Recognize genetics’ role in opioid cases

first_imgCategories: Letters to the Editor, Opinion I would like to commend you for printing a copy of the editorial on “Bloomberg View” in the Oct. 28 Gazette. You had printed my letter to the editor on Jan. 1, 2015, concerning the opioid problem in this country and my recommendations for helping to reduce it.Until recently, I hadn’t read any articles or editorials which supported my recommendations. More recently, that has been changing, including the editorial mentioned above.I have been treating Opioid Use Disorder for over 14 years and it’s obviously a genetic illness. I have had many patients who were siblings, cousins and parent/child. My most recent new patient had a grandmother, as well as a sister, who were heroin addicts. Now we have a genetic test which may predict opioid addiction risk with 88 to 97 percent certainty. The test, called LifeKit Predict, uses an algorithm to calculate a patient’s addiction risk score based on 16 genetic variants in brain reward pathways.This is in addition to the gene, OPRM1, on chromosome number six, which encodes the opioid receptors in the brain. The protein Delta FosB accumulates in the nucleus accumbens with opioid use and is one of the causes of addiction, but decreases with time during treatment. The difference between addiction and physical dependence needs to be recognized. The person taking buprenorphine has a physical dependence, but not an addiction. There’s no “high” or cravings from buprenorphine, and the person feels “normal.” It’s similar to treating someone with diabetes or hypertension.Treating pain is important, but now with this test the doctor can know how careful they need to be with a particular patient. The next problem will be its cost and whether insurance companies will cover such an order by the doctor to obtain this test, as they would for other medical lab tests.If not, will the federal government be willing to pay for this test, which can give the prescribing doctor the information needed? I would hope they would, in view of the fact that they have wasted so much money on worthless programs from ignorance.Jack L. UnderwoodSchenectadyThe writer is a psychiatrist.More from The Daily Gazette:Foss: Should main downtown branch of the Schenectady County Public Library reopen?Schenectady man dies following Cutler Street dirt bike crashMotorcyclist injured in Thursday afternoon Schenectady crashSchenectady police reform sessions pivot to onlineTroopers: Schenectady pair possessed heroin, crack cocaine in Orange County Thruway stoplast_img read more

Trump lawyer is wrong about obstruction of justice

first_imgThis radical view of what lawyers call the “unitary executive” isn’t completely crazy, especially if you take Dowd’s words charitably.But it is wrong.The president can indeed express opinions about legal cases. Yet he isn’t above the law that defines obstruction as an attempt to block the course of justice with corrupt intent.If he tries to pervert the judicial system to advance corrupt interests, he’s violating federal law.He would also be committing a high crime qualifying him for impeachment under the Constitution:The first impeachment charge against Richard Nixon was precisely for obstruction of justice for his conduct in the Watergate coverup.One of the articles of impeachment approved by the House against Bill Clinton was for obstruction of justice. In the 1988 case of Morrison v. Olson, the U.S. Supreme Court upheld the independent counsel statute that was later used to appoint Ken Starr and prosecute President Clinton.The only dissenter was Justice Antonin Scalia, who maintained that the prosecutorial function must belong to the executive under the Constitution.Lots of scholars agree with Scalia and have criticized the Morrison case, but it’s still good law. It’s just that Congress let the law lapse after it expired in 1999.All this is the necessary background to Dowd’s theory.His idea is that, because the president is the head federal prosecutor, and prosecutors are allowed to use discretion in whom they prosecute, any judgment by the president about how that prosecution should be exercised is within the president’s power — and can’t be obstruction of justice.To the extent this view makes sense, it should cover any opinion sincerely expressed by the president for what he judges to be the good of the country — or for any non-corrupt whim.If, for example, Trump sincerely thought that former National Security Adviser Michael Flynn was a good guy who shouldn’t go to prison, it was perfectly legal for him to ask FBI Director James Comey to let the Flynn investigation go. Indeed, even firing Comey because he disagreed would be lawful and not obstruction of justice. To see why Dowd’s view, though wrong, isn’t utterly bizarre, consider that the U.S., almost alone among developed constitutional democracies, puts prosecution in the executive branch instead of a formally independent prosecutorial entity.That’s because the Constitution creates three branches of government, and three only, thus requiring all federal government authority to fit into one of those boxes.Other constitutional systems include the prosecutorial authority alongside the judiciary, so that prosecutors are meant to function as independent quasi-judges.In the U.S. system, from the start, the attorney general worked for the president and federal prosecutors answered to the attorney general.That means the president is formally the prosecutor in chief.The independence prosecutors typically enjoy derives from powerful traditional norms or from regulations that limit the president’s ability to fire —like the Department of Justice regulation that says only the attorney general can fire a special prosecutor like Robert Mueller, and only for good cause.In theory, Congress could create truly independent prosecutors. It can make it a crime for the president to use his discretionary power as commander in chief to order U.S. forces to murder his enemies.What these examples have in common with the crime of obstruction is that Congress is prohibiting the president’s corrupt exercise of discretionary power.And even if all this analysis were wrong, and Congress did lack the power to criminalize presidential corruption, it would still be within Congress’s power to impeach the president for obstruction of justice or other corrupt acts.That’s because Congress is the sole judge of impeachments, and high crimes and misdemeanors don’t have to be actual statutory crimes — they can be corrupt acts connected to the office of the presidency that Congress deems to subvert democracy and the rule of law.In other words, even if he were right about federal law, which he isn’t, Dowd would still be wrong when it came to impeachment. And that’s the forum where Trump’s alleged misconduct will have to be judged first.Noah Feldman, a Bloomberg View columnist, is a professor of law at Harvard University.More from The Daily Gazette:EDITORIAL: Find a way to get family members into nursing homesEDITORIAL: Beware of voter intimidationEDITORIAL: Thruway tax unfair to working motoristsFoss: Should main downtown branch of the Schenectady County Public Library reopen?EDITORIAL: Urgent: Today is the last day to complete the censuscenter_img Categories: Editorial, OpinionIt’s happening: President Donald Trump’s lawyer John Dowd asserted Monday that the “president cannot obstruct justice because he is the chief law enforcement officer under” Article II of the Constitution and “has every right to express his view of any case.” The trouble with Dowd’s view is that he seems to want it to apply to cases where the president had a corrupt intent.That would be, for example, if the president sought to hide his own criminal conduct.Or imagine a president who had a Mafioso friend and wanted to block his friend’s prosecution because the president owed him a favor. Those actions would squarely violate the statute.Dowd’s view seems to be that even in those cases, the president couldn’t be charged with obstruction of justice, because Congress lacks the authority to tell the president when and how to exercise his prosecutorial discretion.Nothing the president ever did in the exercise of that discretion could be made unlawful, unless it violated the Constitution itself.This cannot be right. The president has many powers that come with inherent discretion, and Congress may regulate his exercise of most of them.Congress can make it a crime for the president to take a bribe to exercise his discretionary powers.last_img read more

Letters to the Editor for Wednesday, Jan. 23

first_img1) They voluntarily chose not to make a pension election at their orientation meeting with payroll. The New York State Police and Fire Retirement System (NYSPF) require that if no election is made, they, by default, be placed in the 25-year plan. They then had up to one year, from the date of joining the retirement system, to change to the 20-year plan if they so wished.2) They did not act on correspondence from the NYSPF during this one-year option period.3) Recently, they sued the town over this pension issue and lost their case in court. These members were put in the proper pension system. Taxpayers should ask the Town Board what it will cost the town if these four are allowed the benefits of the 20-year plan vs. the 25-year plan. Members can retire with no age restrictions and they start collecting their pensions immediately after filing for retirement.  Let’s hold people accountable for their own actions or lack thereof. Don’t ask the town taxpayers to foot the bill for this costly redo.Sandra BusinoAlplaus Clay was a political genius, but in sum, his compromises were an 18th Century exercise of kicking the can down the road. Brands notes the last compromise included a tougher fugitive slave law. How in the name of Dred Scott does any historian think that was a great idea?Political compromises to solve problems are essential. But I’m afraid the real legacy of Henry Clay lives on in the worst sense with our current politicians. Our national debt, unfunded public pensions and growing entitlement shortfalls are all examples of pushing problems off to future generations.David OchsePorter Corners Pelosi, Schumer not honest or respectfulAfter viewing on TV the meeting President Trump had with her majesty Pelosi and prince Schumer, all I could see was two nincompoops displaying arrogant claims on the border. A few years ago, they wanted the same things for the border that the president wanted. They know full well what is taking place on the border. They really should be honest with the president and say, “We know the wall is needed, but we dislike you so much, we will not agree on the wall.”Pelosi and Schumer should be working for all the people in this country, not just a few.And at the meeting with the president, they both showed a lack of courtesy toward the president by not facing him and not really looking at him when speaking. Arrogance personified.Shirley H. GuidarelliSchenectadyMore from The Daily Gazette:EDITORIAL: Beware of voter intimidationEDITORIAL: Thruway tax unfair to working motoristsEDITORIAL: Find a way to get family members into nursing homesGov. Andrew Cuomo’s press conference for Sunday, Oct. 18Foss: Should main downtown branch of the Schenectady County Public Library reopen? We rely on many species, such as the many pollinators. If we don’t know what happens to them if there’s a nuclear war (we don’t), maybe we shouldn’t have started the nuclear age in the first place. Nothing lasts forever. Civilization won’t, and neither will the nuclear age. What happens with our large nuclear arsenal when it’s over?Nuclear powers should try to get along to avoid a crisis. Being allies with Putin isn’t the answer, but starting up the Cold War again sounds even worse.You’re better off admiring presidents before the nuclear age (Washington through Hoover) more and admiring less those during the nuclear age. That’s how important this issue is. Americans tend to do the opposite.It’s claimed horseshoe crabs go back 450 million years. All species should attempt to be the horseshoe crab. Why do I have a feeling humans won’t come close?Colin YunickCharlton Get along to avoid a potential nuclear warVasili Arkhipov was a Soviet officer credited with preventing a Soviet nuclear strike during the Cuban Missile Crisis. He’s mostly forgotten today, but it’s believed we came close to a nuclear war. Abortion has severe long-term effectsIf you want to know what’s wrong in America, just read Don Steiner’s Jan. 17 letter and you will see how blind we have become to the murder of innocent children in this country. Hitler has nothing that even comes close to over 50 million innocent girls and boys being ripped from their mother’s womb and disposed of like yesterday’s garbage. Fifty percent of those children were most likely girls. Where’s their right to choose? The Democratic Party is so self-absorbed that this is supposed to be a positive claim to fame for them? No lasting effects? It’s easy for you to say that, Don, as you were allowed to live and have a place in this world. Meanwhile, you celebrate the death of 50 million children. There are 50 million long-lasting effects that you will have to answer for one day.Denise CrisciScotia City must realize the benefits of its treesSo let’s see, the city of Schenectady will no longer replace trees it removes. This is despite the fact ordinances require it and the fact that trees clean the air of pollution, calm aggressive drivers and can lower summer sizzling sidewalk temperatures by 10 degrees. The city can stop the tearing down of affordable housing options and instead allow construction built of flammable particleboard far out of the reach of the average person. And it will not replace city sidewalks.It’s time for city workers to move their desks out onto the summer sidewalks, where the heat can rise above 100 degrees, let their homes be demolished and replaced by new developments they can’t afford and which create more sidewalks that DPW can’t keep up with. And let’s find out if city pensions are invested, as I suspect, in construction companies that can make campaign donations and fill the city to the brim with developments that few can afford to live in and overburden the city’s Public Works Department.The people who work on your cars and stock the grocery stores for you cannot afford to live in these new developments. They are living in the inner cities,  forced to ride the bus and deal with the relentless summer heat on the treeless streets. They’re very likely to develop asthma from the filthy air and from trying to make their way down the broken sidewalks as they wait for the city bus to take care of them. All the while, city officials sit in air-conditioned offices and think of new ways to tax them.Beth R. JacobsNiskayuna Categories: Letters to the Editor, OpinionTaxpayers shouldn’t pay for pension redoIn reference to The Daily Gazette’s Jan. 7 article about the town of Niskayuna’s contracts, the statement Denise McGraw made about four long-term members of the force, who were not put in the proper pension system when they started their employment, is incorrect.I worked 22 years administrating payroll and personnel practices in the Comptroller’s Office at the town of Niskayuna. These members have three facts in common: Clay’s compromises delayed solutionsI started to read Professor H.W. Brands’ recent column in The Gazette on compromise with the hope I would find something I agreed with. But while I still believe that compromise is essential in politics, I wonder if the author could have possibly chosen a worse set of examples than Henry Clay’s compromises. As Brands points out, Clay repeatedly engineered compromises between the free and slave-holding states, which worked out great, at least temporarily (for everyone but the slaves). But it was only a viable strategy as long as new states could be admitted. The fact the Pacific Ocean existed made a lot of future compromises unlikely. What didn’t get addressed was the underlying problem: slavery.last_img read more

Letters to the Editor for Thursday, April 4

first_imgTo drive in and drop off a passenger is to be impeded by the parking lot attendant. (The one blocking my way this morning sported an attitude.)Having made the drop, there is no easy way to get back out.Two things are clear: The traffic planning for the new station was and remains sadly lacking — no surprise given the Bodyshop Bonanza traffic circle up by the casino (among other local stupidities). Whoever took the cumshaw that resulted in this screwup should be hounded from office.Donald JennerScotia Dems squandering new state majorityIn January of this year, the Democrats received the privilege of leading New Yorkers with their dream, having majorities in the Assembly and the Senate to work with the Democratic governor.So far, they have covered our beloved state with a cloud of darkness that is making New Yorkers and many other Americans sick and horrified.The abortion expansion bill offends more consciences than it does not offend. Categories: Letters to the Editor, OpinionNo easy way to get to new train stationSchenectady has a lovely new train station, one that reflects its long and substantial history with railroads. Sadly, the care that the station shows is not at all evident in the way one gets to it.There are two access points, on Erie Boulevard and on Liberty Street. But only the Liberty Street access is open. That access is throttled by the city’s parking lot company. The idea that you can murder a baby by hurting his pregnant mom and not be charged for a crime against that baby is just sick.The idea that a baby surviving an abortion can be killed on the table is beyond cruel.This abortion expansion bill is causing many New Yorkers and many Americans to reconsider the whole idea abortion as nothing more than infanticide with a fancy name.Space prohibits me to note the other bills that lack any sense of morality and the bills that keep New Yorkers paying some of the most ridiculously high taxes in the nation. What a sad way to squander the gift of the majorities that were entrusted to you.Joe RoofSchenectadycenter_img State, bishop must resolve St. Clare’sHow much more can the former employees of St. Clare’s Hospital be beaten down?Another slap in the face is what we just got and they keep coming. Not only did we find out recently that the state rejected a request for monies from the budget to assist with our pension crisis, we also found out that St. Clare’s Corp. formally filed a petition to dissolve.Oh wait, one more thing: The corporation had a remaining balance of nearly $52,000 and decided to give it to Catholic Charities, which is part of the Diocese of Albany, “to be used exclusively as a pensioner relief fund for the benefit of St. Clare’s retirees.” We’ll see.How can our highest-ranking state elected officials and the bishop of Albany live with themselves? None of them seem to care that there are 1,100-plus futures at risk here.We had a meeting almost two months ago with local state officials and the bishop. The state officials did their part and requested monies from the state budget be allocated to assist us with our pension. As noted, it was denied. The bishop said he would be looking into other financial avenues to support us, including the Mother Cabrini fund, but we haven’t heard a peep from him since.The former employees of St. Clare’s Hospital are doing everything they can to turn this disaster around.I guess I don’t understand why or how the governor, comptroller, Bishop Scharfenberger  and others are looking the other way.Kathy AdachRotterdamMore from The Daily Gazette:EDITORIAL: Beware of voter intimidationEDITORIAL: Urgent: Today is the last day to complete the censusEDITORIAL: Find a way to get family members into nursing homesCuomo calls for clarity on administering vaccineFoss: Should main downtown branch of the Schenectady County Public Library reopen?last_img read more

Development

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Oxfordshire industrial

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New town demanded for Cambridgeshire

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The Mancunian way

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Cap & Reg appoints new finance director

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Long division

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