Malibu Beach Recovery Center

A Policeman with Alcoholism and His Rights Under the Law

Pat Olsen — Mon, 13 May 2013 10:08:59 -0800

An interesting test of whether a policeman’s rights were violated when he was fired for driving drunk in an unmarked police car while off-duty is currently taking place in Oregon. As the San Francisco Chronicle explains, Jason Servo is suing well, a bunch of people, saying that his rights were violated because he suffers from alcoholism. He has also been stripped of his police certification and says he was denied due process as well.

I’m not sure how many people know that alcoholism is considered a disability under the Americans with Disabilities Act. I sure didn’t before I started researching this case. (It took me awhile in 2008 to let it sink in that thanks to the Mental Health Parity and Addiction Equity Act, treatment for substance abuse must now be covered in group healthcare plans at a level equal to medical and surgical benefits.)

But back to the case. Servo pleaded guilty and entered a treatment program after the January accident. (He and his car ended up in a ditch.) One of his lawyers said the police department should have worked with Servo because he has a disease and should not have fired him, and the lawsuit alleges that the firing was due to budget cuts. The Chronicle article notes that “The U.S. Equal Employment Opportunity Commission … provides an example of how an alcoholic can justly be fired, and it's similar to the Servo case.

In its example, a federal police officer is involved in an accident for which he is charged with drunken driving. About a month later, he gets a termination notice stating that his conduct makes it inappropriate for him to continue. The officer says the arrest made him realize he is an alcoholic and that he is obtaining treatment. According to the EEOC, the employer may proceed with the firing.”

There’s a difference, however. The police officer in the example was on duty and Servo wasn’t.

This reminds me of the time a colleague I was working with at a high-tech company told me that another worker actually kept a bottle of vodka in a drawer and was constantly taking sips. I believe he was given the option of attending a program. I think the woman who told me was the man’s officemate, but after so many years it’s hard to remember. If it was true, that was a pretty progressive company, because there was no legislation like we have today to support that worker.

The Christian Science Monitor, in printing the same Associated Press article, asks, in the headline about the case: Can he win? I’d love to hear from some legal analysts what his chances are, and I’d like to read what addiction specialists think. And then you wonder: Are police officers held to a higher standard in some cases because they’re charged with protecting the public?

One thing is for sure—this is another story that highlights alcoholism and the workplace and gets people talking about it. That’s one way to make progress.

Pot Smoking at U. of Colorado and News on Teen Smoking

Pat Olsen — Fri, 10 May 2013 11:24:08 -0800

Since pot smoking was legalized in Washington and Colorado in 2012, there’s been no end of media coverage. One of the latest bits, by Maroosha Muzaffar, appeared recently in the Education Life supplement in The New York Times. (Unfortunately, there’s no link available.)

Muzaffar writes that The University of Colorado-Boulder has had a “campus smokeout” on April 20 for more than 10 years, with more than 10,000 attendees. The group would light their joints, or bongs, I suppose, at 4:20 p.m. on the nose, in unison with other pot smokers around the world.

Last year, though, the university cracked down. It sprayed fertilizer that smelled like fish and closed the campus to the public, and posted police in SWAT gear. The same accompaniments were planned for this year (minus the fertilizer). The authorities were worried that people will come from other states to enjoy their seemingly greater freedom this year.

However, a school representative was quick to remind people that the amendment does not allow smoking in public and there’s still a federal ban on pot. He said that the school was worried about safety and the disruption of campus activities.

I had to think about the headline accompanying Muzzafar’s piece for a minute—“10,000 Tokes Over the Line?” It took that long to realize that it was a takeoff on the title of a 1970s song by Brewer and Shipley -- “One Toke Over the Line” that was pretty popular during that decade. Readers of a certain age undoubtedly remember the song that began:

“One toke over the line sweet Jesus / One toke over the line / Sittin' downtown in a railway station / One toke over the line”

When I checked the news on 4/21, it turned out that the college officials had closed the campus in an effort to deter the smoke-in. (It wasn’t clear in the first article that they were planning to go that far.) As a result, celebrants assembled at Civic Center Park in Denver instead, and there were two shots fired. (These types of gatherings are held throughout the country every year on April 20—who knew?).

NBC News reported that three people were wounded at the park and commented that “The shootings came at a sensitive time for Colorado marijuana activists, who are closely watching proposals from state lawmakers on the rules that will govern the sale of small amounts of pot to people 21 and older.”

There’s news on the general smoking front as well, from HealthDay: “Genes May Dictate Teens' Susceptibility to Heavy Smoking”, but I’m wondering if the information isn’t obvious. In a four-decade long study conducted in New Zealand, researchers found that teens who scored high on a genetic risk profile and tried smoking at age 15 were more likely to get hooked than teens who didn’t score as high and tried smoking later. Somehow I would expect this because it sounds so similar to what happens with drinking—the earlier you start, the greater the chance you’ll get hooked.

The genetic risk profile wasn’t explained but it sounds like it hinges on whether the teens’ parents smoked. We know there’s some genetic correlation when it comes to drinking.

Still, as I’ve found with so many studies that seem self-evident, the purpose of some research studies may be to back up what someone think is true, so who am I to criticize?

Malibu Beach Recovery Diet: Carrot and Beet Salad, Oven Roasted Ratatouille, Cherry Rhubarb Pie

Licia Jaccard — Mon, 06 May 2013 09:32:32 -0800

I don’t know if you remember one of your parents telling you incessantly “Eat your vegetables” when you were struggling with your dinner at the family table. Or my favorite: “French fries is not a breakfast food!”.

Even better, now, it is not just “Eat your vegetables!” that is making a comeback, but like the almighty peacock, it’s a multicolored array of rainbow-hewed vegetables, all more enticing than the next. Nowadays, going to the farmer’s market is all about reproducing the color palette of the early impressionists. But, unlike the peacock, this display of colors also reveals a whole pharmacology that puts our modern medicine to shame.

Just like it is, in my opinion, ridiculous to strip wheat from the germ and all the vitamins, minerals and fiber it contains, to mill it, bleach it, refine it, then ooops…. enrich it, add vitamins D and E and calcium and sell it as a better product than the original, just because a few people have built their business on these intermediary steps, just like this, was I saying, I sincerely believe that nature has intended its pharmacology to be ingested as is, and not pulverized, edulcorated, freeze dried, compacted and spit back in the form of a capsule to take morning, noon and night.

In addition to the huge health effects of eating brightly colored vegetables and fruits, I think that the first appetite-inducing contact we have with our food is through our sense of vision which is strongly titillated by color. Just like kids, we love visual stimulation, bright overly contrasted spills of colors and it brings joy to our hearts before we even make sense of what the drawing represents. As adults, we must bring this childlike joy back into our plates and challenge Mother Nature into feeding us the most beautiful symphony for the eyes.

But let us not forget the healing powers of consuming these heavily colored gems. For the sake of simplicity, here are the rough drafts of these benefits:

Blue and Purple Foods – Rich in antioxidants that protect from cell damage. They may help reduce risk of cancer, stroke, and heart disease.

blueberries

blackberries

eggplant

plums

figs

Red Foods - contain lycopene, which may help reduce the risk of cancer.

apples

beets

cranberries

red cabbage

pomegranates

strawberries

tomatoes

Orange and Yellow Foods - help maintain healthy mucous membranes and eyes. They also can lower the risk of heart attack.

yellow apples

cantaloupe

yellow squash

tangerines

sweet potatoes

pumpkin

peaches

pineapple

mangos

Green Foods - contain lutein and indoles that protect eyes and also protect against cancer.

asparagus

avocado

lettuce

broccoli

zucchini

cucumbers

green peppers

limes

White Foods - protect against stomach cancer and heart disease and can help to lower cholesterol and high blood pressure.

cauliflower

ginger

jicama

onions

mushrooms

garlic

turnips

Click on "Continue Reading" for the Recipes

Bon Appétit

Licia

Photo: Claude Monet. Irises in Monet's garden, Giverny (1900)

Carrot and Beet Salad

Serves 4

Ingredients

2 small heads of red beets
4 carrots
2 red onions
2 green onions
1 bunch cilantro
1/4 cup pine nuts
4 cups lettuce, washed and chopped
2 hard-boiled eggs

1-2-3 dressing (recipe follows)

Instructions

Using a food processor, grate the carrots and the beets. Place in a large salad bowl. In the same food processor, chop the cilantro finely. Add to the beet/carrot mixture.

Chop the red onions and green onions and add to the bowl.

In a small skillet, place the pine nuts and slowly roast them until they become fragrant, watching carefully so they do not burn. Let them cook before adding them to the salad.

Chop the hard-boiled eggs and add to the salad.

Add 1/4 cup dressing and toss, mixing all vegetables and salad.

1-2-3 Dressing: In a mason jar with screw-on lid, place 1/3 cup Dijon mustard, 2/3 cups red wine vinegar and 1 cup (3/3) olive oil. Screw on lid and shake until completely emulsified. Use what needed for this salad and refrigerate the rest. Shake well before using.

Oven Roasted Ratatouille

Ingredients

1 large eggplant, 1/2 inch dice
2 zucchini, 1/2 inch dice
2 yellow squash, 1/2 inch dice
1 red onion, chopped
5 cloves garlic, sliced
2 red peppers, 1/2 inch dice
2 yellow peppers 1/2 inch dice
1/2 cup toasted pine nuts
10 large basil leaves, chiffonade
1/2 cup balsamic vinegar
1 Tbsp agave syrup
Salt and pepper
Olive oil as needed

Instructions

Place the eggplant, zucchini, yellow squash, red and yellow peppers in a large mixing bowl. Lightly coat with olive oil and salt and pepper and toss until everything is covered with oil.

Place onto a baking sheet and place into a 400 degree oven and roasted for 30 to 45 minutes, until all of the vegetables are golden brown and caramelized. While the vegetables are roasting, place the pine nuts on a baking sheet and toast at 350 degrees for about 12 minutes. Set aside to cool.

In a large skillet, place 2 Tbsp olive oil and heat for 2 minutes, add the onion and garlic and cook until golden brown. Add the balsamic vinegar, agave and basil and let cook for 2 minutes. Turn off heat and set aside.

When the vegetables come out of the oven, place them in the skillet with the onions and balsamic, add the basil and pine nuts and toss together.

Adjust the salt and pepper and serve warm or cold.

Cherry Rhubarb Pie

Serves 6

This is what I call a “sloppy pie”. Once you cut into it, the juices and the fruit spills out and makes for a messy delicious dish, similar to a cobbler. Top with your favorite vanilla ice-cream or whipping cream for extra indulgence.

Ingredients

2 cups fresh cherries, pitted and cut in quarters
6 stalks of rhubarb, cut into 4" long pieces
1/2 cup water
1/2 cup agave
1 vanilla bean, split
2 large pieces of pie dough, cold (recipe follows)

Instructions

Place in a large saucepan together the cherries, the rhubarb, the water, the agave and the vanilla bean. Cook down the fruit for about 10 minutes, or until they begin to thicken. Stir occasionally at first, then more frequently after 5 minutes to keep the fruit from burning.

Once thick, pour the fruit out onto a cookie sheet on plate to cool completely. Remove vanilla bean.

Place the first layer of dough onto a cookie sheet lined with parchment paper. Using a fork, dock the pastry all over.

Spoon the fruit over this bottom layer, leaving 1" of space all around the edges.

Cover with second piece of pastry. Seal the edges any way you like. Slit the top in any pattern you desire.

Wisk one egg with a touch of milk or cream. Brush onto top pastry.

Bake at 375 degrees until golden brown. Let the pie cool 10 minutes before serving.

Food Processor Pie Dough

Ingredients

2 cups whole-wheat pastry flour
2 tsp agave syrup
2 stick butter
2 egg yolk
4 Tbsp milk

Instructions

Preheat oven to 350 degrees. Mix flour and butter in food processor using the pulse button until the mixture resembles coarse meal. Add egg yolk and milk and pulse until dough forms a ball. Remove from the bowl of the food processor.

Form into two balls and wrap in plastic. Place in the freezer for 10 minutes to firm up.

When ready to roll, remove from freezer and plastic and roll out on a lightly floured surface.

This quantity will be enough for a 2-crust pie. For single crust pie, divide quantities in half and follow the same instructions.

The Good News: F.D.A. Shoots Down OxyContin Generics The Bad News: Pharma Co. Hikes Price on Naloxone

Pat Olsen — Thu, 02 May 2013 10:47:29 -0800

The Food and Drug Administration refused to approve generic versions of OxyContin, which is very good news. Experts agree that this will help stop the epidemic of prescription pill abuse, and the news indicates that the F.D.A. is doing what it can to help.

Purdue Pharma gets a bad name as the manufacturer of the painkiller that “symbolized a decade-long epidemic of prescription drug abuse,” according to The New York Times. However, the company started manufacturing a different version in 2010 that was “less prone to tampering.” (It turned to jelly when people tried to crush it for snorting or injecting.)

Purdue Pharma’s patent was expiring when this ruling came down, which is why this was such good news. It means that the companies that want to manufacture generic versions of the drug won’t be able to contribute to the drug abuse epidemic. If they want to sell the drug at all, these companies will have to come up with formulations that are more difficult to tamper with, like Purdue Pharma did.

A Medpage “breaking news” email noted that there are new labeling requirements for the drug; specifically, that it "has physical and chemical properties that are expected to make abuse via injection difficult and to reduce abuse via the intranasal route." This effectively thwarts companies hoping to sell generics that don’t comply

The bad news for people who really need OxyContin for medicinal purposes is that the price of OxyCodone has risen since 2010. However, if other manufacturers come up with tamper-proof generics, that could keep a lid on prices and even help reduce them.

Endo Pharmaceuticals has also requested that the F.D.A not approve generics for their Opana, another narcotic pain killer of similar “painkilling strength.” This company, too, has come up with a formulation that is harder to tamper with.

However, the article raises the question about the drug manufacturers’ motives, whether they only really care about profits, saying “In court papers filed in response to a lawsuit filed by Endo, the F.D.A. described the company’s action as a ‘thinly veiled attempt to maintain its market share and block generic competition.’”

There’s other news about the price of a drug that, rather than contributes to prescription pill abuse, saves lives. I first wrote about Naloxone over a year ago. If you remember, this medication can help revive a person who overdoses on an opiate like heroin, and there are programs that dispense the drug for free. Hospira is currently the only company still manufacturing the medication, and Alternet noted that the price has skyrocketed by $1,100 since 2008.

The director of a Chicago program called the company in in 2008 to ask for a break, he was able to get a reduced price. Thankfully, Hospira is working with other nonprofits to offer more reasonable prices. Addiction writer Maia Szalavitz noted in another Alternet article that some programs have already folded. Shockingly, Hospira stands to make $20 million from the drug. Naloxone is injected and expensive to make, so there’s little incentive for other companies to jump to market it.

The F.D.A. is considering making Naloxene available over the counter (will that make it less expensive?), but nothing has happened yet.

Drinking and Gun Deaths

Pat Olsen — Wed, 24 Apr 2013 10:58:15 -0800

Perusing information on the relationship between drinking and gun deaths on the Internet is enough to make a person crazy, especially when so many Americans are inflamed about a gunman killing schoolchildren in Connecticut last December and the victims of the Boston Marathon/MIT killings. These latest tragedies seem to have rallied the group that wants an end to these tragedies, which in many people’s minds means stricter gun controls. But the people against gun control are vocal as well and present their own statistics. So researching this is crazy-making.

The most recent mass shootings in the U.S. were by young men who were mentally ill. But for anyone touched by or concerned about alcohol abuse, it isn’t a stretch to also start ruminating about the link between drinking and gun deaths when these tragedies occur.

Two years ago the L.A. Times had an article about a study in the British Medical Journal which found that people who own guns are twice as likely to binge drink (“have five drinks in a single sitting”) and are more than twice as likely to drive when drunk.

What was really scary is the number of deaths cited that were directly related to drinking alcohol:

“Of the 395,366 firearms-related deaths reported in the United States between 1997 -- when this data were actually collected -- and 2009 -- the latest date for which the tally of firearms-related deaths is available -- about one-third are thought to have involved alcohol. In 2007, 34.5% of suicide and homicide victims in the United States had alcohol in their systems at the time of death, and 60% of those were considered acutely intoxicated.”

Granted, many of the latest group homicides in the U.S. have been perpetrated by males who are severely mentally ill. But anyone who grew up with a violent drinker can relate and shudder. Perhaps we saw the person take a knife, or throw a lamp across a room. We know their potential for violence. And to think what might have happened if they’d had a gun—and in some cases, what did happen….Numerous domestic violence episodes occurred when a person was buoyed by alcohol or another drug. Unfortunately, some family members can only imagine what might have happened if a violent family member had a loaded gun while inebriated.

The New York Times had a more recent article on this subject last February: “Violent, Drunk, and Holding a Gun.” It was an editorial about the “multiple mass shootings by deranged young men” that I just mentioned, but said that to focus solely on this group overlooks others “at demonstrably increased risk of committing violent crimes but … not barred by federal law from buying and having guns.” Specifically, people known for violent misdemeanors, and alcohol abusers.

Did you know that it’s illegal for someone who uses a controlled substance to buy or have a gun, but not someone who has been found to abuse alcohol? The Times cited a study that found people who have been hospitalized for drinking or gotten in trouble at work for the same thing were in more danger of committing suicide and homicide.

The article says that the problem is the lack of a useful definition of a pattern of alcohol abuse. That’s hard to believe when the writer goes on to show how Pennsylvania has done it: in that state, anyone who has been found guilty of at least three drunk driving offenses can’t buy a gun. That’s at least a start.

The U.S. Military and One State Tighten Alcohol Rules

Pat Olsen — Mon, 22 Apr 2013 17:29:37 -0800

As I’ve said before, you don’t have long to look for news about alcohol—there’s always something in the news. In December, the Marines and the Navy tightened up their rules about drinking in what The New York Times referred to as “the toughest anti-drinking policy in the United States military.” Random blood tests were ordered for all marines and sailors twice a year (starting on 1/1/2013), and those found to have a blood-alcohol level of 0.01 percent or higher could be referred for counseling. For a reading of 0.04 percent or higher, they must see medical personnel who will determine if they’re fit for duty.

Recall that drivers in the U.S. are considered drunk if their blood-alcohol level is 0.08 percent, so this policy is strict with a capital S. The article says that the Marines are trying to deter its corps members and educate them, but that individuals can be punished if they don’t stay below the limits.

(What is the blood-alcohol level if a person has one drink, I wonder? Can these people have one beer or glass of wine and be safe?) I actually found a blood-alcohol calculator, here, at http://www.ou.edu/oupd/bac.htm It’s from the University of Oklahoma police department and uses how much you weigh, how long you’ve been drinking, and what you’ve been drinking. I tried it and found that if I have two wine coolers in an hour, my blood-level alcohol reading would be .05. If I stick to one, it’s .03. So I’d be in trouble with the Marines even with one. (I’d like someone else to test that calculator, though.)

The point is, the Marines expect their people to stay sober, and according to the article the Navy was planning to introduce mandatory tests in January. The Army and Air Force say that commanders can order tests when appropriate, but of the two, only the Army “prohibits a blood-alcohol content of 0.05 percent or higher.”

Not long after I read that news, I learned that New Mexico tightened its laws in the hope of deterring drunk driving. No, legislators didn’t raise the blood-alcohol level there, they made it illegal for anyone convicted of drunk driving to buy alcohol in a store, restaurant or bar. (New Mexico has one of the highest rates of alcohol-related traffic deaths in the country, according to the article.)

The new law certainly goes above and beyond the use of the ignition interlock device, which some people say are not always effective. For instance, you can blow into the device and start the car while sober but then start drinking after you start driving. People with interlock devices would be given a specially marked license so that sellers of liquor would know not to sell to people with those licenses. Alaska already has a law like this.

Several people were against the law, including the executive director of the D.W.I Resource Center in Albuquerque. She didn’t think it would work. A Democratic state representative said the law tried to “micromanage alcoholism without providing a treatment option.”

CA Introduces Hydrocodone Bill; VT Passes Drug Abuse Bills

Pat Olsen — Mon, 15 Apr 2013 22:34:20 -0800

When was the last time you had two pieces of good news in one day? Well, count yourself lucky because this is one of those days, and in the recovery field, that’s cause for celebration. A few weeks ago, Dr. Nick Techentin, PhD, a therapist who works for Joan at the Malibu Beach Recovery Center's Brentwood House, sent her a link to an L.A. Times article to let her know that her “hard work is starting to catch on.” He was referring to the fact that lawmakers in Washington DC have introduced a bill that should make it harder for people to abuse hydrocodone (for example, Vicodin). The law would place it “in same category as OxyContin, another opiate-based painkiller so potent and addictive that it's sometimes referred to as synthetic heroin,” the article said. This is in accordance with the FDA recommendations from January.

Nick was also referring to Joan’s regular efforts to help those in recovery by bringing awareness to the prescription drug epidemic. You may recall how politically active she has been, or then again you may not be aware. In 2010, Joan brought two MBRC alumni to Sacramento to lobby in favor of a bill sponsored by Senator Mark DeSaulnier to fund CURES, California's online real time prescription drug data base. After the bill failed by a single vote, she invited him visit MBRC to speak with addiction industry professionals about resurrecting the CURES database project. This year after the Los Angeles Times took Attorney General Kamala Harris to task for letting CURES all but die, he reintroduced the bill (with some changes), this time co-sponsored by some political heavyweights like State Senate Speaker Pro Tem Darrell Steinberg, State Senators Fran Pavley and Ted Lieu, and Assembly Budget Committee Chairman Bob Blumenfield.

So the news about hydrocodone was very welcome. The law, if it passes, will be called the Safe Prescribing Act of 2013. There’s no reason to believe it won’t pass, since four lawmakers introduced it, and “more than 40 additional members of Congress from both parties signed on as co-sponsors.”

The second piece of good news concerns the bills passed in VT last month. In an article published in a CT paper, one of the lawmakers involved said the bills were a response to the opiate addiction and methamphetamine abuse in the state. First, the legislation gave good Samaritans, or people who call about overdoses, immunity from prosecution. (Police will not have access to the database without a warrant.) Importantly, it required doctors who prescribe narcotics to register with the state’s CURES-like database and to use it. Pharmacists are required to ask for ID of those picking up prescriptions for certain drugs, and hospitals have to abide by standards set for referring people to drug treatment programs when needed.

Joan added: Just as we were about to publish the above report by Pat, yet another piece of good news arrived. In a surprise showing of bipartisan support, the California State Assembly Health Committee voted in favor of Assemblyman Richard Bloom's AB 831, a bill that would require a temporary state task force of experts to develop a comprehensive plan to address the state's overdose crisis, as well as to establish a modest funding source for groups working to reduce overdose deaths. Assemblyman Bloom represents Malibu, which is home to two dozen alcohol and drug treatment centers, as well as West Los Angeles and Beverly Hills, home to at least another six treatment centers. The bill now moves to the Assembly Appropriations Committee.

Photos (above) Senate Speaker Pro Tem Darrell Steinberg. (Right) Assembyman Richard Bloom.

Malibu Beach Recovery Diet: Indian Spiced Chicken and Asparagus, Sugar Snap Salad, Meyer Lemon Pudding Cake

Licia Jaccard — Thu, 11 Apr 2013 20:33:23 -0800

The air is filled with the scents of spring. It is more than ever a pleasure to go to the Farmer’s market and see what is in store for us this week. When you get accustomed to eating what is “in season” you will never look back. Every bite is as tasteful as nature intended it to be. Furthermore, that is when Nature’s pharmacy is at its best: the sugar levels are at their highest, the vitamins and minerals at their most digestible and easily assimilated by the body.

I acknowledge how convenient it is to buy food in advance and let your printed lists guide you through a week’s worth of meal plans, but the pure joy of biting into a ripe pear or seeing how a crunchy baby kale can fill your plate with delicious tartness is one of the many pleasures of buying fruits and vegetables in season. Even cheese has seasons and one who has not longed for months before the Vacherin cheese was finally on the markets in their oak rims, and for only one week every fall, does not know how much the scarcity of it makes it all worth it.

The flip side of this is that products can disappear as quickly as they show up. I just got used to purchasing a new variety of tangerines called the Sumo tangerine, with an intense sweet orange flavor and unmistakably easy to peel skin, when, all of a sudden, it disappeared from all markets altogether. The same can be said for figs, one day they are here and plentiful and the next gone. So, no blinking there. When it’s good and ripe, that’s when produce is good to enjoy.

Generally speaking, I save a couple of hours for the farmers’ market every weekend. I probably only need half an hour of full shopping time, but each merchant has a special story to share, and the communal feeling that can be experienced at the market is one of many sources of inspiration in the kitchen. Not only do you meet the local chefs who need very little nudging to share their use of the product that you have not yet tasted, but your fellow-shoppers all are prompt to chime in with their personal experience. Many cooking schools feature “Follow the Chef at the market” classes, but you can make up your own without spending a dime when you engage with the locals who share the same interest as you.

The advantage of learning the four or five main techniques of cooking will enable you to let the market decide for you what is ready to make it onto your meal planning list. Sauté, braise, poach, roast, sear… this is all simple and one size fits all. Making yourself more familiar with basic spices and condiments will bring you the diversity that you need to make up your own recipes as you go. Learn the combinations that are the trademark of certain cultures and your kitchen will entice you with new adventures. Be creative in your search for complementary ingredients. Then go to the Farmer’s Market and go crazy with inspiration. Cooking is fun and can be enrichment for both the body and soul.

Click on "Continue Reading" for the Recipes

Bon Appétit,

Licia

Indian Spiced Chicken and Asparagus

Ingredients

1 1/2 teaspoons cumin seeds
1 1/2 teaspoons fennel seeds
1 pound chicken tenders, cut into bite-size chunks
3/4 teaspoon salt, divided
2 tablespoons canola oil, divided
1 medium onion, chopped
3 cloves garlic, minced
1 small fresh chile, seeded and minced
1 tablespoon minced fresh ginger
1 1/2 bunches asparagus (about 1 1/2 pounds), woody ends trimmed, cut into 1-inch pieces
1/2 cup “lite” coconut milk
1/2 cup chopped fresh cilantro

Instructions

Toast cumin and fennel seeds in a small dry skillet over medium heat until fragrant and beginning to brown, about 2 minutes. Finely grind in a spice grinder (such as a clean coffee grinder) or with a mortar and pestle.
Toss chicken with 1 1/2 teaspoons of the spice mixture and 1/4 teaspoon salt in a bowl. Heat 1 tablespoon oil in a large nonstick skillet over medium-high heat. Add the chicken and cook, stirring frequently, until browned, 3 to 4 minutes. Remove to a plate.
Reduce heat to medium and add the remaining 1 tablespoon oil, onion, garlic, chile and ginger; cook, stirring, until softened, 2 to 3 minutes. Add asparagus, sprinkle with the remaining spice mixture and cook, stirring, for 2 minutes. Stir in coconut milk and the remaining 1/2 teaspoon salt and simmer for 2 minutes more. Return the chicken and any accumulated juice to the pan and cook until the chicken is just cooked through and the asparagus is tender-crisp, about 2 minutes more. Serve sprinkled with cilantro.

Sugar Snap Salad

yield: Makes 8 to 10 servings

Ingredients

1 1/2 pounds sugar snap peas, trimmed, stringed, cut in half on diagonal
Kosher salt
tablespoons extra-virgin olive oil
1 tablespoon fresh lemon juice
1 teaspoon white wine vinegar
1/2 teaspoon sumac plus more for garnish (find in middle-eastern stores) or replace with lemon zest
1 bunch radishes (about 6 ounces), trimmed, thinly sliced
4 ounces ricotta or feta, crumbled
Freshly ground black pepper
2 tablespoons coarsely chopped fresh mint

Instructions

Fill a large bowl with ice water; set aside. Cook peas in a large pot of boiling salted water until crisp-tender, about 2 minutes. Drain; transfer to bowl with ice water to cool. Drain peas; transfer to a kitchen towel–lined baking sheet to dry.

Whisk oil, 1 tablespoon lemon juice, vinegar, and 1/2 teaspoon sumac (or lemon zest) in a small bowl. Toss peas, radishes, and cheese in a large bowl.

Add dressing to salad and toss to coat. Season salad with salt, pepper, and more lemon juice, if desired. Garnish with mint and sprinkle with sumac or lemon zest.

Meyer Lemon Pudding Cake

Ingredients

3 tablespoons unsalted butter, room temperature
1/2 cup agave syrup, divided into 1/4 cup and 1/4 cup
1 tablespoon meyer lemon zest
3 large eggs at room temperature, yolks separated from whites
1/4 cup whole-wheat pastry flour
1 teaspoon vanilla extract
1/8 teaspoon salt
1/2 cup meyer lemon juice, freshly squeezed
1 cup milk, at room temperature
1/8 teaspoon cream of tartar

Special Equipment:

a 9-inch pie dish, preferably glass or ceramic
a baking pan big enough to hold the 9-inch pie dish comfortably inside like a 16-inch roasting pan

Instructions

Preheat oven to 325 degrees F. Grease a 9-inch pie dish.
In the bowl of a stand mixer fitted with a paddle attachment, beat together 3 tablespoons butter, and 1 tablespoon lemon zest until light and fluffy. Add in 1/4 cup agave syrup and 3 egg yolks one at a time, beating between each addition.
Once the egg yolks have been incorporated, turn off the mixer and use a rubber spatula to hand mix in the flour, vanilla and salt. Stir in the lemon juice and milk. The batter will be very runny.
In a large mixing bowl, use a handheld whisk to beat together 3 egg whites until soft peaks form. Add in the cream of tartar as well as the remaining 1/4 cup agave syrup and continue beating until stiff peaks form.
Once stiff peaks have formed, use a rubber spatula to hand mix one third of the egg whites into the cake batter until completely mixed. Carefully fold in the remaining egg whites — the batter should be light and fluffy at this point.
Transfer the batter into the prepared baking dish (the cake will not rise so it is okay to fill the dish to the top, if necessary). Place the baking dish into a larger baking or roasting dish. Use a kettle to boil enough water to fit into the roasting pan. Once the water is boiling, carefully pour it into the large dish containing the batter-filled pie pan until it reaches halfway up the outside of the pie pan.
Carefully transfer both pans into the oven and bake for 50-60 minutes, or until the top becomes golden and the middle of the cake barely jiggles when shaken.
Cool the cake on a cooling rack for 45 minutes to 1 hour before cutting or serving to allow the cake to set. The cake is best when served warm and fresh out the oven.

Buprenorphine Implants - Yay or Nay?

Pat Olsen — Wed, 10 Apr 2013 11:35:31 -0800

Buprenorphine has been in the news lately. A pharmaceutical company is seeking FDA approval for implants that release the drug, and it’s not without controversy.

If you need a refresher on this drug, it’s used to treat opioid addiction (addiction to painkillers like OxyContin andVicodin, for example). When used in Subutex and Suboxone, it “enable[s] opioid-addicted individuals to discontinue the misuse of opioids without experiencing withdrawal symptoms,” according to SAMHSA. It carries a lower risk of abuse than heroin and methadone, which is designed to perform the same function, although the potential is there, experts say.

And that was one of the concerns the FDA voiced when the drug came up for review this month. All you had to do wass follow the press to learn the progress of the FDA’s actions. On 3/19, preliminary to an FDA Drug Advisory meeting, the organization released a document containing its thoughts. Shortly afterward, a MedPage article headline proclaimed: “FDA Staff Not Thrilled About Opioid Implant.”

It seems that during clinical trials, some people still needed oral Suboxone to ward off withdrawal symptoms, which in turn, meant that the company’s claims that implants would reduce pediatric exposure to the medication were not reliable. (The company said that with five rods, patients would receive a steady dose of medication for up to 4 to 6 months.)

Or, as Treatment Magazine’s editor succinctly put it, after reading the document:

“Long-acting buprenorphine implants, already brand named Probuphine by Titan Pharmaceuticals as the tiny specialty pharma moves through trials and FDA approvals for the implantable opioid replacement therapy, got a decidedly negative review by FDA staffers in what is the key aspect of the implants - their ability to completely replace daily dosing and thus solve a range of thorny bup issues ranging from diversion to proper dosing and even the possibility of cutting back on the highway robbery $150 to $300 monthly doctor's visits.”

However, two days later, a Medscape article stated “FDA Panel Says a Cautious ‘Yes’ to Buprenorphine Implant.” The writer summarized the panel’s findings as follows:

“The vote was 10 to 4 (with 1 abstaining) that the efficacy, safety, and risk-benefit data supplied by the company supports approval.

The panel ‘seemed to agree that this is a product with great potential utility, but there is some deficiencies in terms of dosing and REMS (Risk Evaluation and Mitigation Strategies) but that overall need for a product such as this on the market exceeded those deficiencies,’ said panel chair Edward Covington, MD, from the Cleveland Clinic Foundation.”

(You might need to register on Medscape to read the article.)

I know implants have been used for birth control for quite some time; it’s interesting to consider them for addiction treatment. You’d think that the convenience would be a big selling point for addicts, but the potential for abuse never occurred to me. And the safety question is troublesome, too. The FDA may have its critics, but it’s a good thing we have them to monitor new therapies

Joan added: Detoxing clients from suboxone or subutex presribed for "long term" pain management is for the most part a long and agonizing ordeal. The last 2 mg are especially difficult. I wrote about Krissie Bergo's detox from the suboxone here. I wonder if the FDA took the end game into consideration. Just what is it like to detox from a buprenorphine implant? Or is the FDA expecting people to have the implant for life?

Drug Testing in Schools - What Side are You On?

Pat Olsen — Sat, 06 Apr 2013 10:39:11 -0800

In 2012 I wrote about the controversy over drug testing welfare recipients, here. Recently a controversy about testing students in athletics and in other extracurricular activities surfaced in a group of towns south of me. The Lacey Township school district held a forum in February to discuss this policy pending in its schools. It was hosted by the Drug/Alcohol Task Force in the schools, who called it “A Red Night Out.” I have no idea why. To signal the danger drugs pose? The proponents came armed with statistics, and what statistics they were. Four people died in Lacey Township from drug overdoses last year, and there were 39 others who overdosed but lived. Thirty of the overdoses were from heroin. A lawyer and parent in the township recounted his son’s story for the audience, which was as sobering as the statistics. The boy’s drug problems began at age 13 and got so bad that his father pressed charges to give him some consequences if he continued rather than getting help. His son is 31 now and clean and says his father did the right thing.

Drug testing can be controversial, to be sure, but I was surprised at one person who wrote an op-ed letter to warn that the testing could backfire: a woman from the NJ Drug Policy Alliance. She said that such an action could result in the “destruction of trust between students and adults at the school” and impair open discussion of the “potentially life-threatening issues adolescents face.” She also thought that it may deter students from participating in extracurricular activities. She’d rather see the money go to an education program to try and combat drug abuse.

I found it interesting that she referred those interested to the American Academy of Pediatrics for saying that the organization opposes this type of drug testing. I decided to see for myself. She was right—I found a page called Drug Testing Your Teen, but it doesn’t state anything about drug testing those involved in school activities. Their policy is that any drug test should be voluntary, and that a child’s doctor should be able to identify drug use by talking to the teen. They point out that it’s a clear sign of distrust if parents drug test (and, I suppose, that can be extended to school testing.)

Hmmm…. I wonder how many people disagree and think that in some cases drug testing is one of the few ways to try and save a teen. I also wonder how recovery professionals feel. I’m sure this controversy has occurred in several, or even many, schools around the nation.

As to whether drug testing works, I went to the NIDA site to try and learn the answer. Here it is, at the end of a long and thoughtful page of information in the form of Frequently Asked Questions:

What has research determined about the utility of random drug tests in schools?

"There is not very much research in this area, and the early research shows mixed results. A study published in 2007 (Goldberg et al, J. Adolesc Health, 41: 421-29, 2007) found that student athletes who participated in randomized drug testing had overall rates of drug use similar to students who did not take part in the program, and in fact some indicators of future drug abuse increased among those participating in the drug testing program. Because of the limited number of studies on this topic more research is warranted."

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