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J. Wenzel, M.A., M.D.

Co-Director, Howard University College of Medicine

We chose to focus on stereotypes of Asians and Jews in America for multiple reasons anxiety and sleep buy atarax 10mg low cost. First anxiety keeping me up at night buy 10 mg atarax otc, we wanted to investigate the breadth of implicit bias in federal and state judges beyond Black and White anxiety 5 year old buy generic atarax 25mg on line. As discussed in Part I anxiety symptoms men 25mg atarax otc, the concept of implicit bias against African-Americans in the legal system is well-researched and now regularly debated by the media and the public, 106 perhaps because it is supported by so many objective measures of inequality that it is nearly impossible to deny. Testing empirically the current state of bias against these groups (among a group as honored as federal and state judges, who presumably would be among the most motivated to avoid bias) would therefore be illuminating in the context of that history of discrimination. Third, both of these groups are perceived largely as American success stories, yet somewhat contradictory data complicates these narratives, such as objective indicators of wealth and achievement, as compared to social-science data demonstrating the continued propagation of negative stereotypes. Judgments relating to the seizing of corporate opportunities for personal gain may well involve moral judgments. In fact, the only empirical study to examine implicit bias in judges was conducted on Black and White implicit attitudes. The median wealth of White families in 2013 was $134,008 compared to $94,440 for Asian-American families and $11,184 for African-American families. And finally, we believed that studying groups that are largely considered favored minority groups is important: if strong implicit biases against Asians and Jews (that may be considered counterintuitive by some) were documented among federal and state judges, it would help illuminate the 0 9 true breadth of implicit bias in the law and all of its attendant dangers. Anti-Asian ExplicitAttitudes and Stereotypes: From Yellow Perilto the "Model Minority " There is a long history of anti-Asian sentiment in the United States. Although this history is complex and well-documented, this Article summarizes briefly the evolution of anti-Asian attitudes and stereotypes to set the stage for our report on modem research on implicit and explicit antiAsian attitudes and stereotypes. In 2013, 25% of Jews had a household income exceeding $150,000, compared with 8% of the general public, and 58% of Jews were college graduates, compared with 29% of the general public. Additional empirical work on other groups in the American legal system is still sorely needed. For example, the incarceration numbers for certain group members, such as Latinos, demonstrate serious concerns that should be investigated in the implicit bias context. Unfortunately, due to the voluntary nature of our study and the need to prevent a large drop-out rate, we were limited in what group stereotypes we could investigate empirically. There are a wide number of sources that can provide a meaningful context to anti-Asian sentiment in the United States. The Japanese-American experience similarly tells a story of discrimination and fearful legal responses to stereotypes. This fear was at its height just ten weeks after the Pearl Harbor attack, when President Franklin D. Roosevelt signed Executive Order 9066, which codified a policy of "exclusion, removal, and detention" that affected 120,000 1 people without review. This law "prohibited persons from walking on the streets while using poles to carry goods, a practice used only by Chinese Americans at the time. These, too, imply that the experience was an unfortunate detour in an otherwise honorable history of respect for the rights of citizens. A 1933 study of Princeton students sought to document their racial and ethnic stereotypes, including stereotypes of Chinese- and 23 Japanese-Americans. Although one can see the beginnings of mixed negative with positive stereotyping in the Princeton survey, researchers report a stronger shift toward positive stereotyping that occurred primarily in the second half of the twentieth century, perhaps beginning in earnest across the American population around the 1960s. The "model minority" and other stereotypes about Asian-Americans did not disappear in the aftermath of the Civil Rights Movement. Modem researchers have been sensitive to the multi-directionality of stereotypes and have investigated the way seemingly positive stereotypes can actually activate a threat response, whereby White Americans became concerned about the overrepresentation of Asian-Americans in desirable 121. Kawai, supra note 110, at 113 ("[Ihe 1941 Pearl Harbor bombing by Japan during inflated the yellow peril stereotype and led to the detention of Japanese Americans World War I1 in concentration camps. With the implicit social cognition revolution, however, researchers have not been limited to using explicit measures to investigate Asian-American stereotypes. Anti-Asian Attitudes and Stereotypes: Implicit Biases Modem studies of implicit bias have occasionally, though not frequently, examined implicit biases that Americans hold towards Asians. These studies have shown that people implicitly classify AsianAmericans as foreigners, ineffective litigators, and inhibited, among other negative categorizations. In that study, Professor Jerry Kang and his colleagues investigated whether the stereotype of the successful litigator was indeed a White stereotype. In light of the historical evidence regarding anti-Asian discrimination, as well as the more modem implicit stereotypes of Asians in America described in this Subsection, it is not surprising that scholars have considered the ways in which Asian-Americans might face automatic discrimination in the legal setting. See Gee, supra note 96, at 195, 197 (arguing that the model minority myth prevents Asian-Americans from becoming jury forepersons where Asian-Americans are not parties to the litigation; can help Asian defendants secure more lenient sentences than they deserve; and combined with the characterization of Asian-Americans as foreign, often create obstacles for Asian-Americans to establish primafacieclaims of racial discrimination due to a belief that they are less protected under the Fourteenth Amendment than are African-Americans); Yen, supranote 96, at 15, 19-20 (arguing that the "yellow peril" stereotype devalues Asian lives because the perception of Asian-Americans as foreign or non-American is a significant hurdle for prosecutors in convincing a non-Asian jury to identify with an Asian victim, and that police who perceive Asian-Americans as foreign may attempt to take advantage of Asian suspects by failing to comply with criminal procedures).

The Vermont Department of Corrections continued to refuse to allow Keith Griggs accessto his methadone treatment anxiety symptoms tinnitus purchase 10mg atarax mastercard, and rather than comply with the court order anxiety upper back pain order 10 mg atarax overnight delivery, released Griggs from prison before his sentencehad been compieted (Boucher anxiety symptoms 35 order 25 mg atarax mastercard, 2003) anxiety symptoms 6 year molars cheap atarax 10mg free shipping. And the K E E P p r o g r a m d e m o n s t r a t e st h a t b o t h o p i o i d - a d d i c t e d i n d i v i d u a l s and society benefit when inmates have accessto treatment for their addiction. Serv in g h e N e e d s f Op i o i d -A d d i cte d t o I nm a t e s n d S o c i e t y a Several arguments can be made for providing accessto methadone/ buprenorphine treatment for opioid-addicted inmates in U. If inmates who suffer from other medical diseases have accessto medical care during their incarceration, opioid-addicted inmates should be treated no differently. In most outpatient programs, the cost for providing accessto this treatment generally amounts to $5,000 per patient per year. This is much lower than the roughly $22,000 per inmate per year cost of incarceration (Boucher,2003), especially in view of the fact that a large number of methadone patients pay for their own treatment and public costs of correctional systemsare steadily rising. Funding will be needed for jail-based treatment programs, especially as more inmate health care programs are provided under contract with entities in the private sector. The funding needed for jailbased programs, and to support continued accessto treatment for opioid-addicted inmates as they leave jail or prison and return to society, could come from federal, state, or county sources. Methadone use varies widely across states: over 50% of correctional facilities that offer methadone do so exclusively for pregnant women or for chronic pain management. Article history: Received 24 December 2008 Received in revised form 11 June 2009 Accepted 12 June 2009 Available online 21 July 2009 Keywords: Methadone Corrections Buprenorphine Prison Opiate replacement therapy 1. The number of incarcerated individuals has grown steadily since 1980, and in 2007, the number of incarcerated individuals rose 1. Growth in incarceration rates can be largely attributed to the "war on drugs," which has resulted in harsher penalties for drug offenses and has led to a threefold increase in drug-related arrests; over half of all sentences in federal prisons are for federal drug-related offenses (Drucker, 1999; Greifinger, 2007). Studies have found that between 50% and 84% of prison inmates have a history of substance use (Drucker, 1999; Greifinger, 2007; Mumola and Karberg, 2006), most in the year prior to incarceration (Mumola and Karberg, 2006). Moreover, prisoners often engage in substance use during incarceration (Clarke et al. Many inmates are uninsured, lack adequate access to health services, and come from medically underserved communities (Freudenberg, 2001). Because correctional systems have high turnover rates and reincarceration rates, inmate health also profoundly affects the health of the communities to which they return (Greifinger, 2007; Nurco et al. Providing inmates with comprehensive health services, including treatment for chemical dependency with pharmacological therapy and counselling services, therefore offers a unique public health opportunity (Bick, 2007; Rich et al. Approximately 55% of individuals with a history of substance use will relapse to substance use within 1 month of release from incarceration (Nurco et al. Relapse to substance use is also associated with increased criminal activity (Hanlon et al. Offering inmates pharmacological treatment and counselling for opiate dependence prior to release decreases the likelihood of drug relapse (Gordon et al. Incarceration also offers an opportunity to intervene and break the cycle of addiction, health risks, criminal behavior, and reincarceration. Methadone prevents withdrawal symptoms and drug cravings, blocks the euphoric effects of other opiates, and reduces the risk of relapse to illicit use of opiates, infectious disease transmission, and overdose death (Gerra et al. Compared with methadone, buprenorphine has fewer regulations governing its use, lower likelihood of fatal overdose, and is associated with less social stigma. Because buprenorphine must be prescribed by a physician, it also provides opportunities for more routine medical care. Only 8% of prison systems referred inmates with a history of opiate dependence to community-based methadone programs upon release; approximately 30% reported that they believed that methadone benefits opiate-dependent prisoners. To assess changes in attitudes and practices during the last 5 years, and to learn more about buprenorphine prescribing and referral practices since its approval, we surveyed the medical directors, their equivalents, or appointed designees of state prisons and the District of Columbia and federal prison systems about their opinions and prescribing practices for methadone and buprenorphine. Methods We emailed or faxed a 17-question survey to the medical directors, equivalent health authorities, or their designees of the 50 state Departments of Corrections. We also surveyed the Federal Bureau of Prisons and the District of Columbia prison, which collectively house approximately 200,000 prisoners (Sabol and Couture, 2008).

Syndromes

• Straining
• Erythrocyte sedimentation rate
• Use of blood thinners (anticoagulants)
• Other new symptoms during or after treatment
• Sweating -- excessive
• Osteoarthritis