Recovery Michigan

Young males between the ages of 10 and 24 have committed suicide in growing numbers as a direct result of austerity measures brought in across Europe following the 2009 recession.

According to new research from the University of Portsmouth and Webster Vienna University, more males of all ages are committing suicide in the Eurozone's poorest countries.

The researchers, Dr Nikolaos Antonakakis and Professor Alan Collins, are urging policy makers to put European citizens' health before wealth as a matter of urgency.

The research is the first to examine the direct impact of fiscal austerity on suicide rates in the group of countries most affected by the Eurozone crisis - Greece, Ireland, Italy, Portugal and Spain.

Patients taking benzodiazepines to treat psychiatric conditions should consider transitioning to other therapies because of heightened risks for dementia and death, according to clinicians from the American College of Osteopathic Neurologists and Psychiatrists.

Benzodiazepines include branded prescription drugs like Valium, Ativan, Klonopin and Xanax. This class of drug received FDA approval in the 1960s and was believed to be a safer alternative to barbiturates.

Despite new psychiatric protocols, some physicians continue to prescribe benzodiazepines as a primary treatment for insomnia, anxiety, post-traumatic stress disorder, obsessive compulsive disorder and other ailments. A growing body of research indicates this practice could greatly increase patients' risk of dementia and Alzheimer's disease, according to Helene Alphonso, DO, Director of Osteopathic Medical Education at North Texas University Health Science Center.

"Current research is extremely clear and physicians need to partner with their patients to move them into therapies, like anti-depressants, that are proven to be safer and more effective," said Dr. Alphonso, a board-certified psychiatrist practicing in Fort Worth. "Due to a shortage of mental health professionals in rural and underserved areas, we see primary care physicians using this class of drugs to give relief to their patients with psychiatric symptoms. While compassionate, it's important to understand that a better long-term strategy is needed."

Last October, just before Halloween, a “mass-casualty event” befell the emergency department at Lansing’s Sparrow Hospital. Staff put incoming patients in every bed, gurney and wheelchair that could be found. A hallway was turned into a ward, patients lined head-to-toe against the walls, a nurse assigned to move up and down the line, checking airways to ensure none were in imminent danger.

Over 200 patients bombarded the ER in a three-hour period, pushing it into Code Yellow status, meaning only heart attack and stroke patients could add to the caseload.

It wasn’t a plane crash or mile-long pileup on I-96 that fueled this emergency, but the annual football rivalry between the University of Michigan Wolverines and the Michigan State University Spartans. The patients, to a man and woman, were drunk; so drunk they needed medical attention to ensure they didn’t die.

The overserved can overwhelm hospitals during football season in Michigan’s legendary college football towns, taking staff attention away from broken limbs and tender appendixes.

For the Michigan home opener Sept. 12, 22 patients with alcohol-related health conditions were seen in the department at the University of Michigan Health System.

Dr. Jeffrey Desmond, interim chief medical officer at U-M’s hospital, likes to say that, unlike most football fans, he yearns for unpleasant conditions on days when the Big House is roaring: “I hope for not-very-exciting games, held early, and in bad weather. It makes a huge difference for the emergency department.”

The targeted modulation of gene activity and cellular signaling pathways could provide a new approach to the treatment of fear and anxiety states according to the recent findings of a project sponsored by the Austrian Science Fund FWF.

Fear extinction is a classical method used in anxiety therapy: memories of negative - anxiety-producing - experiences can be "overwritten" by new learning involving positive (safe) associations. If you have ever been bitten by a dog, you are bound to be afraid of dogs. But if you subsequently have repeated encounters with dogs with no ill effects, the fear will fade. As simple as this method sounds and as effective as it may be, it does not work equally well for everyone. In an FWF project entitled "Epigenetic Mechanisms of Disturbed Memory Regulation" within the Special Research Programme (SFB) of "Cell Signaling in Chronic CNS Disorders", Nicolas Singewald set out to find out why that is so and how extinction can be boosted.

There are, undoubtedly, many subtypes of the illness depression and the current clinical definition includes a list of mental and physical symptoms, some of which are severe—sleep disorder, lack of interest in usual activities, excessive guilt and rumination, lack of energy and fatigue, lack of concentration, change in appetite with weight loss or gain, a change in the level of movement either with agitation and retardation and suicidal ideation. Other important symptoms include pain and generally feeling lousy for long periods.

With such a long list of possible symptoms, there are many subtypes which include some of these symptoms, but not all. With eight discrete symptoms in the definition, there are hundreds of possible variants, but less in clinical experience. It is striking that many of these symptoms occur, also, with medical illness and infections—the “sick feeling” described in previous posts triggered by T cells. Also, a self-limiting form occurs naturally with grief.

Recent research shows that one particular subtype of depression—perhaps as much as a third to a half of cases—is closely related to the occurrence of inflammation, and it is possible that this group might respond to different kinds of treatment than the others.

Those people who have significant amounts of inflammation have the strongest responses to treatments that fight inflammation such as omega-3, celecoxib, and exercise, as well as medications that counteract the effects of cytokines. Those patients that have both inflammation and depression appear to need treatment for both. - See more at: http://jonlieffmd.com/blog/reciprocal-relationship-of-depression-and-inflammation#sthash.csCMdriQ.dpuf

These included restricting access to suicide hotspots (through measures such as the installation of barriers or safety nets), encouraging help-seeking at suicide hotspots (such as the placement of telephones that link to suicide helplines) and increasing the chances of a third-party intervention (such as installing CCTV or introducing suicide patrols).

Overall, the team found that all three interventions led to a significant drop in suicide deaths at high-risk locations, reducing from an average of 5.8 suicide deaths annually (863 suicides over 150 study years) prior to the interventions being introduced to around 2.4 suicide deaths annually (211 suicides over 88 study years) after.

When combined with other interventions, the researchers found that restricting access to suicide hotspots led to a 91% annual reduction in suicide rates at high-risk locations, while a 93% yearly reduction in suicide rates was found when this intervention was used alone.

These drugs became more readily available to patients in the late 1990s, and prescription rates nearly doubled between 1998 and 2013. This epidemic is the unintended consequence of policy and practice that was supposed to benefit patients and keep them safe. A solution to this kind of systemic problem that affects the health, social, and economic welfare of society requires a large-scale, comprehensive course of action. The health care delivery system is ground zero. This article describes how Kaiser Permanente, one of the nation’s largest not-for-profit health plans, is working to reduce opioid abuse among its more than 10 million members, and offers insight for the health care system as a whole.

Misinformation about the use of opioids for chronic, non-cancer pain was a key driver of widespread overuse and abuse in the U.S. Kaiser Permanente physicians developed up-to-date evidence-based treatment guidelines for the proper use of these medications. Guidelines include:

• Focusing on alternatives to opioid therapy as a first-line treatment for chronic, non-cancer pain;
• Providing non-drug treatment options (such as meditation, guided imagery, and Tai Chi);
• Treating patients with the lowest dose of opioids possible, for the shortest duration necessary (in general, less than a 100 mg morphine equivalent dose per day, with no more than a 30-day supply at a time);
• Monitoring patients at risk for opioid abuse via questionnaires, urine drug tests, and prescription history on state prescription drug monitoring databases;
• Recognizing “red flag” behaviors that suggest dependence, misuse, or abuse (such as the need for escalating dosages, requesting refills before they are due, or requesting name-brand drugs, which carry a high “street” resale value); and,
• Using documentation tools to ensure communication and collaboration within and across specialties.

Mr. Bojorquez, 27, served in one of the hardest hit military units in Afghanistan, the Second Battalion, Seventh Marine Regiment. In 2008, the 2/7 deployed to a wild swath of Helmand Province. Well beyond reliable supply lines, the battalion regularly ran low on water and ammunition while coming under fire almost daily. During eight months of combat, the unit killed hundreds of enemy fighters and suffered more casualties than any other Marine battalion that year.

When its members returned, most left the military and melted back into the civilian landscape. They had families and played softball, taught high school and attended Ivy League universities. But many also struggled, unable to find solace. And for some, the agonies of war never ended.

Almost seven years after the deployment, suicide is spreading through the old unit like a virus. Of about 1,200 Marines who deployed with the 2/7 in 2008, at least 13 have killed themselves, two while on active duty, the rest after they left the military. The resulting suicide rate for the group is nearly four times the rate for young male veterans as a whole and 14 times that for all Americans.

Adolescents -- youths between 12 and 17 -- in rural communities are 35 percent more likely to have abused prescription painkillers in the past year than adolescents living in large cities. Adolescents who live in small cities have a 21 percent greater likelihood of abusing prescription painkillers than their large urban counterparts.

"Over 1.3 million adolescents abused prescription opioids within the last year," said Shannon Monnat, assistant professor of rural sociology, demography, and sociology, Penn State. "With this number of adolescents there are major implications for increased treatment demand, risk of overdose and even death from these opioids."

Females are more likely to abuse prescription painkillers than males, according to the researchers.

The painkillers that adolescents tend to abuse include OxyContin, oxycodone, Percocet and other morphine-based drugs.

The researchers suggest there are several reasons for this spread of opioid abuse in rural communities, including an increasing number of painkiller prescriptions written for adolescents, as well as the limited types of medical care available in rural areas.