Recovery Michigan

While there are clear clinical indications for opioid use, concerns arise when they are prescribed or used improperly – for example, when multiple opioids are used at once, over a long period of time, at a high dosage, with inadequate clinical oversight, or in combination with benzodiazepines. Likelihood of misuse or addiction increases with longer use or intermittent use over an extended time period. Medicaid programs use a variety of indicators to identify individuals who are potentially misusing prescription opioids. So-called pharmacy shopping, in which an individual fills prescriptions for opioids at multiple pharmacies, can be considered a proxy for potential misuse. Other proxies are the number of unique prescribers of opioids for the same individual within a specified period of time (doctor shopping), or the number of overlapping opioid prescriptions.

These measures do not necessarily indicate misuse, but many states flag these instances for review. Our analysis found that seven out of 10 Medicaid enrollees with an opioid prescription had claims in one or two months during 2012. About half (48 percent) of prescriptions were for short-term use with a day supply of two weeks or less. About one-third of opioid prescriptions were for a month’s supply (22-31 days). Nearly 300,000 enrollees had prescriptions for 12 months. Some individuals with chronic pain may receive prescriptions for a longer period of time, and could thus count towards that number. Of the 6.9 million enrollees with opioid prescriptions in 2012, about 5 percent received prescriptions from five or more prescribers and about 2 percent filled them at five or more pharmacies. About 1 percent of Medicaid opioid users received prescriptions from five or more prescribers and filled prescriptions at five or more pharmacies during the year.

A new study shows that young people experiencing first episode psychosis have a much higher death rate than previously thought. Researchers analyzed data on approximately 5,000 individuals aged 16-30 with commercial health insurance who had received a new psychosis diagnosis, and followed them for the next 12 months. They found that the group had a mortality rate at least 24 times greater than the same age group in the general population, in the 12 months after the initial psychosis diagnosis. This study, funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health, underscores that young people experiencing psychosis warrant intensive and proactive treatments, services and supports.

The 12-month mortality rate for these young people - from any cause - was at least 24 times higher than their peers in the general population. In the general United States population, only individuals over age 70 come close to a similar 12-month mortality rate.

In addition to mortality, the study examined the health care individuals received in the 12 months after the initial psychosis diagnosis. Those data showed that young people with a new psychosis diagnosis had surprisingly low rates of medical oversight and only modest involvement with psychosocial treatment providers. Overall, 61 percent of them did not receive any antipsychotic medications, and 41 percent did not receive any psychotherapy. Those who died within 12 months of diagnosis received even less outpatient treatment and relied more heavily on hospital and emergency care.

After the body of 14-year-old Tina Fontaine was found in Winnipeg’s Red River in 2014, members of the community took action. At Vice, Geraldine Malone reports on the Bear Clan Patrol, a grassroots group that formed in Winnipeg’s North End neighborhood to walk the streets at night. Nearly three years later, over 530 volunteers act as “boots on the ground,” focusing on harm reduction by handing out condoms, offering rides, diffusing violent confrontations, preventing opioid overdoses by administering naloxone, and protecting the vulnerable to “get that village feel back,” as co-founder James Favel says. They’re “Trying to inspire people to care more about one another.”

Gathering in the small centre before patrol all of the volunteers grab their necessary gear: the bright yellow vests, plastic gloves and containers to store used needles they find on the street. There’s also bags of apples this night. A volunteer named Bob bought them and everyone fills their pockets with the fruit, a hot commodity on the streets, especially with kids. Sometimes they also have candy to hand out, the volunteers laugh that it’s a favourite of the kids.

One kid runs up with an envelope and whispers to a volunteer, “there are needles inside.” It’s taken some time for the Bear Clan to build this kind of trust. Favel says at first when they started people assumed it would be like most social efforts in this neighbourhood—here one day and then gone the next. Good intentions with little follow through is something they know all too well.

Last fall they were in this same housing complex when a woman came outside screaming, Favel says. Two people had been drinking and got into a fight that escalated quickly when one of them brought out a machete. A guy had his fingers almost completely chopped off.

The Bear Clan Patrol have first-aid training and responded quickly, treating the severed fingers and calling for paramedics. It was because of that response the guy ended up keeping mobile fingers, Favel says.

Last November, many of the Bear Clan Patrol members were trained to administer naloxone, an overdose-reversing drug. Members carry the naloxone kits on patrol but they also work with paramedics if they come across someone who may be overdosing.

But perhaps the best name for this trope (for this lifestyle, really) is the Sexy Tragic Muse, which Anne Theriault described beautifully in this 2015 essay.

She’s damaged, often as a result of sexual assault or other abuse by men. Her life carries with it some kind of Deep Lesson, usually a lesson that a male protagonist needs to learn…The Sexy Tragic Muse fetishizes women’s pain by portraying debilitating mental health disorders filtered dreamily through the male gaze. The trope glamourizes addiction and illnesses like depression, bipolar disorder, and schizophrenia — diseases that are distinctly unglamorous for those of us who live with them. The Sexy Tragic Muse is vulnerable, and her vulnerability is sexualized. Her inability to properly care for herself or make decisions on her own behalf is presented as being part of her appeal.

And she was exactly who, in my teens and early 20s, I thought I wanted to be. And that has made it, as I approach 30, all the more difficult to get better.

When you’ve spent most of your life identifying with and even clinging to the worst of you, the most painful, it makes being well and healthy feel an awful lot like giving up.

At M.I.T.’s Media Lab, the digital futurist playground, David Rose is investigating swaddling, bedtime stories and hammocks, as well as lavender oil and cocoons. Mr. Rose, a researcher, an inventor-entrepreneur and the author of “Enchanted Objects: Design, Human Desire and the Internet of Things,” and his colleagues have been road-testing weighted blankets to induce a swaddling sensation and listening to recordings of Icelandic fairy tales — all research into an ideal sleep environment that may culminate in a nap pod, or, as he said, “some new furniture form.”

“For me, it’s a swinging bed on a screened porch in northwestern Wisconsin,” he said. “You can hear the loons and the wind through the fir trees, and there’s the weight of 10 blankets on top of me because it’s a cold night. We’re trying a bunch of interventions.”

Meanwhile, at the University of California, Berkeley, Matthew P. Walker, a professor of neuroscience and psychology and the director of the Sleep and Neuroimaging Laboratory there, is working on direct current stimulation as a cure for sleeplessness in the aging brain. Dr. Walker is also sifting through the millions of hours of human sleep data he has received from Sense, a delicately lovely polycarbonate globe designed to look like the National Stadium in Beijing that measures air quality and other intangibles in your bedroom, then suggests tweaks to help you sleep better.

“I’ve got a mission,” he said. “I want to reunite humanity with the sleep it is so bereft of.” Sense is the first product made by Hello Inc., a technology company started by James Proud, a British entrepreneur, for which Dr. Walker is the chief scientist.

According to the US Department of Labor’s Bureau of Labor Statistics, there are just over 550k mental health workers whose primary focus is the treatment and/or diagnosis of mental health or substance abuse concerns.

That’s exciting to me. I am glad to be reminded that there are people out there caring about this population and pursuing their career in this field. Along with that, about 1 in 5 Americans suffer from mental illness in a given year. Let me say that again — About 20% of people will suffer from something like depression, bipolar, or some other mental disorder this next year.

When I read stats like that, I’m astounded. I don’t think people realize how prevalent mental illness is today. There are so many other statistics I could go over that might blow your mind.

Some would include rates like the 26% of homeless adults staying in shelters who suffer from a severe mental illness. Or how about mood disorders like depression or bipolar being the third highest cause of hospitalization in the U.S. for people aged 18–44. Poverty is another close link to mental illness that only perpetuates the stigma attached to these individuals.

The number of retirement-age Americans taking at least three psychiatric drugs more than doubled between 2004 and 2013, even though almost half of them had no mental health diagnosis on record, researchers reported on Monday.

The new report captures one important dimension, the rise in so-called polypharmacy — three drugs or more — in primary care, where most of the prescribing happens. Earlier research has found that elderly people are more likely to be on at least one psychiatric drug long term than younger adults, even though the incidence of most mental disorders declines later in life.

“The biggest jump was in rural areas,” Dr. Olfson said, “which suggests to me that the increases partly reflect doctors and patients falling back on medications when they have little access to other options,” like talk therapy, massage or relaxation techniques.

Federal health officials recently issued a strong warning to consumers about the risks of combining sedating drugs, like Xanax or Valium, with pain medications like opiates. But the analysis found that people taking opiates were about as likely to be on at least two other drugs as those not taking the strong painkillers.

Patients with ulcerative colitis, a chronic inflammatory bowel disease, often relapse at times of stress. In a clinical trial of 77 ulcerative colitis patients who were in clinical remission but were experiencing reduced quality of life, those assigned to 12 supervised 90-minute weekly sessions of yoga had a greater increase in quality of life and reduced activity of their colitis compared with those who were given written self-care advice.

The findings suggest that regular yoga may be a valuable adjunct to conventional medical therapies for ulcerative colitis.

"Many people use yoga to increase their quality of life. Our study suggests that it might be worthwhile to consider yoga as part of a multimodal integrative approach for treating ulcerative colitis," said Prof. Holger Cramer, lead author of the Alimentary Pharmacology & Therapeutics study.

In a clinical trial conducted among adults in 11 hospitals, researchers have shown that a hand-held EEG device approved in 2016 by the U.S. Food and Drug Administration that is commercially available can quickly and with 97 percent accuracy rule out whether a person with a head injury likely has brain bleeding and needs further evaluation and treatment.

In a report on their clinical trial, described online March 31 in Academic Emergency Medicine, the researchers say the new device — which measures electrical activity in the brain and then uses an algorithm to decide if a patient is likely to have brain bleeding — can help with clinical decision-making and triage of patients, and could reduce the need for CT scans.

“Before our study, there were no objective, quantitative measures of mild head injury other than imaging,” says lead investigator Daniel Hanley Jr., M.D., the Legum Professor of Neurological Medicine and director of the Brain Injury Outcomes Program at the Johns Hopkins University School of Medicine. “This work opens up the possibility of diagnosing head injury in a very early and precise way.

“This technology is not meant to replace the CT scan in patients with mild head injury, but it provides the clinician with additional information to facilitate routine clinical decision-making,” says Hanley. “If someone with a mild head injury was evaluated on the sports or battlefield, then this test could assist in the decision of whether or not he or she needs rapid transport to the hospital. Alternatively, if there is an accident with many people injured, medical personnel could use the device to triage which patients would need to have CT scans and who should go first. Those showing a ‘positive’ for brain injury would go first.”