Veterans Day, Psychedelic Drug Policy, Family Caregivers: RAND Weekly Recap

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November 13, 2020

We discuss the importance of treating co-occurring mental health and substance use disorders among veterans; what to consider when making changes to psychedelic drug policy; why family caregivers should be part of the formal health care team; online shopping during the pandemic; U.S.-China competition in the Indo-Pacific; and 2020's record-breaking fire season.

Dan Smee deployed in Mosul, Iraq, photo courtesy of Dan Smee

Photo courtesy of Dan Smee

There's Help for Veterans with Mental Health and Substance Use Disorders

Having previously served in the Army, Dan Smee reenlisted with the National Guard after 9/11 and was deployed to Iraq. Once he returned home, he began to experience symptoms of PTSD. “The friends lost, the near misses, being blown up and shot at…. Things kind of unraveled for me,“ he says. To cope, he used Ambien and drank heavily. When Smee worked up the strength to seek help, he was told he needed to get sober first.

As the United States honors the service and sacrifice of veterans this week, it's important to recognize that Smee's experience is not uncommon. Thousands of veterans are battling PTSD or depression while also grappling with a substance use disorder. But RAND research finds that few treatment centers address these conditions at the same time. And among those that do, there isn't agreement about what good treatment looks like.

Fortunately, our findings also show that there are effective treatment protocols that can help veterans break the cycle. Smee received such evidence-based treatment and never looked back. Sober for 14 years, Smee now helps veterans who are working through the same problems he experienced.

Psilocybin mushrooms being placed into a pill box, photo by microgen/Getty Images

Photo by microgen/Getty Images

Be Mindful About Changing Psychedelic Drug Policy

Last week, Oregon voters approved a ballot initiative legalizing use of psilocybin—the psychedelic component of “magic” mushrooms—in a therapeutic setting. Californians could soon face a similar choice. But RAND experts warn that ballot initiatives are a poor way to set drug policy, especially for psychedelics. They're often written by people who prioritize repealing prohibition and generating revenue, rather than balanced approaches to regulating a drug's supply and use. If policymakers want comprehensive regulation of psychedelics, they may need to take deliberate action—and soon.

A woman dressing her sick mother, photo by Phynart Studio/Getty Images

Photo by Phynart Studio/Getty Images

Family Caregivers Should Be Included in Health Care Teams

About 53 million people in the United States provide essential daily care for their loved ones. Unfortunately, they're too often treated as secondary members of the care team. A new RAND study examines the major barriers that prevent caregivers from coordinating with formal health care providers. Addressing these barriers could help boost quality of care and improve quality of life for both patients and their families.

A person holds a credit card and types on a laptop while online shopping, photo by Ngampol/Adobe Stock

Photo by Ngampol/Adobe Stock

Online Shopping Habits During the Pandemic

At the start of the pandemic, a RAND survey revealed that most Americans hadn't changed their online shopping habits. But our follow-up survey shows that this pattern has changed, and online shopping has become more common as COVID-19 has spread. About 45 percent of respondents were frequent online shoppers in August, up from 35 percent in February. However, the new data also shows that, even though many households have pivoted to working and shopping from home, those in less-fortunate circumstances are spending less online.

An F-22 Raptor conducts a combat air patrol mission over an undisclosed location in Southwest Asia, September 13, 2019, photo by MSgt. Russ Scalf/U.S. Air Force

An F-22 Raptor conducts a combat air patrol mission over an undisclosed location in Southwest Asia, September 13, 2019

Photo by MSgt. Russ Scalf/U.S. Air Force

Who Has the Edge in the Indo-Pacific?

How can U.S. and Chinese influence in the Indo-Pacific be measured? What are Washington and Beijing competing over, exactly? And how do different players in the region view this struggle? To find out, RAND researchers visited nine countries and interviewed more than 100 officials and experts in 2018 and 2019. They concluded that there is no clear winner. Rather, each power has varying levels of influence across Indo-Pacific nations, with China exerting more economic influence and the United States showing more diplomatic and military sway.

A firefighter works on the Blue Ridge Fire burning in Yorba Linda, California, October 26, 2020, photo by Ringo Chiu/Reuters

A firefighter works on the Blue Ridge fire burning in Yorba Linda, California, October 26, 2020

Photo by Ringo Chiu/Reuters

Another Record-Breaking Fire Season Shows the Need for Change

Thirteen million acres burned. Fourteen thousand structures destroyed. Three billion dollars spent on efforts to keep the blaze at bay. The 2020 fire season is the worst on record. According to to Jay Balagna of the Pardee RAND Graduate School and RAND's Aaron Clark-Ginsberg, the American West needs a comprehensive fire strategy if it's going to survive. What's lacking is coordination among the agencies and responders that battle wildfires. The current approach also doesn't account for complex drivers of risk, such as climate change, forest mismanagement, and aging infrastructure. Mitigating this risk will require intervention at every point.

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