Category Archives: Substance Abuse

Jan 21 2014
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Recommended Reading: How Can Communities Educate Teens About Drug Abuse?

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Many teens are unaware of how drug abuse can negatively affect their lives. The Fourth Annual National Drug Facts Week, which runs Jan. 27 to Feb. 2, is an initiative of the National Institute on Drug Abuse (NIDA) that aims to change that. The week-long health observance arms communities with the materials and tools they need to debunk myths and educate teens about drug abuse.

Featured in a piece on Reclaiming Futures’ website, NIDA Public Affairs Officer Brian Marquis highlights the science-based information NIDA has provided to teachers, counselors, social workers and community members, as well as the teen-focused events that community leaders are hosting across the country to communicate with young adults about the dangers of drug abuse. Reclaiming Futures, a program funded by the Robert Wood Johnson Foundation, helps young people in trouble with drugs, alcohol and crime by reinventing the way police, courts, detention facilities, treatment providers and communities work together to meet this urgent need. 

“Using ideas and resources provided by NIDA, there is a way for everyone to learn the facts and help shatter myths about drug abuse during National Drug Facts Week and beyond,” Marquis wrote in his post.

Spurred by new recommendations from the Robert Wood Johnson Foundation’s Commission to Build a Healthier America, NIDA is encouraging communities to use its resources to improve the nation’s health by investing in children.

Learn more about National Drug Facts Week events across the country.

Jan 7 2014
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VitalSigns: Health Professionals Fall Short on Alcohol Consumption and Binge Drinking Counseling

The January 2014 VitalSigns report, a monthly report from the U.S. Centers for Disease Control and Prevention (CDC) on leading health indicators, looks at the failure of too many health care professionals to counsel patients on the risks of consuming too much alcohol and binge drinking. According to a recent survey cited in the new report, only one in six adults reports counseling by a health care professional during routine visits, and that number drops to one in four for binge drinkers, despite the fact that studies show that counseling could save lives and reduce health care costs.

Research by the CDC finds that having physicians ask  patients about alcohol consumption and brief counseling could reduce the amount of alcohol consumed on an occasion by 25 percent.  At least 38 million adults drink too much and most are not alcoholics, according to the CDC.  Drinking too much includes binge drinking, high weekly use, and any alcohol use by pregnant women or those under age 21. And it causes about 88,000 deaths in the United States each year, costing the economy about $224 billion.

file Source: American Journal of Preventive Medicine, 2011; Volume 41

Significantly, alcohol screening and brief alcohol counseling are now covered by many health insurance plans without a copay as a result of the Affordable Care Act.

A review of studies by CDC researchers found that brief (6-15 minutes) intervention sessions were effective in significantly reducing weekly alcohol consumption. A patient survey conducted following brief counseling sessions found that patients reported:

  • 3.6 fewer drinks per week for adults
  • Binge level drinking was reported by 12 percent fewer participants
  • Increased adherence to recommended drinking limits was achieved by 11 percent more participants.

“Drinking too much alcohol has many more health risks than most people realize,” says CDC Director Tom Frieden, MD, MPH. “Alcohol screening and brief counseling can help people set realistic goals for themselves and achieve those goals. Health care workers can provide this service to more patients and involve communities to help people avoid dangerous levels of drinking.”

In a briefing for reporters today, Frieden said that for every one alcoholic in the United States there are about six people who drink too much, and many don’t realize that their drinking is excessive.

The Dietary Guidelines for Americans recommend that adults who drink only do so in moderation, which is defined as up to one drink a day for women and two for men.

The National Institute on Alcoholism and Alcohol Abuse recommends that health professionals discuss alcohol use with all patients and has a screening tool to help determine how much patients drink, assess problems associated with drinking and refer patients for specialized treatment if needed.

>>Bonus Links:

Dec 10 2013
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Public Health News Roundup: December 10

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Study: Strong State Laws Can Help Curb Binge Drinking
Strong state laws can help curb binge drinking, according to a new study in the American Journal of Preventive Medicine. Binge drinking, defined as more than four or five alcoholic drinks in a two-hour period, is a factor in about half of the 80,000 alcohol-related deaths each year. Researchers analyzed and graded 29 alcohol control policies across the United States, finding that those with the better policies were one-fourth as likely as those with poorest scores to have binge drinking rates in the top 25 percent of states. They also found that rates were 33 percent higher in states in the bottom quarter of grades than those in the top quarter. "Unfortunately, most states have not taken advantage of these policies to help drinkers consume responsibly, and to protect innocent citizens from the devastating secondhand effects and economic costs from excessive drinking," said study senior author Tim Naimi, MD, an associate professor of medicine at Boston University Schools of Medicine and attending physician at Boston Medical Center. "The bottom line is that this study adds an important dimension to a large body of research demonstrating that alcohol policies matter—and matter a great deal—for reducing and preventing the fundamental building block of alcohol-related problems." Laws and policies that can help prevent binge drinking include limiting hours of sale, increasing alcohol taxes and holding those who sell alcohol legally responsible for harm inflicted by consumers who recently consumed alcohol, according to the U.S. Centers for Disease Control and Prevention. Read more on alcohol.

VP to Announce $100M to Improve Access to Mental Health Services
Vice President Joe Biden will today announce $100 million to improve access to mental health services across the country. The plan comes a year after the school shooting in Newtown, Connecticut, and Biden will make the announcement at a meeting of the families of the victims of the tragedy and mental health advocates. The U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) will provide the funding. "HHS will soon issue a $50 million funding opportunity to help Community Health Centers establish or expand behavioral health services for people living with mental illness or addiction," said a White House official, according to Reuters. "Additionally, USDA has set a goal of financing $50 million for the construction, expansion, or improvement of mental health facilities in rural areas over the next three years." Read more on mental health.

Kids Who Watch Violent Movies Also Exposed to Other Risky Behaviors
Exposing kids to violent movies can also expose them to other examples of potentially harmful behavior, according to a new study in the journal Pediatrics. "Parents should be aware that youth who watch PG-13 movies will be exposed to characters whose violence is linked to other more common behaviors, such as alcohol and sex, and that they should consider whether they want their children exposed to that influence," said study lead author Amy Bleakley, a policy research scientist at the University of Pennsylvania's Annenberg Public Policy Center. The study analyzed nearly 400 top-grossing movies released from 1985 to 2010, finding that 90 percent included at least one act of violence that involved a main character, and that a main character used tobacco, consumed alcohol or engaged in sexual behavior in 77 percent of the films. Read more on violence.

Nov 5 2013
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Public Health News Roundup: November 5

Study: Acetaminophen Use and Even Light Drinking Dramatically Raises Kidney Dysfunction Risk
Acetaminophen use when paired with even moderate or light drinking can increase the risk of kidney dysfunction by 123 percent, according to a new study released today at the American Public Health Association’s 141st Annual Meeting in Boston. Using data from the 2003-2004 National Health and Nutrition Examination Survey, researchers analyzed data on more than 10,000 people who were asked questions about their alcohol consumption, use of acetaminophen and health conditions. “Pain is the most common symptom among the general public and is also most frequently self-treated with acetaminophens,” noted Harrison Ndetan, lead researcher of the study. “Where this becomes a greater concern is among young adults, who have a higher prevalence of alcohol consumption. These findings highlight a serious concern among health professionals who deal frequently with pain patients, particularly those with mild pain who are more susceptible to consuming both.” Read more on substance abuse.

Flight Attendants: Expanded Use of Electronic Devices In-flight Needs Reworked Safety Messaging for Flyers
The decision by the Federal Aviation Administration (FAA) last week to let passengers use electronic devices—but not make cell phone calls—during all phases of a flight has flight attendants concerned that the ruling could compromise passenger safety if flyers are distracted by the devices when the cabin crew makes its safety announcements before takeoff.

Most airlines will introduce the new rule on devices by the end of the year. To qualify they have to assure the FDA that their fleet’s airplanes can tolerate any potential radio interference from the devices. Flight attendants would like heavy devices stored under seats or in the overhead bins during takeoff and landing for added safety. In a statement released just after the FAA ruling, the  Association of Flight attendants said “AFA will work diligently alongside the FAA and industry to find creative, science-based approaches to ensure that passengers comply with the new operator policies and that their attention is not diverted from the important safety information provided by cabin crew during routine pre-flight briefings and unexpected emergencies, and that risks posed by loose items in the cabin are safely managed during the most critical portions of [a] flight.” Read more on injury prevention.

Two Questions Could Help Diagnose Strep, Reduce Unnecessary Antibiotic Prescriptions
“Do you have a cough and have you had a fever in the last 24 hours?” These two simple questions could help people determine whether they need to see a doctor for strep throat, which could in turn limit unnecessary antibiotic prescriptions, according to a new study in the Annals of Internal Medicine. While high fevers can indicate strep, coughs do not. The study found the questions, when paired with an accounting of how common strep infections were in a particular area, where nearly as effective as lab tests at determining whether a patient actually had a strep infection. "This enables us to use the test of time," said co-study author Dr. Kenneth Mandl, a professor of bioinformatics at Harvard. "If we determine that you're low risk and most cases will not have an important complication from strep anyway, then you can be followed clinically rather than come in for a test right away, and you may improve." About 15 million people in the United States see a doctor for a sore throat each year, with 70 receiving antibiotics; estimates indicate that only 20-30 percent of children and 5-15 percent of adults actually benefit from the medications. Read more on prescription drugs.

Oct 22 2013
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Recommended Reading: Painkiller Addiction and America’s Veterans

CIR's "Veteran Affairs: Painkillers" Interactive CIR's "Veteran Affairs: Painkillers" Interactive

In 2008, the U.S. Department of Veterans Affairs (VA) sent Army paratrooper Jeffrey Waggoner to an Oregon hospital to recover from an addiction to painkillers. However, once there they instead gave him a steady stream of medications, eventually releasing him for a weekend with 19 prescription drugs in hand. He was found dead of an overdose three hours later.

“As a parent, you’d want to know how this happened to your child,” said his father, Greg Waggoner, according to a new report from The Center for Investigative Reporting (CIR). “You send your child to a hospital to get well, not to die.”

In its investigation, CIR found that, post 9/11, the VA has increasingly been treating addictions with a variety of drugs, “feeding addictions and contributing to a fatal overdose rate among VA patients that is nearly double the national average.” Over the past dozen years, prescriptions for the four opiates hydrocodone, oxycodone, methadone and morphine have increased by 270 percent.

Waggoner’s weekend leave medications included 12 oxycodone pills.

As part of its investigation, CIR has created a comprehensive interactive tool that shows the VA systems with the highest prescription rates and allows users to search for information by region and system. The data is culled from CIR’s own research, as well as information from the VA and the U.S. Census Bureau.

Trust for America’s Health also recently released an interactive tool on the growing public health issue of prescription drug abuse—about 6.1 million Americans use or abuse prescription drugs. The tool allows users to search state-by-state prescription drug overdose death rates and find out how each scores on 10 key steps to curb abuse.

>>Read The Center for Investigative Reporting’s “VA’s opiate overload feeds veterans’ addictions, overdose deaths

>>Read NewPublicHealth’s story, “New Report: Most States Not Implementing Enough Proven Strategies to Prevent Prescription Drug Abuse

Oct 17 2013
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Faces of Public Health: Q&A with Lori Butterfield

Lori Butterfield, writer and producer of 'Lipstick & Liquor' Lori Butterfield, writer and producer of 'Lipstick & Liquor'

Lipstick & Liquor, a recently released documentary, takes a close-up look at a secret that is killing women and harming their families. Excessive alcohol use is the third leading cause of preventable death among women between the ages of 35 and 55. Excessive drinking among women is also a contributing factor in one-third of suicides, one-fourth of accidental deaths and one-half of traffic deaths. Significantly, drinking is more likely to reach advanced stages before it is discovered.

The film, which will launch on iTunes and Amazon.com in December, shares the stories of four women and their struggles with alcoholism. The goal of the film, says Lori Butterfield, the film’s writer and producer as well as a senior vice president of creative content for Home Front Communications, is to help women everywhere shake off the stigma associated with women alcoholics, and to provide understanding and insight into the struggle to stay sober. The documentary includes expert commentary from medical researchers, addiction specialists and authors who shed light on the conditions impacting the increase in alcohol use and abuse among American women.

NewPublicHealth recently spoke with Lori Butterfield about the film.

NPH: How did the documentary come about?

Lori Butterfield: My interest in raising awareness began with a story about a woman named Diane Schuler. In the summer of 2009, Diane made headlines after killing herself and seven other people while driving the wrong way on the Taconic Parkway in Westchester County, New York. The toxicology report showed that Diane had been drinking and yet her husband and other family members came out very publicly and said, “Oh she would never do that, she was a wonderful mother, she was a perfect wife.” And I remember thinking at the time, how could someone hide their alcoholism so well that their own family had no idea? That story really stuck with me.

Then, in November of that year, I was overseeing a video project for an Ad Council campaign about “Buzzed driving” [see recent Buzzed Driving campaigns from the Ad Council]. That’s when I read a very startling statistic. It said the number of DUI arrests for women had shot up more than 30 percent in the last decade while the rate for men was actually going down. And I also read that binge drinking for women was on the rise, so something was happening, but I wasn’t quite connecting the dots.

Read More

Oct 9 2013
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Public Health News Roundup: October 9

Airport Noise May Increase Heart Disease and Stroke Risk
People who live near busy international airports may be at increased risk of heart disease and stroke due to the high levels of noise, according to two new studies in the British Medical Journal. One study looked at hospital admissions around London Heathrow airport, finding the risks were 10 to 20 percent higher when compared to areas with the least noise. The other study, by researchers at the Harvard School of Public Health and Boston University School of Public Health, analyzed data on more than 60 million Americans ages 65 and older living near 89 airports, finding that areas with 10 decibel higher aircraft noise also saw a 3.5 percent increase in the hospital admission rate. Researchers say the link needs further study to show causation. "The exact role that noise exposure may play in ill health is not well established," said Anna Hansell of Imperial College London, who led the British study. "However, it is plausible that it might be contributing, for example by raising blood pressure or by disturbing people's sleep." The findings indicate that populated areas must be looked at closely when communities consider expanding large airports. Read more on heart health.

Private Talk Sessions with NICU Nurses Ease Anxiety in Mothers of Premature Babies
“Listening matters” when it comes to easing the worries of the mothers of premature infants. One-on-one talks sessions between NICU nurses and the mothers can help reduce feelings of anxiety, confusion and doubt, according to a new study in the Journal of Perinatology. "Having a prematurely born baby is like a nightmare for the mother," said Lisa Segre, an assistant professor in the University of Iowa College of Nursing. "You're expecting to have a healthy baby, and suddenly you're left wondering whether he or she is going to live." The study looked at 23 mothers who when through an average of five 45-minute sessions, find they gave mothers a chance to really talk about their worries and were effective at easing concerns across the board. "Listening is what nurses have done their whole career," said NICU nurse and study co-author Rebecca Siewert. "We've always been the ones to listen and try to problem solve. So, I just think it was a wonderful offshoot of what nursing can do. We just need the time to do it." Read more on maternal and infant health.

Early Puberty Tied to Great Risk of Experimentation with Cigarettes, Alcohol and Marijuana
Early puberty is linked to increased risk of experimentation with cigarettes, alcohol and marijuana, according to a new study in the journal Addiction. Puberty typically begins between the ages of 9 and 10, will girls on average beginning it earlier than boys. "While puberty is often thought of as a solely biological process, our research has shown that pubertal development is a combination of biological, psychological and social processes that all likely interact to influence risk-taking behavior like substance use," said study author Jessica Duncan Cance, a public health researcher at the University of Texas at Austin. "Our study suggests that being the first girl in the class to need a bra, for example, prompts or exacerbates existing psychological and social aspects that can, in turn, lead to substance use and other risky behaviors early in life.” Read more on pediatrics.

Sep 18 2013
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ASTHO Annual Meeting: NewPublicHealth Q&A with Terry Cline, PHD, Health Commissioner of Oklahoma

Terry Cline, PhD Terry Cline, PhD

For the last several years, each incoming president of the Association of State and Territorial Health Officials (ASTHO) has introduced a President’s Challenge for the year of their presidency to focus attention on a critical national health issue. Previous challenges have included injury prevention, health equity and reducing the number of preterm births. This year, incoming ASTHO president Terry Cline, PhD, will focus his President’s Challenge on prescription drug abuse, a national public health crisis that results in tens of thousands of deaths each year.

>>Follow our ASTHO Annual Meeting coverage throughout the week.

Just before the ASTHO annual meeting began, NewPublicHealth spoke with Cline about the scope of the issue and steps Cline will introduce to help health officers collectively focus their attention on reducing this public health crisis.

NPH: Why have you chosen prescription drug abuse as your President’s Challenge?

Terry Cline: If you look at the trend lines in the United States, we’ve seen a very rapid increase in the number of deaths from the misuse of prescription drugs. We’ve also seen a huge increase in the number of children born with neonatal abstinence syndrome, which has actually tripled in the last decade. Prescription drug abuse has created an incredible burden on the health of people in the United States. Deaths are just one indicator; others include lost productivity, absenteeism and health care costs. Just using neonatal abstinence syndrome as an example, in 2000 the total hospital charges were about $190 million and in 2009, which is the last year we have that data, it was $720 million. Because in many states Medicaid pays for a large percentage of the births, in 2000 that amount was about $130 million out of the $190 million, and in 2009 it was $560 million of the $720 million. So that is becoming a larger and larger financial burden on states as well, and that does not include the long-term effects on babies.

The President’s Challenge will be looking at the absolute number—bringing down the number of deaths, which stand at more than 16,000 deaths per year. We’ve seen opioid deaths increase and continue every year over the last decade. And in most states now, the number of deaths from prescription drugs is actually greater than the number of deaths from automobile accidents, which has steadily gone down over the last decade. So, one is an example of a public health success; the decrease in motor vehicle deaths stems from a comprehensive approach and work with multiple sectors to bring that death rate down. The other, prescription drug deaths, is an alarming increase. My hope is that with the President’s Challenge, we can really increase awareness and leverage public health agencies across the country to mobilize around this issue.

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Sep 17 2013
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Public Health News Roundup: September 17

Antibiotic-resistant Infections on the Rise; Threat Called "Urgent"
Antibiotic-resistant infections sicken more than two million Americans each year, killing more than 23,000 in the process, according to a new study from the U.S. Centers for Disease Control and Prevention (CDC). The report ranked the threats according to seven factors, including health impact, economic impact, how common the infection is and how easily it is spread. It classified carbapenem-resistant Enterobacteriaceae (CRE), drug-resistant gonorrhea, and Clostridium difficile as “urgent." C. difficile alone causes about 250,000 hospitalizations and at least 14,000 deaths each year. Excessive antibiotic use is the number one cause of the increase in antibiotic-resistant infections, with as many as 50 percent of prescriptions either not needed or prescribed inappropriately. “Every time antibiotics are used in any setting, bacteria evolve by developing resistance. This process can happen with alarming speed,” said Steve Solomon, MD, director of CDC’s Office of Antimicrobial Resistance. “These drugs are a precious, limited resource—the more we use antibiotics today, the less likely we are to have effective antibiotics tomorrow.” Antibiotic-resistant infections also add as much as $20 billion in excess direct health care costs and account for as much as $35 billion in lost economic productivity. Read more on prescription drugs.

Survey: Nearly 80 Percent of College Students Oppose Concealed Handguns on Campus
Nearly 80 percent of the students in 15 Midwestern colleges and universities oppose allowing concealed handguns on their campuses, according to a new study in the Journal of American College Health. Ball State University researchers surveyed 1,649 undergraduate students, finding 78 percent were against the handguns and would not apply for a permit if they were legal. “Firearm morbidity and mortality are major public health problems that significantly impact our society,” said study co-author Jagdish Khubchandani, a member of Ball State’s Global Health Institute and a community health education professor in the university's Department of Physiology and Health Science. “The issue of allowing people to carry concealed weapons at universities and colleges around the U.S. has been raised several times in recent years. This is in spite of the fact that almost four of every five students are not in favor of allowing guns on campus.”

The study also found that:

  • About 16 percent of undergraduate students own a firearm and 20 percent witnessed a crime on their campus that involved firearms
  • About 79 percent of students would not feel safe if faculty, students and visitors carried concealed handguns on campus
  • About 66 percent did not feel that carrying a gun would make them less likely to be troubled by others
  • Most students also believed that allowing concealed carry guns would increase the rate of fatal suicides and homicides on campus

Read more on violence.

‘Bath Salts’ Drugs Led to 23,000 ER Visits in 2011
The use of “bath salts” drugs accounted for almost 23,000 emergency department visits in the United States in 2011, according to a new report from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). The report is the first national study to analyze the link between the street drugs and emergency department visits. "Although bath salts drugs are sometimes claimed to be 'legal highs' or are promoted with labels to mask their real purpose, they can be extremely dangerous when used," said Elinore McCance-Katz, MD, SAMHSA's chief medical officer. The drugs can cause heart problems, high blood pressure, seizures, addiction, suicidal thoughts, psychosis and even death. About two-thirds of the visits also involved at least one other drug, with 15 percent of the visits also being linked to marijuana or synthetic forms of marijuana. There were approximately 2.5 million U.S. emergency department visits linked to drug misuse or abuse in 2011. Read more on substance abuse.

Sep 5 2013
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APA ‘A Healthy Minds Minute’ Video Series: Reversing the Stigma Against Mental Illness

It’s been more than forty years since a U.S. vice presidential candidate, Senator Thomas Eagleton, was forced to withdraw his name from the ticket after it was revealed he’d been treated for depression. Medical science and understanding have come a long way since then. Still, for many there is still a stigma surrounding mental illness—a stigma that can leave people, already hurting, feeling even more alone.

This is a clear and major public health issue which dramatically reduces the likelihood that someone with a mental health condition will seek out and have access to effective health care and social services. In fact, only 38 percent of U.S. adults with diagnosable mental illnesses receive the treatment they need. The numbers are even worse for children and adolescents, with less than 20 percent getting treatment.

September is Suicide Prevention Month and Sept. 10 is the 11th-annual World Suicide Prevention Day. This year’s theme is “Stigma: A Major Barrier for Suicide Prevention.” Suicide is one of the top ten leading causes of death in the United States—with more than 38,000 deaths each year—and many of those people suffered in silence rather than reaching out to loved ones and available avenues of help.

As part of the collective effort to combat this barrier to full and compassionate care, the American Psychiatric Association (APA) is working to raise awareness so that people with mental illnesses and substance use disorders can feel more confident in seeking treatment, just as anyone with most any other medical concern would be.

APA’s new Public Service Advertisements (PSAs) series, called “A Healthy Minds Minute,” features a number of celebrities and prominent figures calling for equal access to quality care and insurance coverage for people with mental illness and substance use disorders. Below is a video with Former Congressman Patrick Kennedy.

>>Watch the APA’s “A Healthy Minds Minute” online video series.