is true for crack cocaine articles.
Conclusions: Our analysis suggests that race and legality may influence policy responses to substance-use epidemics. Comparisons also suggest that the evolution of the media narrative on substance use cannot alone account for the divergence in framing between the two epidemics.
During the COVID-19 pandemic, telemedicine has been a substantial tool in promoting resilience in the health care system. Beyond the pandemic, telemedicine has potential to expand access to care and save costs for patients and systems. 1,2 However, many of the pandemic-inspired changes to licensing regulations are set to expire when the public health emergency ends. Physicians who are seeking a national or multistate telemedicine practice may again face a problematic patchwork of state regulations, licensure applications, and onerous fees. The US federal government should take advantage of pandemic-inspired momentum to promote telehealth via regulatory leadership.
State-Based Medical Licensure: Problematic PatchworkHistorically, each state has been responsible for licensing the practice of medicine and may require special purpose licenses, telemedicine licenses, telemedicine certificates, or full licenses to practice telemedicine within its jurisdiction. The Interstate Medical Licensure Compact (IMLC) emerged to facilitate the process of obtaining medical licensure in multiple states while ensuring that states remain responsible for professional licensure.Once physicians are licensed by a state board, they must generally adhere to the laws of the state where the patient is located. States differ in their legal definition of the patient-clinician relationship, informed consent through telemedicine, and the prescribing powers of telemedicine physicians. 3 For example, the Table compares 2 states on key points associated with the delivery of telehealth care.Physicians who fail to adhere to state laws where a patient is located may face malpractice suits in the patient's state. For example, in Indiana, out-of-state physicians are subject to the jurisdiction of Indiana's courts and its substantive and procedural laws regarding medical claims. Forcing disciplinary action to follow the patient can discourage telemedicine because physicians will be reluctant to face liability in unfamiliar forums.Author affiliations and article information are listed at the end of this article.
Employers and governments are interested in the use of serological (antibody) testing to allow people to return to work before there is a vaccine for SARS-CoV-2. We articulate the preconditions needed for the implementation of antibody testing, including the role of the U.S. Food & Drug Administration.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.