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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

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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.

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“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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Fewer students smoking and drinking alcohol in Washington state

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Picture of a table after a party with wine and beer bottlesFewer students in Washington state are smoking cigarettes or drinking alcohol, according to the state’s latest Healthy Youth Survey.

The survey is taken every two years by students in grades 6, 8, 10, and 12 in more than 1,000 Washington public schools.

 

Among the findings:

Tobacco:

  • Cigarette smoking is down in all grades. About 10 percent of 10th graders reported smoking a cigarette at least once in the past 30 days —  down from nearly 13 percent in 2010 and from 25 percent in 1999.
  • Nearly as many 10th graders smoked tobacco from a hookah pipe as from a cigarette, and about 7 percent said that they smoked a cigar in the last month.
  • Statewide, about 50,000 youth smoke – and 40 start smoking every day.

Alcohol:

  • Nearly 11,000 fewer students are using alcohol compared to 2010. Still, more than 115,000 youth currently drink.  Twelve percent of 8th graders, 23 percent of 10th graders, and 36 percent of 12th graders used alcohol in the past 30 days.

Marijuana:

  • The  number of secondary school students who believe using marijuana is risky dropped to the lowest level since the state started collecting data and the percentage of Washington 10th and 12th graders who smoke marijuana is nearly double the percentage of cigarette smokers.

Suicide and Depression:

  • About 8 percent of 8th and 10th graders attempted suicide in the past year.
  • Over 100,000 youth, ages 12-17, seriously considered suicide – about one in every six students.
  • More than one in four teens surveyed said they felt so sad or hopeless for two weeks in a row that they stopped doing usual activities: 26 percent in 8th grade, 31 percent in 10th grade, and 30 percent in 12th grade.
  • These numbers haven’t changed much over the past 10 years.

Sex:

  • Nearly one third (32 percent) of 10th graders and more than half (55 percent) of 12th graders reported having ever had sexual intercourse.
  • About 7 percent of 10th graders and 16 percent of 12th graders reported they had four or more sexual partners.
  • About 6 percent of 10th graders and 5 percent of 12th graders reported having sex for the first time at age 12 or younger.

To learn more:

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Accidental poisonings leading cause of deaths at home

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A jumble of pill bottles

Photo by Erin DeMay via Flickr

By Stephanie Stephens, HBNS Contributing Writer
Research Source: American Journal of Preventive Medicine

An increasing number of people are dying from unintentional injury at home, with more than 30,000 deaths occurring between 2000 and 2008, finds a new study in the American Journal of Preventive Medicine. Poisoning, falls and fire/burn injuries caused the most fatalities, respectively.

The study reveals that poisonings were the leading cause of unintentional home injury deaths for those ages 15 to 59 years, largely resulting from unintentional drug overdoses of narcotics, hallucinogens and other drugs.

Additionally, more men and boys died from home injury than women and girls did and adults 80 years and older had higher rates of injury-related in-home death than other ages.

“These injuries are predictable and preventable,” said lead author Karin Mack, Ph.D. of the National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention.

Mack and her colleagues called for more research to develop effective interventions to modify the home like smoke alarms, limiting access to non-prescription drugs, and closer supervision of children.

Other helps would be broader dissemination of prevention messages to specific audiences including healthcare and education providers, law enforcement and policymakers, and media, they said.

The researchers used combined state-specific death certificate data from the National Vital Statistics System, an inter-governmental public health database. New Mexico had the highest rates of unintentional home injury death during the study period with the lowest in Massachusetts.

Mack said that despite the uptick in home injury during the study period, she was encouraged by momentum occurring in the field of healthy homes, citing two publications that helped spark national interest in home safety: a 2009 report, “The Surgeon General’s Call to Action to Promote Healthy Homes,” and a 2011 report from the American Public Health Association, “Healthy & Safe Homes: Research, Practice, and Policy”.

Much more needs to be done, said Carol W. Runyan, M.P.H., Ph.D., a professor of epidemiology and community and behavioral health at the Colorado School of Public Health.

“The increases in poisoning, largely due to prescription pain medication, have been most dramatic over the past decade, signaling a need to rethink how pain medications are prescribed and used,” she said.

Falls continue to be the major source of fatal home injury in older adults and suffocation the leading cause for infants, Runyan said.

“As the authors note, most of these injuries are preventable through changes in the home environment and safety practices. Unfortunately, this enormous and costly public health problem has not received the national attention it deserves. Funding to understand and address the problem is a pittance compared to other health problems and many health professionals are poorly trained to address these challenges,” she said.

Runyan said the deaths are not inevitable results of uncontrollable or accidental circumstances. “Hopefully this paper will stimulate a shift in the national attention and support for prevention,” she said.
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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Binge Drinking: a serious, under-recognized problem among women and girls – CDC

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From the U.S. Centers for Disease Control and Prevention

Binge drinking is a dangerous behavior but is not widely recognized as a women’s health problem.

Drinking too much – including binge drinking – results in about 23,000 deaths in women and girls each year.

[Binge drinking for women is defined as consuming 4 or more alcohol drinks (beer, wine, or liquor) on an occasion.]

Binge drinking increases the chances of breast cancer, heart disease, sexually transmitted diseases, unintended pregnancy, and many other health problems.

Drinking during pregnancy can lead to sudden infant death syndrome and fetal alcohol spectrum disorders.

About 1 in 8 women aged 18 years and older and 1 in 5 high school girls binge drink. Women who binge drink do so frequently – about 3 times a month – and have about 6 drinks per binge. There are effective actions communities can take to prevent binge drinking among women and girls.

Binge drinking infographic

 

For a PDF of this infographic go here.

Problem

Drinking too much can seriously affect the health of women and girls.

Drinking too much can seriously affect the health of women and girls.

  • Women’s and girls’ bodies respond to alcohol differently than men’s. It takes less alcohol for women to get intoxicated because of their size and how they process alcohol.
  • Binge drinking can lead to unintended pregnancies. It is not safe to drink at any time during pregnancy.
  • If women binge drink while pregnant, they risk exposing their developing baby to high levels of alcohol, increasing the chances the baby will be harmed by the mother’s alcohol use.

Drinking is influenced by your community and your relationships.

  • Alcohol use in a community is affected by alcohol’s price and availability.
  • Underage drinking is affected by exposure to alcohol marketing.
  • Underage drinking is also influenced by adult drinking, and youth often obtain alcohol from adults.

What Can Be Done

Federal agencies and national partners are:

  • Recognizing that binge drinking is an important women’s health issue.
  • Working with states and communities to support Community Guide recommendations to reduce binge drinking.
  • Informing people about the US Dietary Guidelines on alcohol consumption (see box).
  • Helping states and communities to report on how many people binge drink, how often and how much they drink when they binge, and whether health care providers are screening and counseling for excessive alcohol use.
  • Reporting on youth exposure to alcohol marketing because it influences underage drinking.

We know what works

The Guide to Community Preventive Services(Community Guide) recommends effective policies to prevent binge drinking. Learn more at: www.thecommunityguide.org/alcohol.

States and communities can:

  • Follow Community Guide recommendations to reduce binge drinking. The same approaches that work in the population as a whole can work for women and girls.
  • Increase enforcement of laws on the sale and consumption of alcohol.
  • Develop partnerships with a variety of groups, including schools, women’s and girls’ organizations, law enforcement, and public health agencies to reduce binge drinking.
  • Report on how many people binge drink, how often, and how much they drink when they binge.

Key Points on Alcohol Consumption from the 2010 US Dietary Guidelines for Americans

  • Don’t begin drinking or drink more frequently on the basis of potential health benefits.
  • If you do choose to drink, do so in moderation. This is defined as up to 1 drink a day for women or 2 for men.
  • Don’t drink at all if you are under age 21, pregnant or may be pregnant, or have health problems that could be made worse by drinking.

Doctors, nurses, and others who treat patients can:

  • Ask women about binge drinking and counsel those who do to drink less (see Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse). This screening and counseling can also be effectively done using the internet, telephone, or other electronic methods, as recommended by the Community Guide.
  • Advise women who are pregnant or might be pregnant not to drink at all.
  • Recognize that most binge drinkers are not alcohol dependent or alcoholics, but may need counseling.
  • Support effective policies to prevent binge drinking such as those recommended by the Community Guide.

Women and girls can:

  • Avoid binge drinking. If you choose to drink alcohol, follow the US Dietary Guidelines.
  • Choose not to drink alcohol if you are underage or if there is any chance you could be pregnant.
  • Be cautious about consuming drinks if the alcohol content is unknown to you.

To learn more:

Read the CDC’s WMMR article: Vital Signs: Binge Drinking Among Women and High School Girls — United States, 2011.

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Washington state moves to address epidemic of prescription painkiller overdose deaths – BMJ

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A feature article on efforts in Washington state to address the epidemic of prescription painkiller overdose deaths by LocalHealthGuide editor Michael McCarthy appears this week in the BMJ, the journal of the British Medical Society.

Containing the opioid overdose epidemic

In the late 1990s, Washington State began to relax its rules regulating the prescription of opioids. Shortly thereafter, overdose deaths began to climb.

“We saw the deaths increase within a year,” says Gary Franklin, medical director for the Washington Department of Labor and Industries, which administers compensation for job related injuries and illnesses for more than 3.2 million workers in the state.

“These were productive people who were working the day they came into the system with a back sprain or whatever, and three years later they were dead from an accidental overdose of opioids,” Franklin says. “I had never seen anything so sad.” . . .

Read the full article on the BMJ website.

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Workplace clinics expand focus beyond injuries and preventive care

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By Michelle Andrews

On-site workplace clinics used to be primarily focused on patching up people who got injured on the job. Then companies added primary care and started emphasizing preventive screenings and other “wellness” services.

Now, some big employers are beefing up their clinic offerings further with a host of add-ons, including physical therapy, dental and vision exams, mental health counseling and even acupuncture and massage.

The new services may not always improve a company’s bottom line. But they’re a convenient perk for busy employees and can help maintain employee productivity by reducing absences.

In addition, in competitive industries such as technology and financial services, such benefits can help retain employees and attract new ones, experts say.

In 2011, 31 percent of employers with 500 or more workers had on-site clinics, and another 9 percent said they were considering them, according to the annual survey of employer health plans by human resources consultant Mercer.

“It’s a matter of providing enhanced access and making it easier for workers to get enhanced services,” says Bruce Hochstadt, a Mercer consultant.

When Linda Wolohan’s doctor prescribed physical therapy last December to treat a bulging disk in her back, she opted to use a physical therapist at the Valley Forge, Pa., headquarters of her employer, Vanguard, rather than one near her home an hour away.

“It was convenient,” says Wolohan, 54, who works in the mutual fund company’s public relations department. “Getting to a physical therapist near home was hard to schedule.”

Wolohan paid $10 a session, a slightly lower co-payment than if she had used a physical therapist in the community.

More From This Series: Insuring Your Health

Obstetrics And Dentistry

Like most companies that provide on-site clinics, Vanguard is self-insured, meaning the company pays its employees’ health-care claims directly.

Given the high volume of employee physical therapy claims, it made sense financially to provide the service in-house, says Julie Clark, who oversees the clinic, the company gym and other wellness services.

The company has three part-time physical therapists at the clinic, which opened last year. The clinic staff, which also includes a doctor, a nurse practitioner and a couple of nurses, is employed by CHS Health Services, a Reston, Va.-based company that staffs and runs 115 on-site health clinics in 32 states.

Employees’ costs vary. Some employers provide clinic services free. Discounted co-payments such as the one Wolohan paid are common, experts say.

“They want to encourage employees to take advantage of the services on-site,” says Ed McNamara, vice president of sales and marketing at CHS. “It’s a productivity savings and an employee-benefit savings.”

Workers at American Express facilities in Phoenix and Salt Lake City have access to dental services at a van that parks at each of the facilities. In addition to dental exams and cleanings, employees can get fillings and crowns, among other treatments. Services are free for employees enrolled in the company dental plan.

American Express varies the on-site services it offers based on employee needs, says David Kasiarz, senior vice president for global compensation and benefits. The company may provide an OB/GYN at a call center with a mostly female workforce, for example, or a dermatologist in Florida and Phoenix, where skin cancer is more common than in other areas.

On the coasts, especially in Silicon Valley and Southern California, a growing number of companies have added acupuncture, massage therapy and chiropractic services to their clinic offerings, experts say.

“The companies that tend to do it see it as a retention tool,” says Ha Tu, a senior researcher at the Center for Studying Health System Change, who co-authored a study about workplace clinics. “They’re perks, as opposed to offering massage therapy, for example, and expecting direct payoff.”

Mental Health Care

Employers are also paying more attention to mental health issues. Some are adding services at their on-site clinics.

In other cases, they’re linking the employee assistance program, which provides short-term counseling and mental health referrals, with the clinics, says Julie Stone, a senior consultant with benefits consultant Towers Watson.

Services can take many forms. At Prudential Financial, health-care providers at the company’s eight clinics began noticing employee stress from the financial crisis and recession a few years ago. So the company made budget coaches available by phone.

“The financial situation was affecting their health,” says Myrtho Montes, who manages all the company’s on-site health programs.

KHN wants to hear from you: Contact Kaiser Health News
This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Proposed changes to psychiatric manual could affect addiction diagnosis

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By Michelle Andrews

What’s in a name? That’s a question that experts are wrestling with as they prepare to revise the diagnostic manual that spells out the criteria for addiction and other substance-use problems.

The catalyst for this discussion is a set of proposed changes to the Diagnostic and Statistical Manual of Mental Disorders, the reference guide upon which clinicians, researchers, insurers and others rely to identify and classify psychiatric disorders.

The revised guide, called DSM-5, will incorporate changes to more than a dozen categories of disorders, including those related to mood, eating and personality, as well as substance use and addiction.

Developed under the auspices of the American Psychiatric Association, the revised manual is scheduled for release in May 2013.

The new guidelines would do away with the diagnostic categories of “substance abuse,” which generally is defined by such short-term problems as driving drunk, and “substance dependence,” which is chronic and marked by tolerance or withdrawal, in favor of a combined “substance use and addictive disorders” category.

Supporters say by creating a category for mild disorders, may make it easier to identify and address drug or alcohol problems before they become serious

.They would also, for the most part, merge the criteria used to diagnose disorders related to the use of alcohol, cigarettes, illicit or prescription drugs and other substances into a single 11-item list of problems typically associated with these disorders.

The list covers issues such as being unable to cut down or control the use of that substance and failing to meet obligations at work, school or home.

People would be given a diagnosis based on how many criteria on that list they met:

  • no disorder (0-1),
  • mild disorder (2-3),
  • moderate (4-5) or severe (6 or more).

Supporters say the proposed changes, by creating a category for mild disorders, may make it easier to identify and address drug or alcohol problems before they become serious.

According to the National Institute on Alcohol Abuse and Alcoholism, people are at risk for developing a substance use disorder if their drinking exceeds four drinks on any single day and more than 14 drinks per week for men, and three drinks on any single day and more than seven drinks per week for women.

People who routinely drink heavily at sporting events or regularly get high with friends may be at risk for a substance use disorder, but they generally don’t need lengthy treatment to change their ways, experts say.

“A lot of times, people aren’t aware that their consumption is way higher than average.”

The new DSM guidelines might make it easier for primary-care doctors to be reimbursed by insurers for screening for alcohol and drug problems and conducting short counseling sessions that have been shown to be effective.

The goal is to educate patients about the higher risks they face of, for example, having a car accident or liver problems if they drink, and to motivate them to change, says Keith Humphreys, a psychiatry professor at Stanford University and a former senior drug policy adviser to the Obama administration.

“A lot of times, people aren’t aware that their consumption is way higher than average,” he says. “If you tell people they drink more than others, they can change and avoid the consequences.”

The U.S. Preventive Services Task Force also recommends screening and behavioral counseling to reduce alcohol misuse in adults.

Under the federal health law adopted in 2010, it’s covered as a free preventive benefit for people in health plans that are new or have changed enough to lose their grandfathered status.

But some addiction experts worry that using the 11-point list of criteria to place substance use disorders on a continuum from mild to severe suggests that there’s a natural escalation from non-use to occasional use to risky use to addiction.

“I think that’s not consistent with clinical research,” says Eric Goplerud, who directs the substance abuse, mental health and criminal justice studies department at NORC, a research organization at the University of Chicago.

It’s analogous to depression, he says. “People are sad when bad things happen to them, but not all are on an escalator that will lead them to psychotic depression.”

Because the new guidelines use a single spectrum for substance use and addictive disorders, some addiction experts worry that, for example, adolescents who meet the criteria for mild substance use because they’ve engaged in binge drinking and missed classes because of it within the past 12 months – thereby earning a score of 2 — might be labeled as having a mild addictive disorder, which in many cases would not be accurate.

Some may resist treatment if they are labeled addicts, says Yifrah Kaminer, a professor of psychiatry and pediatrics at the University of Connecticut Health Center. “Adolescents vehemently don’t like stigmatization,” he says. “They’ll say, ‘This treatment is only for addicts, and I don’t want to go.’ ”

Even though the Mental Health Parity and Addiction Equity Act of 2008 requires insurers to cover mental and physical health services equally, “people still have to fight for addiction treatment,” says Marvin Seppala, chief medical officer at Hazelden, a Minnesota nonprofit that runs drug and alcohol treatment centers around the country.

The parity law doesn’t cover group plans at companies with 50 or fewer employees, nor individual health insurance plans.

One of the longest running programs, however, doesn’t require insurance because it’s free: Alcoholics Anonymous.

Please send comments or ideas for future topics for the Insuring Your Health column toquestions@kaiserhealthnews.org.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Sign for an emergency room.

Some insurers deny ER coverage to people who have been drinking

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Sign for an emergency room.By Michelle Andrews

Up to half of the people who are treated at hospital emergency departments and trauma centers are under the influence of alcohol, experts say.

That may be a sobering statistic, yet a recent study found that emergency departments can capitalize on this “teachable moment” to discourage problem drinking in the future.

But laws in more than half the states permit insurers to deny payment for medical services related to alcohol or drug use and that can derail hospitals’ best intentions, experts say.

Faced with the prospect of not getting paid for care, some emergency department personnel may sidestep the problem by simply not testing patients’ blood or urine for alcohol.

In the study, published online in the Annals of Emergency Medicine in March, nearly 600 emergency department patients who were identified as hazardous or harmful drinkers (defined for men as drinking more than 14 drinks per week or more than four on any single occasion, and for women as more than seven weekly drinks or three on any one occasion) took part in a seven-minute interview.

During the interview, an emergency department staff member discussed the link between a patient’s injuries and alcohol, as well as guidelines for low-risk drinking, and encouraged the patient to discuss what was stopping him from drinking less and to set a drinking goal.

Compared with those who received standard care, patients who took part in the sessions reduced their average number of weekly drinks significantly as well as their episodes of binge drinking and drinking and driving over the next 12 months.

“In the emergency department on a weekend, all the cases may be drug or alcohol related, and yet we don’t do” screening and intervention, says Gail D’Onofrio, the study’s lead author who is chair of emergency medicine at Yale University School of Medicine. “Our goal is to normalize this in the emergency department.”

Although some of the nearly 4,000 emergency departments screen patients for drug or alcohol use, it’s not required. Level 1 and 2 trauma centers, however, which are typically equipped to handle emergency patients suffering from serious injuries sustained, for example, in major car accidents, must screen for problem drinkers. Level 1 trauma centers must also be able to provide counseling.

More From This Series: Insuring Your Health

Such screening and counseling can be effective, says Larry Gentilello, a trauma surgeon who has published studies on injury prevention and substance abuse.

“Most of the people who are injured don’t need to go into treatment,” he says. “They aren’t alcoholics or alcohol dependent. That’s why one counseling session can help them by talking about the risks of drinking.”

The extent to which so-called alcohol-exclusion laws deter emergency medical personnel from screening and counseling patients for alcohol or drugs is unknown.

The laws have a long history. Since 1947, more than 40 states have passed measures allowing health plans to refuse to pay for care if the patient’s injuries occurred while he was under the influence of alcohol or, in some states, drugs, say experts.

As people came to understand alcohol addiction and the possibility of treatment, however, it became clear that the laws were counterproductive. In 2001, the National Association of Insurance Commissioners recommended against them.

Since then, at least 15 states have repealed or amended their laws and now prohibit exclusions of coverage for drinking or drugs, according to data from the National Institute on Alcohol Abuse and Alcoholism. Maryland and the District of Columbia are among them; Virginia’s law remains in place.

Regardless of state law, self-insured companies that pay their employees’ health care costs directly can refuse to cover employees for alcohol-related claims.

The laws have ensnared both problem and occasional drinkers.

In Washington state a law, RCW 48.20.385, specifically bars insurers from denying coverage solely because an injury was sustained as a result of the insured being intoxicated or under the influence of a narcotic. http://apps.leg.wa.gov/rcw/default.aspx?cite=48.20.385.

Gentilello describes the case of a Seattle woman who was celebrating her 25th wedding anniversary and had a few glasses of champagne at dinner with her family.

It was a rainy night and she was dressed up and wearing high heels. As she and her husband tried to hail a cab, she tripped on a curb, fell and broke her ankle. In the emergency department, her chart noted that she had a few drinks.

Her insurer refused to pay. Washington subsequently adopted a prohibition on alcohol-related claims exclusions in 2004.

It’s unclear how frequently insurers continue to apply such laws to avoid paying claims. Susan Pisano, a spokeswoman for America’s Health Insurance Plans, a trade organization, says the group doesn’t know what member practice is.

Cynthia Michener, a spokeswoman for Aetna, says that “to our knowledge” the company doesn’t apply such exclusions. Other insurers, including UnitedHealthcare and Humana, didn’t provide information about their practices.

But a professor who has written about such laws says there are indications that health plans continue to use them to deny payment.

“There are tons of these cases,” says Sara Rosenbaum, a professor of health law and policy at George Washington University’s School of Public Health and Health Services.  “The only evidence we have suggests that these cases go on.”

“There’s no reason to think that insurers, eager to hold down costs, wouldn’t continue” to deny payment based on such exclusions, she adds.

Please send comments or ideas for future topics for the Insuring Your Health column to questions@kaiserhealthnews.org.

KHN wants to hear from you: Contact Kaiser Health News

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Teen in Shadow - Thumb

Training teens to handle emotions improves mental health

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By David Pittman, Contributing Writer
Health Behavior News Service

Teens who received emotional intelligence training in school had improved scores on several measures of emotional well-being, including less anxiety, depression and social stress, according to a new study in the Journal of Adolescent Health.

Improvements from the training lasted up to six months after the program ended.

Emotional intelligence, or EI, refers to the ability to accurately appraise, express and regulate emotion. “The ability to handle emotions is essential for one’s physical and psychological well-being,” said study lead author Desiree Ruiz-Aranda.

In addition, adolescents who are healthier mentally are healthier physically and may engage in fewer risky behaviors.

Key Points:

  • The inability to regulate emotional states has been linked to mental health problems, such as anxiety and depression.
  • Many mental health disorders appear during adolescence.
  • Teens who receive emotional intelligence training have lower measures of depression and social stress, even up to six months later.

“Emotional abilities need to begin as early as possible and preventive interventions should ideally be provided prior to developing significant symptoms,” said Ruiz-Aranda.

The study examined about 300 Spanish students who participated in 24 one-hour training sessions during a two-year period.

Teens in the study group participated in games, role-playing, art and discussion designed to promote the recognition of emotions in different contexts and to build empathy and emotional problem solving.

When compared with a control group, these teens had lower measures of depression, social stress, and other negative feelings, even up to six months later.

Successful programs need to be catered to individual cultures and ages and be applied to everyday settings, Ruiz-Aranda said.

Schools have not done well in preparing students for life with things such as emotional intelligence training, said Gary Low, Ph.D., professor emeritus of education at Texas A&M University in Kingsville.

He added that schools often don’t help students learn to cope with fears, stresses, relationships and other areas of life.

“We just hope that people learn that as they grow older, and I think we’ve not paid attention to developing a curriculum that would really help young people experience more success in life,” he said.

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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State disciplines health care providers

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State seal of Washington statePeriodically Washington State Department of Health issues an update on disciplinary actions taken against health care providers, including suspensions and revocations of  licenses, certifications, or registrations of providers in the state.

The department has also suspends the credentials of people who have been prohibited from practicing in other states.

Information about health care providers is also on the agency’s website.

To find this information click on “Provider Credential Search” on the left hand side of the Department of Health home page (www.doh.wa.gov).

The site includes information about a health care provider’s license status, the expiration and renewal date of their credential, disciplinary actions and copies of legal documents issued after July 1998.

This information is also available by calling 360-236-4700.

Consumers who think a health care provider acted unprofessionally are also encouraged to call and report their complaint.

Here is the March 29th update issued by the Washington State Department of Health:

Note: Health care providers charged with unprofessional conduct have 20 days to respond to the Department of Health in writing. The case then enters the settlement process. If no disciplinary agreement can be reached, the case will go to a hearing.

State disciplines health care providers

OLYMPIA – The Washington State Department of Health has taken disciplinary actions or withdrawn charges against health care providers in our state.

The department’s Health Systems Quality Assurance Division works with boards, commissions, and advisory committees to set licensing standards for more than 70 health care professions (e.g., medical doctors, nurses, counselors).

Information about health care providers is on the agency website. Click on “Provider Credential Search” on the left hand side of the Department of Health home page (www.doh.wa.gov). The site includes information about a health care provider’s license status, the expiration and renewal date of their credential, disciplinary actions and copies of legal documents issued after July 1998. This information is also available by calling 360-236-4700. Consumers who think a health care provider acted unprofessionally are also encouraged to call and report their complaint.

Benton County

In February 2012 the Nursing Assistant Program charged certified nursing assistant Carleen J. Grawl (NC10011749) with unprofessional conduct. She allegedly neglected vulnerable adults while serving as a licensed provider of an adult family home.

In February 2012 the Dental Commission charged dentist James WM Huffman (DE00005580) with unprofessional conduct. He allegedly took a controlled substance from his dental practice for his own use

Clallam County 

In March 2012 the Nursing Commission charged registered nurse Sandra Leilani Dalton (RN00057746) with unprofessional conduct. She’s allegedly unable to practice with reasonable skill and safety.

Clark County

In February 2012 the Nursing Assistant Program charged certified nursing assistant Cherri S. Boltz (NC60110832) with unprofessional conduct. She allegedly entered into a romantic and sexual relationship with a patient.

In March 2012 the Board of Pharmacy charged pharmacy technician Cory A. Reese (VA00072656) with unprofessional conduct. He allegedly tested positive for marijuana in a urinalysis provided by his employer.

In February 2012 the Board of Pharmacy ended the probation order against pharmacist Steven R. Tomlinson (PH00010612).

Grays Harbor County

In February 2012 the Examining Board of Psychology released Ryan D. Donahue (PY00003754) from terms and conditions set against his license.

King County

In February 2012 the Medical Commission modified the agreed order against physician Robert G. Haining (MD00008934). His credential remains on probation and restrictions are placed against his license.

In February 2012 the Nursing Commission charged registered and licensed practical nurse Leonard M. Muigua (RN60106705, LP00056164) with unprofessional conduct. He allegedly mentally abused a vulnerable adult while working in an adult family home.

In March 2012 the Health Care Assistant Program granted the application of Alisha Jean Williams (HC60215131) and placed her license on probation for three years. She was convicted of eight counts of forgery.

Kitsap County 

In March 2012 the Licensed Mental Health Counselor Program charged licensed mental health counselor Starla S. Allen (LH00004595) with unprofessional conduct. She allegedly failed to comply with prior terms and conditions set against her license.

In February 2012 the Chemical Dependency Professional Program ended the probation order against chemical dependency professional trainee Bettye Jean Dobson (CO60127832). 

Mason County

In February 2012 the Chemical Dependency Professional Program reinstated the certification of chemical dependency professional trainee Steven Michael Dorland (CO60225022) and placed it on probation.

Pierce County

In February 2012 the Board of Osteopathic Medicine and Surgery released osteopathic physician assistant Kristie Michelle Mattern (OA60206687) from terms and conditions set against her license.

In February 2012 the Dental Commission charged dental assistant Kim M. Shipman (D160087419) with unprofessional conduct. She was convicted of two counts of theft.

In February 2012 the Health Care Assistant Program granted the application of Kariann L. Williams (HC60261292) and placed her license on probation for two years. She was convicted of forgery.

Snohomish County

In March 2012 the Chemical Dependency Professional, Licensed Mental Health Counselor, and Sex Offender Treatment Provider Programs ended the probation order against Rochelle R. Long(CP00003867, LH00007726, AF10000160).

After a hearing in February 2012, the Nursing Assistant Program corrected the final order against registered and certified nursing assistant Lamin Sonko (NA60088539, NC10045877). His credentials remain on probation for 60 months.

Spokane County

In February 2012 the Nursing Commission charged registered nurse Teresa M. Couper (RN00176866) with unprofessional conduct. She allegedly practiced without a valid credential.

In February 2012 the Emergency Medical Services Program released emergency medical technician Raymond W. Hamilton (ES00124034) from terms and conditions set against his certification.

In February 2012 the Nursing Assistant Program charged registered nursing assistant Danny Ray Osborne (NA00131144) with unprofessional conduct. He allegedly physically and mentally abused vulnerable adults while providing services in a supported living setting.

In March 2012 the Dental Commission entered into an agreed order with dentist Thomas F. Weiler (DE00005502) and placed conditions against his license. The care he provided allegedly fell below the standard by failing to adequately diagnose and treat a patient’s condition.

Thurston County

In February 2012 the Nursing Commission charged registered nurse Virginia Hadley (RN00064544) with unprofessional conduct. She allegedly failed to meet standards in caring for a patient who required monitoring, assessment, oxygen, and resuscitation.

Walla Walla County

In February 2012 the Nursing Assistant Program charged certified nursing assistant Elizabeth A. Shelton (NC10088885) with unprofessional conduct. She was convicted of violation of the Uniform Controlled Substance Act — obtaining a controlled substance by fraud.

Yakima County

In February 2012 the Unlicensed Practice Program issued a notice of intent to issue cease-and-desist order against Karyen Thompson. She allegedly impersonated a physician from about 2008 to 2011. She doesn’t hold a license to practice medicine in Washington. She was convicted of two counts of criminal impersonation, two counts of practice without a license, and two counts of possession of stolen property.

Out of State

Florida: In March 2012 the Nursing Commission charged licensed practical nurse Anita M. Johnson (LP00050856) with unprofessional conduct. When applying for a license to practice in Washington, she allegedly failed to disclose licensure and disciplinary actions against her licenses to practice in Wisconsin, Illinois, and Texas.

Idaho: In February 2012 the Board of Pharmacy reinstated the license of pharmacist Michael P. Gardner (PH00010532) and placed conditions against his license with which he must comply.

Idaho: In February 2012 the Nursing Assistant Program ended the probation order against certified nursing assistant Rayna Lynne Potter (NC60202666).

Montana: In February 2012 the Nursing Commission charged registered nurse Jason C. Shaffer (RN00161748) with unprofessional conduct. He allegedly failed to comply with terms and conditions set against his license.

Ohio: In February 2012 the Medical Commission released physician David C. Blocker (MD00027013) from terms and conditions set against his license. Dr. Blocker’s license is unrestricted in Washington.

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State seal of Washington state

State disciplines health care providers

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State seal of Washington statePeriodically Washington State Department of Health issues an update on disciplinary actions taken against health care providers, including suspensions and revocations of  licenses, certifications, or registrations of providers in the state.

The department has also suspends the credentials of people who have been prohibited from practicing in other states.

Information about health care providers is also on the agency’s website.

To find this information click on “Provider Credential Search” on the left hand side of the Department of Health home page (www.doh.wa.gov).

The site includes information about a health care provider’s license status, the expiration and renewal date of their credential, disciplinary actions and copies of legal documents issued after July 1998.

This information is also available by calling 360-236-4700.

Consumers who think a health care provider acted unprofessionally are also encouraged to call and report their complaint.

Here is the January 26th update issued by the Washington State Department of Health:

Note: Health care providers charged with unprofessional conduct have 20 days to respond to the Department of Health in writing. The case then enters the settlement process. If no disciplinary agreement can be reached, the case will go to a hearing.

State disciplines health care providers

The Washington State Department of Health has taken disciplinary actions or withdrawn charges against health care providers in our state.

The department’s Health Systems Quality Assurance Division works with boards, commissions, and advisory committees to set licensing standards for more than 70 health care professions (e.g., medical doctors, nurses, counselors).

Information about health care providers is on the agency website. Click on “Provider Credential Search” on the left hand side of the Department of Health home page (www.doh.wa.gov). The site includes information about a health care provider’s license status, the expiration and renewal date of their credential, disciplinary actions and copies of legal documents issued after July 1998. This information is also available by calling 360-236-4700. Consumers who think a health care provider acted unprofessionally are also encouraged to call and report their complaint.

Chelan County

In December 2011 the Nursing Assistant Program charged registered nursing assistant Frances J. Pocan (NA00189315) with unprofessional conduct. A patient allegedly gave her money to pay the patient’s bills, and she failed to pay the bills or return the money to the patient.

Clark County

In December 2011 the Massage Program charged Douglas L. Black (MA00011374) with unprofessional conduct for allegedly having a sexual relationship with a patient.

In December 2011 the Medical Commission charged physician Patrick Chau (MD00030053) with unprofessional conduct. Allegations include failing to comply with terms and conditions set against his license, prescribing controlled substances inadequate notes about why he prescribed the substances, and failing to follow-up with patients.

Douglas County 

In December 2011 the Nursing Assistant Program charged registered nursing assistant Maria Elena Vasquez (NA60168663) with unprofessional conduct. She allegedly borrowed money from a patient and failed to repay the loan.

Jefferson County

In December 2011 the Veterinary Board of Governors released veterinarian Joyce M. Murphy (VT00001824) from terms and conditions set against her license.

King County 

In December 2011 the Unlicensed Practice Program notified Steve Becker that it intends to issue a cease-and-desist order. He’s charged with performing a forensic evaluation, administering psychological tests, and diagnosing a patient without a valid psychologist or counselor license.

In December 2011 the Dental Commission granted the application of dental assistant Jaime Lynn Clarke (D160231847) and placed conditions against her registration. She was convicted of driving under the influence and entered into a deferred prosecution for charges of driving under the influence.

In January 2012 the Nursing Commission amended the statement of charges against registered nurse Flor D. Cruz (RN00076122). She allegedly failed to act on a patient’s change in vital signs, failed to perform a complete assessment of the patient, and failed to communicate the changes in the patient’s condition to a physician or other staff. She also allegedly rented a room in her house to a former inmate at the jail where she worked, and checked the inmates medical records without authorization.

In December 2011 the Secretary of Health ended the probation order against physician Terrill L. Harrington (MD00038084).

In December 2011 the Nursing Assistant Program charged certified nursing assistant Gus Ernie Hayes (NC10013627) with unprofessional conduct. He was convicted of violating a no-contact order and entered a deferred prosecution for charges of assault, malicious mischief, and resisting arrest.

In December 2011 the Medical Commission charged physician Jim Chun Jen Hsu (MD00044903) with unprofessional conduct. The diagnosis and surgery he performed on a patient’s shoulder was allegedly below the standard of care.

In January 2012 the Chemical Dependency Professional Program granted the application of chemical dependency professional trainee Jina Marie Milius (CO60185460) and placed conditions against her certification. She was convicted of vehicular homicide, theft, and underage alcohol possession.

In December 2011 the Health Care Assistant Program ended the probation order against Laura Lena Miller (HC60068282, HC60151774).

In December 2011 the Dental Commission charged dentist Steven H. Nguyen (DE00008242) with unprofessional conduct. It’s alleged that he knowingly allowed an employee without a valid license to perform denturist and dental assistant duties.

In December 2011 the Nursing Assistant Program charged certified nursing assistant Krystal J. Shoulders (NC10100007) with unprofessional conduct. She allegedly took a patient’s debit card and purchased about $250 of groceries for her own use.

In December 2011 the Nursing Assistant Program ended the probation order against certified nursing assistant Maylee B. Vo (NC60156056).

Kitsap County

In December 2011 the Nursing Assistant Program charged registered nursing assistant Ashley Marie Rowland (NA60102636) with unprofessional conduct. She entered into a deferred prosecution for the charge of theft.

Lewis County

In December 2011 the Nursing Assistant Program denied the application of registered nursing assistant applicant Lisa J. Sipe (NA60255488). She was convicted of child molestation.

Mason County

In December 2011 the Chemical Dependency Program denied the application of chemical dependency professional trainee applicant Joseph Lee Schaeffer (CO60245631). He was convicted of methamphetamine possession, two counts of driving with a suspended license, two counts of domestic violence assault, attempting to elude police, and resisting arrest.

Pierce County

In December 2011 the Nursing Assistant Program charged registered nursing assistant Katie J. Byrd (NA60214486) with unprofessional conduct. Allegations include sleeping while caring for a patient, smoking marijuana with the patient, driving the patient while under the influence, and shoplifting. She also allegedly had the patient pawn jewelry so she could get a tattoo.

In December 2011 the Chemical Dependency Professional Program charged chemical dependency professional Terrance O. Jones (CP60044697) with unprofessional conduct. He was convicted of three counts of domestic violence assault, marijuana possession, and two counts of violating a no-contact order.

In January 2012 the Counselor Program ended the probation order against agency affiliated counselor and certified counselor Sabryna D. Klug (CG60165266, CL60165237).

In December 2011 the Nursing Commission placed licensed practical nurse Nancy L. Picou (LP00047746) on probation for five years. She allegedly received prescriptions for controlled substances for herself, filled them, and gave them to her husband.

Spokane County

In January 2012 the Certified Counselor Program granted the application of Michael Tyrone Deal (CL60246873) and placed conditions against his certificate. He was convicted of two counts of obstructing police, driving without a license, false statement, two counts of possessing stolen property, attempting to elude police, driving with a suspended license, and illegal drug conduct.

In January 2012 the Nursing Assistant Program granted the application of certified nursing assistant Julie Raeann Potts (NC10096507) and placed her certification on probation. She entered into a deferred sentence for an assault charge.

Thurston County

In January 2012 the Nursing Assistant Program reinstated the certification of James R. Pollard (NC10085152).

Yakima County

In January 2012 the Unlicensed Practice Program notified Randy Allan of its intent to issue a cease-and-desist order. He allegedly advertised and represented himself as an equine dentist without evidence that he is supervised by a licensed veterinarian.

In January 2012 the Chemical Dependency Professional Program granted the application of chemical dependency professional trainee Frances Salinas Gonzalez (CO60256819) and placed her certification on probation for three years. She was convicted of solicitation to obtain Vicodin by fraud, and driving under the influence. Her registered counselor credential was suspended for two years.

Out of State

Virginia: In December 2011 the Nursing Commission reinstated the license of registered nurse Brandon L. Bailey (RN00176831) and placed his license on expired status until he meets reactivation requirements.

 

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Map of Seattle

King County homicides lowest in ten years

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There were 59 homicides in King County last year, the lowest number in a decade, according to a report from the King County Medical Examiner released today.

The number deaths due to suicide, accidents and opioid overdoses also fell, the report says

Overall, 12,959 people died in the county last year.

Of those, 2,060 fell under the Medical Examiners jurisdiction, including suspicious, sudden, unexpected or violent deaths.

 Other findings in the report:

  • Traffic fatalities declined by nearly one-third over the past ten years, falling steadily from 220 in 2001 to 150 last year.
  • While accidental drug overdoses declined from 2009 to 2010, they still comprised more than a third of all accidental deaths.
  • Firearms were the most frequent instrument of death in homicides and suicides.

Opioid deaths down

There was a substantial decrease in the number of methadone and oxycodone deaths from 2009 to 2010.

  • Methadone was present in 77 deaths in 2010, compared to 129 in 2009, and was the primary cause of death in 67 of those deaths in 2010, compared to 85 in 2009.
  • Oxycodone was present in 77 deaths in 2010 compared to 105 deaths in 2009.

To learn more:

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