Recovery Michigan

The VA National Center on Homelessness among Veterans is pleased to announce the release of the Housing Navigator Toolkit. This Toolkit is designed to provide housing navigators, program managers, administrators, staff, and other key stakeholders working to end Veteran homelessness with a number of resources, tools, and ideas which can be used to help develop or refine local navigator programming.  The information contained in this toolkit is intended to assist with the integration of navigator programs into existing systems of care.  This toolkit can also be used to provide context for other provider staff (e.g., case managers, peer support specialists, healthcare providers, local government agencies), who will likely collaborate with navigators to help homeless Veterans overcome barriers to housing and engage in needed treatment services.  Moreover, this toolkit will become a “living” document that will be enhanced regularly to provide additional education and training for both VA and non-VA partners through the VA National Center on Homelessness among Veterans. 

While this Toolkit has been tailored for policy makers and program managers at the federal, state, and local levels, the information contained herein is relevant to all stakeholders engaged in ending homelessness.  If you have any questions regarding this document please contact Dr. Roger Casey at  Roger.Casey@va.gov.

SBIRT is beginning its implementation in Michigan....

As a result of strong consumer advocacy, Massachusetts is now the first state in the nation to take the sensible step of verbally screening all middle and high school students for drug and alcohol problems. Governor Charlie Baker recently signed into law a landmark bill on the opioid epidemic that includes the school screening requirement. Other states across the country would be wise to follow suit. Our young people need the protection of this public health approach that focuses on preventing addiction before it starts.

Ninety percent of people who develop an addiction to drugs or alcohol started using in their teens. The new law, called the Substance Abuse Treatment, Education, and Prevention (STEP) Act, requires school nurses to screen all students in two grades using a validated questionnaire and follow-up. The specific grades in middle and high school will be decided by each school district. By conducting open, non-judgmental conversations with students, school nurses will encourage healthy choices and provide supportive, factual information. If needed, young people will be referred for additional counseling.  

The law takes statewide an effective strategy for screening and early intervention that Massachusetts piloted from 2013-2015 with over 3,000 public school students in grades 7-9. About 10 percent of those screened received brief counseling because they reported using alcohol or drugs, and 3 percent were referred to treatment. School nurses in the seven pilot school districts continue to have conversations with students every day about substance use. In the past year, over 100 school districts have requested training and support from the state to begin verbal screening of middle and high school students.

For over a year, I’ve been documenting the lives of three long-term drug users – Marie, Cheryl and Johnny – who are participating in Vancouver’s heroin-assisted clinical study and program.

In recent years, heroin use in North America has exploded into an “epidemic.” At the same time, policymakers and the public have clashed over how to properly treat this public health scourge. Many heroin users receive methadone and other forms of treatment. However, some of the most vulnerable addicts haven’t responded to medication and detox.

I spent weeks building a rapport and trust with Marie, Cheryl and Johnny, who’ve all been addicted to heroin for years. They’ve each repeatedly tried detox and methadone and have been unable to stop using heroin.

In a sense, heroin-assisted treatment, a science-based, compassionate approach, is their last resort.

Those involved in the program – often users who haven’t sufficiently responded to other forms of treatment – receive pharmacological heroin in a clinical setting. While these programs have long been recognized as scientifically sound and cost-saving in countries like Switzerland, the Netherlands and Denmark, heroin-assisted treatment is only beginning to be offered in North America.

Some soldiers find themselves fighting a completely different battle when they return to civilian life — dealing with post-traumatic stress.

That’s why Rep. Ron DeSantis (R-Fla.) has introduced the Puppies Assisting Wounded Servicemembers Act. The bill, cleverly called PAWS, would be a $10 million pilot program that would pair post-9/11 veterans with severe PTSD with service dogs, according to a press release.

“The threat to our service members does not end when they return home, as evidenced by the tragic rates of veteran suicides,” DeSantis wrote in a guest column for The Florida Times-Union.‎ “We must make sure that all veterans are honored and taken care of.”

Cole Lyle, a Marine who served overseas for six years, and his service dog, Kaya, inspired the bill. According to DeSantis’ column in The Florida Times Union, when Lyle returned home from Afghanistan in 2011, he had a post-deployment health assessment. It indicated that Lyle was suffering from depression, post-traumatic stress and anxiety. He was prescribed medication, but he didn’t feel like it was helping.

“In fact, I thought they were exacerbating my symptoms,” Lyle told Fox and Friends.

After two of his friends who also has PTSD killed themselves, he decided to quit his medication cold turkey after a year and a half of treatment.

Core symptoms of anorexia nervosa, including the urge to restrict food intake and feeling fat, are reduced after just one session of a non-invasive brain stimulation technique, according to King's College London research published today inPLOS ONE.

This new study is the first randomised control trial to assess whether repetitive transcranial stimulation (rTMS), already an approved treatment for depression, is also effective in reducing symptoms of anorexia.

Up to 20 per cent of people with anorexia die prematurely from the disorder and treatments in adults are moderately effective, with only 20-30 per cent of people recovering from the best available talking therapies.

Given the urgent need to improve treatments, researchers are increasingly looking towards emerging neuroscience-based technologies that could target the underlying neural basis of anorexia.

'We found that one session of rTMS reduced the urge to restrict food intake, levels of feeling full and levels of feeling fat, as well as encouraging more prudent decision-making. Taken together, these findings suggest that brain stimulation may reduce symptoms of anorexia by improving cognitive control over compulsive features of the disorder.'

The weight gain that can result from quitting smoking does not eliminate the reduction in cardiovascular risks associated with smoking cessation among patients with serious mental illness, at least not during the first year. A report from a Massachusetts General Hospital (MGH)-based research team, being published online in the Journal of Clinical Psychiatry, describes the results of a one-year trial but cannot rule out future health risks associated with continuing weight gain.

"These findings highlight the importance of smoking cessation among this vulnerable population," says Anne Thorndike, MD, MPH, of the MGH Department of Medicine, lead and corresponding author of the report. "But they also indicate that continued weight gain associated with tobacco cessation is likely to contribute to a rise in the already high rates of obesity,diabetes and hypertension among people with serious mental illness."

An increased risk of cardiovascular disease is a primary cause of the greatly reduced life expectancy - up to 25 years less than the general population - among those with serious mental illness. Both obesity and smoking are at least twice as high among adults with mental illness, and other risk factors such as hypertension, diabetes and elevated cholesterol levels are also more common. While a 2013 study led by another MGH research team found that the health benefits of quitting smoking were not eliminated by resultant weight gain, participants in that study did not have mental illness, were not obese and had low levels of other risk factors prior to smoking cessation. The authors of the current study also note that most smoking cessation trials have excluded patients with serious mental illness, leaving open the question of whether they would share the benefits seen in the general population.

Real Stories by Real People. Interesting approach.

Intermittent explosive disorder (IED) has been defined as "recurrent, impulsive, problematic outbursts of verbal or physical aggression that are disproportionate to the situations that trigger them."

Up to 16 million Americans are thought to have IED, more than the total number for bipolar disorder and schizophrenia combined.

Toxoplasmosis is a common and generally harmless parasitic infection that is passed on through the feces of infected cats, contaminated water or undercooked meat.

It affects around 30% of all humans but is normally latent.

Research has revealed that the parasite is found in brain tissue, and it has been linked to a number of psychiatric conditions, including schizophrenia, bipolar disorder and suicidal behavior.

Researchers from the University of Chicago, led by Dr. Emil Coccaro, have been looking for more effective ways to diagnose and treat IED and impulsive aggression.

Findings showed that 22% of those with IED tested positive for toxoplasmosis exposure, compared with 9% of the healthy control group and 16% of the psychiatric control group.

The psychiatric group and the healthy group had similar scores for aggression and impulsivity, but the group with IED scored far higher on both counts than either of the other two groups.

An association emerged between toxoplasmosis and impulsivity. However, when the team adjusted for aggression scores, this association became non-significant, indicating a strong correlation between toxoplasmosis and aggression.