Dealing with Immigration in the Context of EU Enlargement: the Case of Transitional Provisions

This analysis addresses the issue of immigration in the context of the European Union enlargement. Focusing on the use of transitional provisions, it attempts to explain why and when EU leaders give workers from new member countries access to their labor market. Building on the observation that EU leaders seem not to use provisions in the spirit of the law, I gauge the importance of domestic political stakes in the use of those provisions. The empirical results suggest that although EU leaders implement and repeal provisions based on economic circumstances, political factors do intervene in the decision-making process. However, it remains uncertain whether those political factors are institutional or purely electoral.

Electronic health records: essential tools in integrating substance abuse treatment with primary care.

While substance use problems are considered to be common in medical settings, they are not systematically assessed and diagnosed for treatment management. Research data suggest that the majority of individuals with a substance use disorder either do not use treatment or delay treatment-seeking for over a decade. The separation of substance abuse services from mainstream medical care and a lack of preventive services for substance abuse in primary care can contribute to under-detection of substance use problems. When fully enacted in 2014, the Patient Protection and Affordable Care Act 2010 will address these barriers by supporting preventive services for substance abuse (screening, counseling) and integration of substance abuse care with primary care. One key factor that can help to achieve this goal is to incorporate the standardized screeners or common data elements for substance use and related disorders into the electronic health records (EHR) system in the health care setting. Incentives for care providers to adopt an EHR system for meaningful use are part of the Health Information Technology for Economic and Clinical Health Act 2009. This commentary focuses on recent evidence about routine screening and intervention for alcohol/drug use and related disorders in primary care. Federal efforts in developing common data elements for use as screeners for substance use and related disorders are described. A pressing need for empirical data on screening, brief intervention, and referral to treatment (SBIRT) for drug-related disorders to inform SBIRT and related EHR efforts is highlighted.