Category Archives: Alcoholism

King County teen e-cigarette use is on the rise, but fewer smoke cigarettes or drink alcohol

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Map of SeattleFrom Public Health – Seattle & King County

Most King County youth are heeding public health prevention warnings about cigarette smoking and drinking and driving, according to new, preliminary results from the Healthy Youth Survey.

However, e-cigarettes use among youth is increasing.

One in five King County high school seniors reports vaping or e-cigarette use, which is double the number that smokes cigarettes. Continue reading

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States gear up to help Medicaid enrollees beat addictions

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CocaineBy Chrisine Vestal
Stateline

Under the Affordable Care Act, millions of low-income adults last year became eligible for Medicaid and subsidized health insurance for the first time.

Now states face a huge challenge: how to deal with an onslaught of able-bodied, 18- to 64-year olds who haven’t seen a doctor in years.

“It took a lot of time and effort to enroll everyone, particularly those who were new to the system,” said Matt Salo, director of the National Association of Medicaid Directors. “The next big step, and the biggest unknown, is finding out exactly how this newly insured population will use the health care system.”

In addition to increasing the number of people with health insurance, the Affordable Care Act for the first time made coverage of addiction services mandatory for all insurers, including Medicaid.

Until now, the vast majority of Medicaid beneficiaries were pregnant women, young children, and disabled and elderly adults. Relatively few able-bodied adults without children qualified, so states did not set up their Medicaid programs to treat them.

The newly insured, most of them young adults, have different needs. Though not as sick as existing Medicaid beneficiaries, the newcomers are more likely than the general population to have undiagnosed and untreated chronic illnesses such as diabetes and heart disease.

The starkest difference between the new population and the old one, however, is that the new enrollees have much higher rates of drug and alcohol addiction and mental illness.

The number of Medicaid enrollees receiving addiction services is expected to skyrocket over the next two years.

Of the estimated 18 million adults potentially eligible for Medicaid in all 50 states, at least 2.5 million have substance use disorders. Of the 19 million uninsured adults with slightly higher incomes who are eligible for subsidized exchange insurance, an estimated 2.8 million struggle with substance abuse, according to the most recent national survey by the U.S. Substance Abuse and Mental Health Services Administration.

In addition to increasing the number of people with health insurance, the ACA for the first time made coverage of addiction services and other behavioral health disorders mandatory for all insurers, including Medicaid. As a result, the number of Medicaid enrollees receiving addiction services is expected to skyrocket over the next two years.

Although Medicaid and other state and federal programs historically have provided care for people with serious mental illness, coverage of addiction treatments has been spotty. Optional under Medicaid until now, coverage in most states was limited, typically just for pregnant women and adolescents.

“It’s the biggest change in a generation for addiction services,” said Robert Morrison, executive director of the National Association of State Alcohol and Drug Abuse Directors. “Comprehensive addiction programs didn’t exist in Medicaid until now.” Continue reading

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Alcohol poisoning kills six Americans a day – CDC

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From the US Centers for Disease Control and Prevention

whiskey-glassAlcohol poisoning deaths are caused by drinking a large amount of alcohol in a short period of time.

This can result in very high levels of alcohol in the body, which can shutdown critical areas of the brain that control breathing, heart rate, and body temperature – resulting in death.

Despite the risks, more than 38 million U.S. adults report binge drinking an average of four times per month and consume an average of eight drinks per binge.

Binge drinking is defined as consuming four or more drinks for women and five or more drinks for men on an occasion.

The more you drink, the greater your risk of death.

Key findings of this Vital Signs report include:

  • There are more than 2,200 alcohol poisoning deaths in the U.S. each year – an average of 6 alcohol poisoning deaths every day.
  • Three in four alcohol poisoning deaths involve adults ages 35-64, and most deaths occur among men.
  • While the majority of deaths are among non-Hispanic whites, American Indians/Alaska Natives have the most alcohol poisoning deaths per million people.
  • Deaths rates from alcohol poisoning vary widely across states, from 5.3 alcohol poisoning deaths per million residents in Alabama to 46.5 deaths per million residents in Alaska.

Alcohol poisoning CDC Continue reading

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Teen prescription opioid abuse, cigarette, and alcohol use down, but e-cigarette use up

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Two white tabletsFrom the US Department of Health and Human Services

Use of cigarettes, alcohol, and abuse of prescription pain relievers among teens has declined since 2013 while marijuana use rates were stable, according to the 2014 Monitoring the Future (MTF) survey, released today by the National Institute on Drug Abuse (NIDA). However, use of e-cigarettes, measured in the report for the first time, is high.

These 2014 results are part of an overall two-decade trend among the nation’s youth. The MTF survey measures drug use and attitudes among eighth, 10th, and 12th graders, is funded by NIDA, and is conducted by researchers at the University of Michigan at Ann Arbor. NIDA is part of the National Institutes of Health.

“With the rates of many drugs decreasing, and the rates of marijuana use appearing to level off, it is possible that prevention efforts are having an effect,” said NIDA Director Nora D. Volkow, M.D.

Continue reading

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Use a Rule of Thumb to Control How Much You Drink

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Picture of a table after a party with wine and beer bottlesSticking to a general rule of pouring just a half glass of wine limits the likelihood of overconsumption, even for men with a higher body mass index. That’s the finding of a new Iowa State and Cornell University study to be published in a forthcoming issue of the International Journal of Drug Policy.

via Use a Rule of Thumb to Control How Much You Drink.

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Women’s health week – 48: Drugs

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tacuin womenFrom the Office of Research on Women’s Health

As with many other diseases, the likelihood of becoming addicted differs from person to person, and between males and females.

For substance abuse overall, men are about twice as likely as women to be dependent on most illicit drugs and/or alcohol.

When someone first begins using drugs, addiction does not seem like a dangerous disease, and a person may perceive what seem to be positive effects of drug use. Continue reading

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Women’s health – Week 47: Alcohol

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tacuin womenFrom the Office of Research on Women’s Health

Even in small amounts, alcohol can have negative effects on a woman’s health. In some ways, heavy drinking is a lot more risky for women than it is for men.

Women who drink more than one drink per day increase their risk for motor vehicle crashes, other injuries, high blood pressure, stroke, violence, suicide, and certain types of cancer. Continue reading

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Medicaid tailored to those with mental health problems

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Jigsaw puzzle with one piece to add

This KHN story also ran in .

Studies show that enrollees with mental illness, who also have chronic physical conditions, account for a large share of Medicaid spending.

Seeking to improve care and lower costs, Florida this month became the first state to offer a Medicaid health plan designed exclusively for people with serious mental illnesses, such as schizophrenia, major depression or bipolar conditions. Continue reading

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One in 10 deaths among working-age adults due to excessive drinking – CDC

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WhiskyFrom the US Centers for Disease Control and Prevention

Excessive alcohol use accounts for one in 10 deaths among working-age adults ages 20-64 years in the United States, according to a report from the Centers for Disease Control and Prevention published today in Preventing Chronic Disease.

Excessive alcohol use led to approximately 88,000 deaths per year from 2006 to 2010, and shortened the lives of those who died by about 30 years.

These deaths were due to health effects from drinking too much over time, such as breast cancer, liver disease, and heart disease; and health effects from drinking too much in a short period of time, such as violence, alcohol poisoning, and motor vehicle crashes.

In total, there were 2.5 million years of potential life lost each year due to excessive alcohol use.

Nearly 70 percent of deaths due to excessive drinking involved working-age adults, and about 70 percent of the deaths involved males. About 5 percent of the deaths involved people under age 21.

The highest death rate due to excessive drinking was in New Mexico (51 deaths per 100,000 population), and the lowest was in New Jersey (19.1 per 100,000).

 

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Obamacare boosts hospital mental healthcare for young adults

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teen-in-shadow-lightBy Jay Hancock
JUNE 11TH, 2014, 5:00 AM

Expanded coverage for young adults under the Affordable Care Act substantially raised inpatient hospital visits related to mental health, finds a new study by researchers at Indiana and Purdue universities.

That looks like good news: Better access to care for a population with higher-than-average levels of mental illness that too often endangers them and people nearby.

But it might not be the best result, said Kosali Simon, an economist at Indiana University and one of the authors.

Greater hospital use by the newly insured might be caused by inadequate outpatient resources to treat mental-health patients earlier and less expensively, she said. Continue reading

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Stopwatch public domain cdc

Prescription painkiller overdoses soar among women

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Pills-red-and-whitePrescription Painkiller Overdoses

A growing epidemic, especially among women

Vital Signs, a publication of the US Centers for Disease Control and Prevention

The numbers

48,000: Nearly 48,000 women died of prescription painkiller* overdoses between 1999 and 2010

400%: Deaths from prescription painkiller overdoses among women have increased more than 400% since 1999, compared to 265% among men.

30: For every woman who dies of a prescription painkiller overdose, 30 go to the emergency department for painkiller misuse or abuse.

About 18 women die every day of a prescription painkiller overdose in the US, more than 6,600 deaths in 2010. Prescription painkiller overdoses are an under-recognized and growing problem for women.

Although men are still more likely to die of prescription painkiller overdoses (more than 10,000 deaths in 2010), the gap between men and women is closing.

Deaths from prescription painkiller overdose among women have risen more sharply than among men; since 1999 the percentage increase in deaths was more than 400% among women compared to 265% in men.

This rise relates closely to increased prescribing of these drugs during the past decade. Health care providers can help improve the way painkillers are prescribed while making sure women have access to safe, effective pain treatment.

When prescribing painkillers, health care providers can

  • Recognize that women are at risk of prescription painkiller overdose.
  • Follow guidelines for responsible prescribing, including screening and monitoring for substance abuse and mental health problems.
  • Use prescription drug monitoring programs to identify patients who may be improperly obtaining or using prescription painkillers and other drugs.

*”Prescription painkillers” refers to opioid or narcotic pain relievers, including drugs such as Vicodin (hydrocodone), OxyContin (oxycodone), Opana (oxymorphone), and methadone.

Problem

Prescription painkiller overdoses are a serious and growing problem among women.

  • More than 5 times as many women died from prescription painkiller overdoses in 2010 as in 1999.
  • Women between the ages of 25 and 54 are more likely than other age groups to go to the emergency department from prescription painkiller misuse or abuse. Women ages 45 to 54 have the highest risk of dying from a prescription painkiller overdose.*
  • Non-Hispanic white and American Indian or Alaska Native women have the highest risk of dying from a prescription painkiller overdose.
  • Prescription painkillers are involved in 1 in 10 suicides among women.

*Death data include unintentional, suicide, and other deaths. Emergency department visits only include suicide attempts if an illicit drug was involved in the attempt.

More than 5 times as many women died from prescription painkiller overdoses in 2010 as in 1999.

  • Women are more likely to have chronic pain, be prescribed prescription painkillers, be given higher doses, and use them for longer time periods than men.
  • Women may become dependent on prescription painkillers more quickly than men.
  • Women may be more likely than men to engage in “doctor shopping” (obtaining prescriptions from multiple prescribers).
  • Abuse of prescription painkillers by pregnant women can put an infant at risk. Cases of neonatal abstinence syndrome (NAS)—which is a group of problems that can occur in newborns exposed to prescription painkillers or other drugs while in the womb—grew by almost 300% in the US between 2000 and 2009.
If you take mental health drugs and prescription painkillers, discuss the combination with your health care provider.

Prescription painkiller overdose deaths are a growing problem among women.

Prescription painkiller overdose deaths are a growing problem among women.
SOURCE: National Vital Statistics System, 1999-2010 (deaths include suicides)Every 3 minutes, a woman goes to the emergency department for prescription painkiller misuse or abuse.

SOURCE: Drug Abuse Warning Network, 2010. (Suicide attempts are included for the cases (.03% of total) where opioids were combined with illicit drugs in the attempt.)

What Can Be Done

Icon: Federal government

The US government is:

  • Tracking prescription drug overdose trends to better understand the epidemic.
  • Educating health care providers and the public about prescription drug misuse, abuse, suicide, and overdose, and the risks for women.
  • Developing and evaluating programs and policies that prevent and treat prescription drug abuse and overdose, while making sure patients have access to safe, effective pain treatment.
  • Working to improve access to mental health and substance abuse treatment through implementation of the Affordable Care Act.

Icon: Health care providers

Health care providers can:

  • Recognize that women can be at risk of prescription drug overdose.
  • Discuss pain treatment options, including ones that do not involve prescription drugs.
  • Discuss the risks and benefits of taking prescription painkillers, especially during pregnancy. This includes when painkillers are taken for chronic conditions.
  • Follow guidelines for responsible painkiller prescribing, including:
    • Screening and monitoring for substance abuse and mental health problems.
    • Prescribing only the quantity needed based on appropriate pain diagnosis.
    • Using patient-provider agreements combined with urine drug tests for people using prescription painkillers long term.
    • Teaching patients how to safely use, store, and dispose of drugs.
  • Avoiding combinations of prescription painkillers and benzodiazepines (such as Xanax and Valium) unless there is a specific medical indication.
  • Talk with pregnant women who are dependent on prescription painkillers about treatment options, such as opioid agonist therapy.
  • Use prescription drug monitoring programs (PDMPs)—electronic databases that track all controlled substance prescriptions in the state—to identify patients who may be improperly using prescription painkillers and other drugs.

Icon: Building

States can:

  • Take steps to improve PDMPs, such as real time data reporting and access, integration with electronic health records, proactive unsolicited reporting, incentives for provider use, and interoperability with other states.
  • Identify improper prescribing of painkillers and other prescription drugs by using PDMPs and other data.
  • Increase access to substance abuse treatment, including getting immediate treatment help for pregnant women.
  • Consider steps that can reduce barriers (such as lack of childcare) to substance abuse treatment for women.

Icon: Women

Women can:

  • Discuss all medications they are taking (including over-the-counter) with their health care provider.
  • Use prescription drugs only as directed by a health care provider, and store them in a secure place.
  • Dispose of medications properly, as soon as the course of treatment is done. Do not keep prescription medications around “just in case.” (Seewww.cdc.gov/HomeandRecreationalSafety/Poisoning/preventiontips.htm)
  • Help prevent misuse and abuse by not selling or sharing prescription drugs. Never use another person’s prescription drugs.
  • Discuss pregnancy plans with their health care provider before taking prescription painkillers.
  • Get help for substance abuse problems (1-800- 662-HELP); call Poison Help (1-800-222-1222) for questions about medicines.

Science Behind this Issue

Related Pages

On Other Web Sites

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Teens have unsupervised access to prescription drugs

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By Stephanie Stephens, HBNS Contributing Writer
Research Source: Journal of Adolescent Health

A new study in the Journal of Adolescent Health found that 83.4 percent of teens had unsupervised access to their prescription medications at home including 73.7 percent taking pain relief, anti-anxiety, stimulant and sedative medications that have the potential for abuse.

pills-spill-out-of-bottle

“It was surprising to me that parents were not storing medications securely because I expected them to be locked up and for parents to administer the medications,” said Paula Ross-Derow, Ph.D., of the University of Michigan’s Institute for Research on Women and Gender.

She and her colleagues explored the supervision of prescribed medications among 230 adolescents in 8th and 9th grade, using an online survey and in-person interview.

Emergency room visits for non-medical use of prescription narcotic pain relievers are increasing in people under age 21, and death by poisoning due to prescription overdoses is up 91 percent in less than a decade among adolescents ages 15 to 19, note the researchers.

They acknowledge that it is possible that parents and guardians may not believe that their children would engage in non-medical use or give away their prescription medications and therefore do not take steps to secure them.

“Dr. Ross-Durow’s paper shows that the majority of adolescents who are prescribed controlled medications have easy, unsupervised access to them,” said Silvia Martins, M.D., Ph.D., associate professor of epidemiology at Columbia University. “This is of great concern, since it not only can lead to the possibility of overdose of medications with potential abuse liability, but also can contribute to diversion of these medications and nonmedical use by their peers.”

“Parents don’t recognize that other kids come into their homes and can open a cabinet or see meds on the kitchen counter and take them,” Ross-Durow explained. “Teenagers may give them away—thinking they’re helping a friend—and they don’t see this as a risky behavior, or some may sell the medications. Visitors in the home may simply steal them.”

The researchers admit they don’t know whether providers are adequately educating parents and encourage more studies around this topic. “Plus, what we did not ask, but realized when examining our findings, is about other medications prescribed to parents and how those are stored. What we want to know is when medications are readily available in the home; does that lead to nonmedical use? We believe unsupervised access lays the groundwork for that,” said Ross-Durow.

Journal of Adolescent Health:www.jahonline.org

Paula Lynn Ross-Durow, Ph.D., Sean Esteban McCabe, Ph.D., and Carol J. Boyd, Ph.D. (2013). Adolescents’ Access to Their Own Prescription Medications in the Home, Journal of Adolescent Health.

Health Behavior News Service is part of the Center for Advancing Health

The Health Behavior News Service disseminates news stories on the latest findings from peer-reviewed research journals. HBNS covers both new studies and systematic reviews of studies on (1) the effects of behavior on health, (2) health disparities data and (3) patient engagement research. The goal of HBNS stories is to present the facts for readers to understand and use for themselves to make informed choices about health and health care.

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National Prescription Drug Take-Back Day – April 27

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Web Button-round-400x400pxThe Drug Enforcement Administration (DEA) has scheduled another National Prescription Drug Take-Back Day which will take place on Saturday, April 27, 2013, from 10:00 a.m. to 2:00 p.m.

This is a great opportunity for those who missed the previous events, or who have subsequently accumulated unwanted, unused prescription drugs, to safely dispose of those medications.

In the five previous Take-Back events, DEA in conjunction with our state, local, and tribal law enforcement partners have collected more than 2 million pounds (1,018 tons) of prescription medications were removed from circulation.

The National Prescription Drug Take-Back Day aims to provide a safe, convenient, and responsible means of disposal, while also educating the general public about the potential for abuse of these medications.

To find a Take-Back center near you go here.

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Teens and Sexual Assault, Part 8: The Media’s Response to the Steubenville Convictions

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Photo by Brainloc

Photo by Brainloc

By
This article first appeared on Seattle Children’s Teenology 101 blog.

I thought Part 7 was my last post in the series, but the media response to the sentencing of the two rapists in the Steubenville case has been so outrageous that I’m going to tack on a postscript here.

One of the first news reports to come out after the conviction was from CNN, and it spent much more time sympathizing with the rapists than the victim- in fact, the victim was not mentioned. You can watch the video here.

A concerned Poppy Harlow states, ”It was incredibly emotional, incredibly difficult even for an outsider like me, to watch what happened, as these two young men, that had such promising futures, star football players, very good students, literally watched as they believed their life fell apart…”

She then goes on to describe said emotion in the courtroom, and the offenders’ sadness. Later on, another reporter asked a legal correspondent, “What’s the lasting effect of two young men being found guilty in juvenile court of rape, essentially?”

There is so much wrong there: the concern over the rapists, the “essentially” tacked on to “rape”, the complete and utter absence of any thoughts of the victim. Just as people were beginning to criticize CNN, it turned out that the problem was not just with them.

NBC kept talking about the rapists’ “promising football careers.” I’m not sure why that’s relevant.

ABC News ran a piece on Ma’lik Richmond that talked extensively about his athletic prowess and difficult childhood. And yet, many athletes with difficult childhoods have refrained from raping someone.

Good Morning America mentions that “A juvenile judge will decide the fates of Trent Mays and Ma’lik Richmond, who face incarceration in a detention center until their 21st birthdays and the almost-certain demise of their dreams of playing football.” Perhaps if you dream of playing football, it’s best not to commit a sex crime.

The Associated Press opens a story with “Two members of Steubenville’s celebrated high school football team were found guilty Sunday of raping a drunken 16-year-old girl.” They are celebrated high school football players, the victim is left with the epithet “drunken.”

What none of these major media outlets seem to be addressing is that (ideally) if you rape someone, you pay the consequences for it. None of them are lamenting the long-term effects on a young women of being raped by two young men (and having pictures of it sent to peers). None of them are pointing out that this situation wouldn’t have happened if the two offenders had made the choice not to rape someone. Their promising football careers would be continuing untouched, they might have gone to great universities, and enjoyed all the opportunities and rewards given to people who have chosen not to commit rape.

What are our teens supposed to think when the mainstream media’s treatment of rapists is not full of revulsion, fear, or condemnation, but seems almost… affectionate? At the least, they feel very bad for them.

And they fail to mention concern over the fate of the rape victim. In fact, if she’s mentioned at all, it’s to point out that she was intoxicated. As Henry Rollins (yes, thatHenry Rollins) said in a piece in Raw Story, “It is ironic and sad that the person who is going to do a life sentence is her.”

I spoke earlier in this series about how important it is to talk to your teen about issues regarding sexual consent. It’s also important for you to talk to your teen about rape culture, how they can make sure they’re not a part of it, and what they can do to change it.

About Jen Brown, RN, BSN

Jen Brown, RN, BSN Teens never cease to amaze me with their strength, creativity, and new perspectives! Throughout my career, I’ve enjoyed helping teens and their parents tackle health concerns and navigate social issues. Nursing is my second career; my first degree was in biology from Carleton College, and a few years later I went to the University of Virginia for their Second Degree Nursing Program. Recently I began a graduate program at the University of Washington.

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