Monday, February 14, 2005

Ambulatory Detoxification of Patients with Alcohol Dependence Article in American Family Physician - "The lifetime prevalence of alcohol problems is thought to be between 13.7 and 23.5 percent, indicating that these problems are common in ambulatory patients. Family physicians play an important role in identifying these patients and intervening to the degree appropriate for the severity of disease and the patient's willingness to change. Patients who have alcohol dependence may require detoxification to prevent alcohol withdrawal syndrome (AWS). When clinically appropriate, detoxification can be initiated in the ambulatory setting. Most ambulatory patients with alcohol dependence can be detoxified quickly and safely without the use of psychoactive drugs."  
  

Aripiprazole Use in Children and Adolescents Article from Pediatric Pharmacotherapy at Medscape - "On November 15, 2002, the newest of the atypical antipsychotics, aripiprazole, was approved by the Food and Drug Administration (FDA) for the treatment of schizophrenia. It has subsequently been approved for use in the treatment of bipolar mania as well. This agent has been shown to be similar in efficacy to traditional antipsychotics as well as other atypical antipsychotics, but offers an improved adverse effect profile. There is growing interest in the use of aripiprazole in children with schizophrenia, schizoaffective disorder, and conduct disorders..." [Viewing Medscape resources requires registration, which is free].  
  

State Data on Alcohol, Tobacco, and Illegal Drug Use  Page at the SAMHSA/OAS web site that has links to a variety of resources. As noted in an email from SAMHSA, " SAMHSA's Office of Applied Studies (OAS) has just released the following State report on the web, based on SAMHSA's National Survey on Drug Use & Health (NSDUH). It provides State level data for substance use and serious mental illness and is filled with maps and tables. Data from the 2002 and 2003 NSDUH were pooled to get more stable estimates for each State and DC. Also below is the direct link for some State cocaine treatment data." See, especially, State Estimates of Substance Use From the 2002-2003 National Surveys on Drug Use & Health. "To find data on a specific topic," notes the email, "go to SAMHSA's Office of Applied Studies' topics website at http://www.oas.samhsa.gov/topics.cfm. You can always get to the topics website by clicking on 'Topics' on the OAS banner at the top of most OAS web pages. You can also get data on specific drugs by clicking on 'Drugs' on the OAS banner. You can get to the treatment topics at the Topics page or by clicking on 'Treatment' on the footer of most OAS web pages."  
  

NIH Chief Calls for Ethics Summit Los Angeles Times story - "The director of the National Institutes of Health — describing consulting payments from drug companies as a "systemic problem" that threatened the integrity of his agency — has called for a summit of government and academic leaders to address conflicts of interest throughout American medical research. Dr. Elias A. Zerhouni last week banned all of his agency's scientists from accepting consulting fees, stock or any other compensation from the biomedical industry. He also instructed the scientists to divest stock holdings in any biomedical company. The reforms, Zerhouni said in an interview, will put the NIH ahead of universities and private physicians in battling conflicts of interest." [Viewing Los Angeles Times stories requires registration, which is free].  
  

Social Isolation, Guns and a 'Culture of Suicide' New York Times story - "...suicides occur at a higher rate in rural areas than in cities or suburbs, with the rate rising steadily the more rural the community. With homicides, the trend works in reverse, with higher rates in more urban areas. Researchers have long known the statistics, but new research illuminates the substantial role of firearms in suicide. When Professor Branas examined data from the federal Centers for Disease Control and Prevention, he found that the risk of dying by gunshot was the same in rural and urban areas from 1989 to 1999, findings that were published in The American Journal of Public Health. ... Suicide risk factors like depression, economic worries and alcohol use are, of course, prevalent in urban areas, said Dr. Alex Crosby, an epidemiologist in the National Center for Injury Prevention and Control at the Centers for Disease Control. But they are heightened in rural areas by social isolation, lack of mental health care and the easy availability of guns. " [Viewing New York Times resources requires registration, which is free].  
  

Therapists Question Canada's Action on Hyperactivity Drug New York Times story - "Psychiatrists said yesterday that they were as confused as they were concerned by the news that Canadian regulators had suspended the use of a commonly prescribed hyperactivity drug amid reports of deaths linked to its use. 'The news just threw a curveball into our efforts to advise doctors on how to treat attention deficit disorders in kids,' said Dr. Oscar Bukstein, an associate professor of psychiatry at the University of Pittsburgh School of Medicine. 'I think everyone in the field is going to be more fastidious in how they screen children for potential heart or other problems' before prescribing drugs, said Dr. Bukstein, who is helping the American Academy of Child and Adolescent Psychiatry write treatment guidelines for the attention disorder. Canadian health officials said on Wednesday that they were suspending the sale of Adderall XR indefinitely because the drug was linked to 20 deaths, 12 of those children..." [Viewing New York Times resources requires registration, which is free].  
  

DHS Says It Will Guard Mental Health Records (Iowa) Brief WCCI story - "The Department of Human Services said it will tightly guard personal information on thousands of mental health patients. The agency wants to collect names, addresses, and other information on about 50,000 patients who receive mental health care paid for by the government. The agency said it needs the data to improve services, but patient advocates said it may jeopardize people's privacy..."  
  

Medicaid proposal worries health workers (Florida) Daytona Beach News-Journal story - "Mental health advocates are worried a proposal by Gov. Jeb Bush to limit which prescription drugs people on Medicaid can receive will cause people like Henderson to not get the proper drugs and wind up in hospitals, jails or homeless. 'It's bad medicine and bad economics and a bad policy to be proposing,' said Bob Sharpe, president of the Florida Council for Community Mental Health and the state's former Medicaid director. Bush and the state Agency for Health Care Administration are asking the Legislature to approve the plan, expected to save $292 million, because drug spending is the fastest growing part of the Medicaid budget, agency officials say."  
  

Mental health story needs clarification (Maine)Letter to the editor of the Morning Sentinel by a professor and senior research associate Institute for Health Policy Muskie School of Public Service University of Southern Maine - "I am responding to the article "Study shines light on mental health costs" (Jan. 25) to clarify some points it made. My co-authors, David Lambert and Stuart Bratesman, and I found that, from 1996 to 2002, for all MaineCare members, spending on behavioral health care services increased much more rapidly -- 163 percent -- than spending on medical services, which rose 112 percent, or spending on long-term care such as nursing home or home health care, which rose 6 percent. ... The greater cost increase for behavioral compared to medical or long-term care services was a result of more members diagnosed with behavioral conditions and more spent per month on their services. Many changes contribute to this, including greater awareness of mental- health problems, expanded programs for children with behavioral conditions, access to more effective treatments and medications, and a shift by the state of coverage onto Medicaid to increase access to federal funds. These increases are dramatic and warrant careful consideration..."  
  

'Urgent steps' needed at prison mental health unit (Iowa) Des Moines Register story - " 'Urgent and decisive steps' are needed immediately to address many problems in treating prisoners at a Fort Madison penitentiary mental health unit where four inmates have committed suicide, according to a consultant's report released today. Thomas White, a consultant for the National Institute of Corrections, said the Clinical Care Unit at the Iowa State Penitentiary is 'currently incapable of providing the level and quality of mental health treatment that should be provided to severely mentally ill offenders.' White said it appeared clear to him that there is virtually no professional therapy being provided to the 150 mentally ill inmates who reside in the Clinical Care Unit, despite the existence of individual treatment plans."