Category Archives: Alcoholism

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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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.

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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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.

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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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