Ramsey expects law mandating drug tests for those receiving government assistance
NASHVILLE — Senate Speaker Ron Ramsey expects Tennessee will put in place a law that requires drug tests for people drawing government assistance or workers’ compensation. Other high-ranking Republicans aren’t so sure.
The House speaker and the governor have voiced concerns about the cost and whether federal rules that govern the programs, including food stamps and welfare, give the state enough flexibility to start drug-testing programs that can survive a legal challenge.
Ramsey, R-Blountville, recently told the Nashville Chamber of Commerce that a similar proposal last legislative session carried a $12 million price tag, but did not take into account the savings the state or employers will see from cutting off benefits to drug users.
“This is your money that we’re trying to protect here,” Ramsey told the business group. “Folks, we don’t need to give any support to that lifestyle.”
Ramsey said he’s confident that lawmakers will be able to make a strong case based on other states’ experience that the proposal would be revenue neutral.
House Speaker Beth Harwell said while she agreed with the aim of the drug-testing proposal, addressing the state’s financial picture is a bigger priority.
“With the budgetary constraints that we face in this state, we want to make sure that those who are receiving assistance from the state are qualified and are doing everything they personally can do to take care and provide for themselves,” said Harwell, a Nashville Republican. “I think there will be a thorough discussion, but I think it’s too early to predict whether it will pass.”
Gov. Bill Haslam told reporters recently that he hasn’t seen specifics of the proposal, but that there are still a series of questions that need to be addressed.
“We need to see what sort of federal leeway we have there, and I haven’t gotten that data back yet,” he said. “And No. 2, who would implement that and how would it be implemented?”
The governor said similar calculations came into play during the last legislative session over various proposals to curb illegal immigration in Tennessee, most of which did not become law.
Florida became the first state to enact drug testing for welfare applicants since Michigan tried and failed. Michigan’s random drug testing program for welfare recipients lasted five weeks in 1999 before it was halted by a judge, kicking off a four-year legal battle that ended with an appeals court ruling it unconstitutional.
Florida’s law is also being challenged in the courts.
Less than 1 percent of welfare applicants in Florida tested positive in the first quarter after the law went into effect in July. Thirty-two applicants failed the test, 7,028 passed and 1,597 didn’t take it, according figures released by the state.
Proponents of the law have suggested applicants would be deterred because they knew they would test positive, meaning the law is preventing taxpayer funds from being spent on drugs. Critics say applicants may not have taken the test because they couldn’t afford the $25-$35 test fee or didn’t have easy access to a testing facility. People who decline to take the test aren’t required to explain why.
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What is Tourette syndrome?
What are the symptoms?
What is the course of TS?
Can people with TS control their tics?
What causes TS?
What disorders are associated with TS?
How is TS diagnosed?
How is TS treated?
Is TS inherited?
What is the prognosis?
What is the best educational setting for children with TS?
What research is being done?
Where can I get more information?
What is Tourette syndrome?
Tourette syndrome (TS) is a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics. The disorder is named for Dr. Georges Gilles de la Tourette, the pioneering French neurologist who in 1885 first described the condition in an 86-year-old French noblewoman.
The early symptoms of TS are typically noticed first in childhood, with the average onset between the ages of 3 and 9 years. TS occurs in people from all ethnic groups; males are affected about three to four times more often than females. It is estimated that 200,000 Americans have the most severe form of TS, and as many as one in 100 exhibit milder and less complex symptoms such as chronic motor or vocal tics. Although TS can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst tic symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood.
What are the symptoms?
Tics are classified as either simple or complex. Simple motor tics are sudden, brief, repetitive movements that involve a limited number of muscle groups. Some of the more common simple tics include eye blinking and other eye movements, facial grimacing, shoulder shrugging, and head or shoulder jerking. Simple vocalizations might include repetitive throat-clearing, sniffing, or grunting sounds. Complex tics are distinct, coordinated patterns of movements involving several muscle groups. Complex motor tics might include facial grimacing combined with a head twist and a shoulder shrug. Other complex motor tics may actually appear purposeful, including sniffing or touching objects, hopping, jumping, bending, or twisting. Simple vocal tics may include throat-clearing, sniffing/snorting, grunting, or barking. More complex vocal tics include words or phrases. Perhaps the most dramatic and disabling tics include motor movements that result in self-harm such as punching oneself in the face or vocal tics including coprolalia (uttering socially inappropriate words such as swearing) or echolalia (repeating the words or phrases of others). However, coprolalia is only present in a small number (10 to 15 percent) of individuals with TS. Some tics are preceded by an urge or sensation in the affected muscle group, commonly called a premonitory urge. Some with TS will describe a need to complete a tic in a certain way or a certain number of times in order to relieve the urge or decrease the sensation.
Tics are often worse with excitement or anxiety and better during calm, focused activities. Certain physical experiences can trigger or worsen tics, for example tight collars may trigger neck tics, or hearing another person sniff or throat-clear may trigger similar sounds. Tics do not go away during sleep but are often significantly diminished.
What is the course of TS?
Tics come and go over time, varying in type, frequency, location, and severity. The first symptoms usually occur in the head and neck area and may progress to include muscles of the trunk and extremities. Motor tics generally precede the development of vocal tics and simple tics often precede complex tics. Most patients experience peak tic severity before the mid-teen years with improvement for the majority of patients in the late teen years and early adulthood. Approximately 10-15 percent of those affected have a progressive or disabling course that lasts into adulthood.
Can people with TS control their tics?
Although the symptoms of TS are involuntary, some people can sometimes suppress, camouflage, or otherwise manage their tics in an effort to minimize their impact on functioning. However, people with TS often report a substantial buildup in tension when suppressing their tics to the point where they feel that the tic must be expressed (against their will). Tics in response to an environmental trigger can appear to be voluntary or purposeful but are not.
What causes TS?
Although the cause of TS is unknown, current research points to abnormalities in certain brain regions (including the basal ganglia, frontal lobes, and cortex), the circuits that interconnect these regions, and the neurotransmitters (dopamine, serotonin, and norepinephrine) responsible for communication among nerve cells. Given the often complex presentation of TS, the cause of the disorder is likely to be equally complex.
What disorders are associated with TS?
Many individuals with TS experience additional neurobehavioral problems that often cause more impairment than the tics themselves. These include inattention, hyperactivity and impulsivity (attention deficit hyperactivity disorder—ADHD); problems with reading, writing, and arithmetic; and obsessive-compulsive symptoms such as intrusive thoughts/worries and repetitive behaviors. For example, worries about dirt and germs may be associated with repetitive hand-washing, and concerns about bad things happening may be associated with ritualistic behaviors such as counting, repeating, or ordering and arranging. People with TS have also reported problems with depression or anxiety disorders, as well as other difficulties with living, that may or may not be directly related to TS. In addition, although most individuals with TS experience a significant decline in motor and vocal tics in late adolescence and early adulthood, the associated neurobehavioral conditions may persist. Given the range of potential complications, people with TS are best served by receiving medical care that provides a comprehensive treatment plan.
How is TS diagnosed?
TS is a diagnosis that doctors make after verifying that the patient has had both motor and vocal tics for at least 1 year. The existence of other neurological or psychiatric conditions can also help doctors arrive at a diagnosis. Common tics are not often misdiagnosed by knowledgeable clinicians. However, atypical symptoms or atypical presentations (for example, onset of symptoms in adulthood) may require specific specialty expertise for diagnosis. There are no blood, laboratory, or imaging tests needed for diagnosis. In rare cases, neuroimaging studies, such as magnetic resonance imaging (MRI) or computerized tomography (CT), electroencephalogram (EEG) studies, or certain blood tests may be used to rule out other conditions that might be confused with TS when the history or clinical examination is atypical.
It is not uncommon for patients to obtain a formal diagnosis of TS only after symptoms have been present for some time. The reasons for this are many. For families and physicians unfamiliar with TS, mild and even moderate tic symptoms may be considered inconsequential, part of a developmental phase, or the result of another condition. For example, parents may think that eye blinking is related to vision problems or that sniffing is related to seasonal allergies. Many patients are self-diagnosed after they, their parents, other relatives, or friends read or hear about TS from others.
How is TS treated?
Because tic symptoms often do not cause impairment, the majority of people with TS require no medication for tic suppression. However, effective medications are available for those whose symptoms interfere with functioning. Neuroleptics (drugs that may be used to treat psychotic and non-psychotic disorders) are the most consistently useful medications for tic suppression; a number are available but some are more effective than others (for example, haloperidol and pimozide).
Unfortunately, there is no one medication that is helpful to all people with TS, nor does any medication completely eliminate symptoms. In addition, all medications have side effects. Many neuroleptic side effects can be managed by initiating treatment slowly and reducing the dose when side effects occur. The most common side effects of neuroleptics include sedation, weight gain, and cognitive dulling. Neurological side effects such as tremor, dystonic reactions (twisting movements or postures), parkinsonian-like symptoms, and other dyskinetic (involuntary) movements are less common and are readily managed with dose reduction.
Discontinuing neuroleptics after long-term use must be done slowly to avoid rebound increases in tics and withdrawal dyskinesias. One form of dyskinesia called tardive dyskinesia is a movement disorder distinct from TS that may result from the chronic use of neuroleptics. The risk of this side effect can be reduced by using lower doses of neuroleptics for shorter periods of time.
Other medications may also be useful for reducing tic severity, but most have not been as extensively studied or shown to be as consistently useful as neuroleptics. Additional medications with demonstrated efficacy include alpha-adrenergic agonists such as clonidine and guanfacine. These medications are used primarily for hypertension but are also used in the treatment of tics. The most common side effect from these medications that precludes their use is sedation. However, given the lower side effect risk associated with these medications, they are often used as first-line agents before proceeding to treatment with neuroleptics.
Effective medications are also available to treat some of the associated neurobehavioral disorders that can occur in patients with TS. Recent research shows that stimulant medications such as methylphenidate and dextroamphetamine can lessen ADHD symptoms in people with TS without causing tics to become more severe. However, the product labeling for stimulants currently contraindicates the use of these drugs in children with tics/TS and those with a family history of tics. Scientists hope that future studies will include a thorough discussion of the risks and benefits of stimulants in those with TS or a family history of TS and will clarify this issue. For obsessive-compulsive symptoms that significantly disrupt daily functioning, the serotonin reuptake inhibitors (clomipramine, fluoxetine, fluvoxamine, paroxetine, and sertraline) have been proven effective in some patients.
Behavioral treatments such as awareness training and competing response training can also be used to reduce tics. A recent NIH-funded, multi-center randomized control trial called Cognitive Behavioral Intervention for Tics, or CBIT, showed that training to voluntarily move in response to a premonitory urge can reduce tic symptoms. Other behavioral therapies, such as biofeedback or supportive therapy, have not been shown to reduce tic symptoms. However, supportive therapy can help a person with TS better cope with the disorder and deal with the secondary social and emotional problems that sometimes occur.
Is TS inherited?
Evidence from twin and family studies suggests that TS is an inherited disorder. Although early family studies suggested an autosomal dominant mode of inheritance (an autosomal dominant disorder is one in which only one copy of the defective gene, inherited from one parent, is necessary to produce the disorder), more recent studies suggest that the pattern of inheritance is much more complex. Although there may be a few genes with substantial effects, it is also possible that many genes with smaller effects and environmental factors may play a role in the development of TS.
Genetic studies also suggest that some forms of ADHD and OCD are genetically related to TS, but there is less evidence for a genetic relationship between TS and other neurobehavioral problems that commonly co-occur with TS. It is important for families to understand that genetic predisposition may not necessarily result in full-blown TS; instead, it may express itself as a milder tic disorder or as obsessive-compulsive behaviors. It is also possible that the gene-carrying offspring will not develop any TS symptoms.
The gender of the person also plays an important role in TS gene expression. At-risk males are more likely to have tics and at-risk females are more likely to have obsessive-compulsive symptoms.
Genetic counseling of individuals with TS should include a full review of all potentially hereditary conditions in the family.
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What is the prognosis?
Although there is no cure for TS, the condition in many individuals improves in the late teens and early 20s. As a result, some may actually become symptom-free or no longer need medication for tic suppression. Although the disorder is generally lifelong and chronic, it is not a degenerative condition. Individuals with TS have a normal life expectancy. TS does not impair intelligence. Although tic symptoms tend to decrease with age, it is possible that neurobehavioral disorders such as ADHD, OCD, depression, generalized anxiety, panic attacks, and mood swings can persist and cause impairment in adult life.
What is the best educational setting for children with TS?
Although students with TS often function well in the regular classroom, ADHD, learning disabilities, obsessive-compulsive symptoms, and frequent tics can greatly interfere with academic performance or social adjustment. After a comprehensive assessment, students should be placed in an educational setting that meets their individual needs. Students may require tutoring, smaller or special classes, and in some cases special schools.
All students with TS need a tolerant and compassionate setting that both encourages them to work to their full potential and is flexible enough to accommodate their special needs. This setting may include a private study area, exams outside the regular classroom, or even oral exams when the child's symptoms interfere with his or her ability to write. Untimed testing reduces stress for students with TS.
What research is being done?
Within the Federal government, the National Institute of Neurological Disorders and Stroke (NINDS), a part of the National Institutes of Health (NIH), is responsible for supporting and conducting research on the brain and nervous system. The NINDS and other NIH components, such as the National Institute of Mental Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute on Drug Abuse, and the National Institute on Deafness and Other Communication Disorders, support research of relevance to TS, either at NIH laboratories or through grants to major research institutions across the country. Another component of the Department of Health and Human Services, the Centers for Disease Control and Prevention, funds professional education programs as well as TS research.
Knowledge about TS comes from studies across a number of medical and scientific disciplines, including genetics, neuroimaging, neuropathology, clinical trials (medication and non-medication), epidemiology, neurophysiology, neuroimmunology, and descriptive/diagnostic clinical science.
Genetic studies. Currently, NIH-funded investigators are conducting a variety of large-scale genetic studies. Rapid advances in the technology of gene discovery will allow for genome-wide screening approaches in TS, and finding a gene or genes for TS would be a major step toward understanding genetic risk factors. In addition, understanding the genetics of TS genes may strengthen clinical diagnosis, improve genetic counseling, lead to the clarification of pathophysiology, and provide clues for more effective therapies.
Neuroimaging studies. Advances in imaging technology and an increase in trained investigators have led to an increasing use of novel and powerful techniques to identify brain regions, circuitry, and neurochemical factors important in TS and related conditions.
Neuropathology. There has been an increase in the number and quality of donated postmortem brains from TS patients available for research purposes. This increase, coupled with advances in neuropathological techniques, has led to initial findings with implications for neuroimaging studies and animal models of TS.
Clinical trials. A number of clinical trials in TS have recently been completed or are currently underway. These include studies of stimulant treatment of ADHD in TS and behavioral treatments for reducing tic severity in children and adults. Smaller trials of novel approaches to treatment such as dopamine agonists and glutamatergic medications also show promise.
Epidemiology and clinical science. Careful epidemiological studies now estimate the prevalence of TS to be substantially higher than previously thought with a wider range of clinical severity. Furthermore, clinical studies are providing new findings regarding TS and co-existing conditions. These include subtyping studies of TS and OCD, an examination of the link between ADHD and learning problems in children with TS, a new appreciation of sensory tics, and the role of co-existing disorders in rage attacks. One of the most important and controversial areas of TS science involves the relationship between TS and autoimmune brain injury associated with group A beta-hemolytic streptococcal infections or other infectious processes. There are a number of epidemiological and clinical investigations currently underway in this intriguing area.
housing for low income families. I work a part time position, with no benifits. ( on my income alone, i qualify for the housing that i provide) I have to agree to a drug test, to keep my job, and pay an outragious amount of taxes out of my paycheck to SUPPORT my tenants who have made a living out of being a sponge. Sucking up every $$ available. These people, get food stamps, familes first, they live rent free, have free cell phones, provided by the goverment ( tax payers) the lids get reduced lunches, and free lunches provided in the summer, commodities, given monthly. Now in to work day after day, listening to their complaints about how life aint fair, and now they are talking about being drug
tested. Meanwhile they are smoking the most expensive cigs on the market, and flippin their rib-eyes in the grill, while i go home and have bologna and cheese sandwitch, cause i cant afford a rib- eye. YES if im gonna have to SUPPORT these people with my taxes anyway, i'd rather not be supporting the crack- heads!! Drug test em!!
Why should even 1 taxpayer dollar be spent getting recipients high? There are far too many people ABUSING public assistance services because they CAN. Why work when someone will provide for your needs. This keeps the UPSTANDING recipients receiving and the dopeheads from wasting your TAX DOLLARS. If their children are hungry then they should rely on family or friends or their church to care for them. If they have nobody else then they can move to another state that doesn't drug test. If HF wants to give his money to dopeheads then he can just write them a check.
Absolutely they should be tested. If they aren't wasting money on illegal drugs, then no problem. Otherwise, why should we, the working people of America buy three meals a day for people who are too shiftless to get out and work - so they can just stay home and stone out? The question arises that this may deprive their children of food (yes, this does bother me). Well.... if the parents are on drugs, they shouldn't have children in their homes possibly being neglected and at the very least witnessing drug use. It's pretty obvious: keep your nose clean and you won't get in trouble. Bottom line - if you want a handout, you have to play by the rules.
The same reason employers are allowed to drug test us. I bet you have had to take a drug test to get a check ? Was there probable cause ? I bet not. The left want people to think you are presumed a drug user until you take a drug test. If you think it's profiling, then those of us who have a job have been profiled the same. It has nothing to do with probable cause. There are hard decisions to be made and it won't be easy to keep our economy from failing. The problem with the people you mention are they are no better off under the Dems control either. BTW, I'm a veteran but not sure how it plays into these comments.
Give me one reason the government should be able to drug test anybody without probable cause. HF gets it all to well. This liberal led US Troops into battle in Desert Storm and has spent his life serving the public students and teachers of Tennessee. Bullying teachers, public education, poor people, old people, gay people, female people, workers, and damn near any people is all these GOP cowards know how to do. Their power overreach has awoken the public and it will never be easy for them to bully us again.
E and HF just don't get it. It's ok to drug test public and private employes, but we should not drug test those receiving government aid and assisstance ? Criminal/law enforcement matter ? Probable cause ? Bull crap. The best way to reflect negative light on a good and reasonable idea is to blow it way out of proportion. Just make it a conspiracy theory and the liberals jump on board.
Spay and neuter our irresponsible recipients. Pill count them on their pain med's.
I was in line at the convince store while a parent used the "SNAP"
( Supplemental Nutritional Assistance Program ) card to buy a 12 pack of Pepsi, 12 pack of Mountain Dew, Bag of Twizzlers ( some kind of candy )
and doughnuts for a child that was already jerked out of the frame at 9:30 pm. Then the parent paid cash for a twelve pack of Michelob Ultra and two packs of Marlboro Red's. Only in America.
Big Brother is here and he is Ron Ramsey and the TeaPublicans. Less government intrusion from the GOP...yeah right! Drug use is a criminal/law enforcement matter. Should we punish the children and families of the unemployed and poor if mommy or daddy has a drug addiction? Nobody wants their tax dollars going to waste due to fraud or to support drug users....duh. However, some of us do not mind our money going to help the unemployed back on their feet or poor families feed their children without being subjected to a drug test. There is not nearly as much fraud, waste, and drug use (look at Florida) as Ramsey and his bullying, mean-spirited, self righteous, and hypocritical supporters would have us believe. Nathan is right! Instead of drug testing, spend the 12 million investigating waste, fraud, and abuse and clean it up. Spend the 12 million on drug rehab or drug enforcement programs. I still believe that the only time the governemnt should be able to drug test anyone is if they have probable cause. We start with welfare recepients, who will Ron and the TeaPublicans decide to test next? Veterans? Homosexuals? Women? The Mentally Disabled? Ethnic Minorities? I fought for freedom and individual liberty, not this garbage.
I am subject to random drug testing to keep my job, I don't understand what the problem is for having those who don't or won't work tested. I think they should extend it to also include alcohol and cigarette testing and additional tattoos posted. If they have the money to drink, smoke, take drugs and get tats, they don't need assistance.
First of all, there is alot of welfare fraud going on that is reported but nothing is done about it. Also the workers are not checking on recipients whom are receiving assistance, who have had there children taken away and are still recieving food stamps, rental assistance, wic for those children. They also evade paying child support, and should be arrested when they go to the office to renew their assistance. Yes, i think drug test should be given, but before you kick someone off assistance, you should try to help them with some type of recovery program. IF they dont seek help or make progress within an alloted time, then take away there assistance. For right now though, the program needs to spend more on investigating fraud and getting those people off the programs. Then when law abiding citizens go to use them the programs will be there to help them get back on their feet, which was what it was intended to do, not a lifestyle.