Tagged Mental Health

PTSD Isn’t Limited To Combat Soldiers: Parents Of Sick Kids Often Have All The Same Symptoms Yet Go Overlooked

Historically, psychiatrists didn’t consider medical diseases traumatic events, but parents of sick children can often have PTSD symptoms such as reliving the experience, avoiding reminders of the event or condition, feeling numb or detached from others, anxiety, difficulty concentrating and being constantly on the lookout for danger. In other public health news: a depression treatment, genetic testing, heart health, women’s safety and healthy diets.

When Background Checks Fail, Job Of Taking Guns From People Who Aren’t Supposed To Have Them Falls To An Understaffed ATF

Even though background checks are required to purchase guns, the overtaxed system doesn’t always work in a timely fashion. More weapons are getting into the hands of dangerous people, The Wall Street Journal reports. Then, understaffed federal and state agencies struggle with how to take away those guns. In other news on gun control efforts, some companies are installing gunshot detectors.

What Role Should Big Social Media Companies Play In Public Health Issues?

The recent attempts from social media companies to limit antivaccination posts highlights both the struggles of trying to monitor such content and the impact the tech leaders can have on the national conversation. In other health and technology news: the limits of artificial intelligence, exposure of personal health information, and a mental health app that can help with loneliness.

When Being Tied Down To Kidney Dialysis Is Unappealing, An Alternative Option Few Are Told About Can Help Older Patients

More than 200,000 patients age 65 and older receive dialysis and are often told they’d die without it, yet few are informed about a conservative option that helps manage the disease. Public health news also looks at spanking; gay Catholic priests; CBD oil; a CRISPR patent; unsafe radiation exposure; presidents’ public speech patterns; new Ebola treatments and more.

Ambivalence Over Motherhood Could Reshape Practices Around Family Planning

New data from a CDC survey finds that in up to 19 percent of pregnancies, women are unsure if they want to be pregnant, a state of mind doctors need to be in tune with when counseling them, researchers say. Public health news looks at AIDS death rates in the South; depression’s harmful role in aging brains; looking for treatments in moss piglets and a reason to get off the couch this weekend, as well.

Discharged, Dismissed: ERs Often Miss Chance To Set Overdose Survivors On ‘Better Path’

The last time heroin landed Marissa Angerer in a Midland, Texas, emergency room — naked and unconscious — was May 2016. But that wasn’t her first drug-related interaction with the health system. Doctors had treated her a number of times before, either for alcohol poisoning or for ailments related to heavy drug use. Though her immediate, acute health issues were addressed in each episode, doctors and nurses never dealt with her underlying illness: addiction.

Angerer, now 36 and in recovery, had been battling substance use disorder since she started drinking alcohol at age 16. She moved onto prescription pain medication after she broke her ankle and then eventually to street opiates like heroin and fentanyl.

Just two months before that 2016 overdose, doctors replaced an infected heart valve, a byproduct of her drug use. She was discharged from the hospital and began using again the next day, leading to a reinfection that ultimately cost her all 10 toes and eight fingers.

“[The hospital] didn’t have any programs or anything to go to,” Angerer said. “It’s nobody’s fault but my own, but it definitely would have been helpful if I didn’t get brushed off.”

This scenario plays out in emergency departments across the country, where the next step — a means to divert addicted patients into treatment — remains elusive, creating a missed opportunity in the health system.

A recent study of Medicaid claims in West Virginia, which has an opioid overdose rate more than three times the national average and the highest death rate from drug overdoses in the country, documented this disconnect.

Researchers analyzed claims for 301 people who had nonfatal overdoses in 2014 and 2015. By examining hospital codes for opioid poisoning, researchers followed the patients’ treatment, seeing if they were billed in the following months for mental health visits, opioid counseling visits or prescriptions for psychiatric and substance abuse medications.

They found that fewer than 10 percent of people in the study received, per month, medications like naltrexone or buprenorphine to treat their substance use disorder. (Methadone is another option to treat substance use, but it isn’t covered by West Virginia Medicaid and wasn’t included in the study.) In the month of the overdose, about 15 percent received mental health counseling. However, on average, in the year after the overdose, that number fell to fewer than 10 percent per month.

“We expected more … especially given the national news about opioid abuse,” said Neel Koyawala, a second-year medical student at Johns Hopkins School of Medicine in Baltimore, and the lead author on the study, which was published last month in the Journal of General Internal Medicine.

It’s an opportunity that’s being missed in emergency rooms everywhere, said Andrew Kolodny, the co-director of Opioid Policy Research at the Heller School for Social Policy and Management at Brandeis University outside Boston.

“There’s a lot of evidence that we’re failing to take advantage of this low-hanging fruit with individuals who have experienced a nonfatal overdose,” Kolodny said. “We should be focusing resources on that population. We should be doing everything we can to get them plugged into treatment.”

He compared it to someone who came into the emergency room with a heart attack. It’s taken for granted that the patient would leave with heart medication and a referral to a cardiac specialist. Similarly, he wants patients who come in with an overdose to start buprenorphine in the hospital and leave with a referral to other forms of treatment.

Kolodny and Koyawala both noted that a lack of training and understanding among health professionals continues to undermine what happens after the overdose patient is stabilized.

“Our colleagues in emergency rooms are not particularly well trained to be able to help people in a situation like this,” said Dr. Margaret Jarvis, the medical director of a residential addiction treatment center in Pennsylvania.

It was clear, Angerer said, that her doctors were not equipped to deal with her addiction. They didn’t know, for instance, what she was talking about when she said she was “dope sick,” feeling ill while she was going through withdrawal.

“They were completely unaware of so much, and it completely blew my mind,” she said.

When she left the hospital after her toe and finger amputations, Angerer recalls her next stop seemed to be a tent city somewhere in Midland, where she feared she would end up dead. Instead, she persuaded her mother to drive her about 300 miles to a treatment facility in Dallas. She had found it on her own.

“There were a lot of times I could have gone down a better path, and I fell through the cracks,” Angerer said.

The bottom line, Jarvis said, is that when a patient comes into the emergency room with an overdose, they’re feeling sick, uncomfortable and “miserable.” But surviving that episode, she emphasized, doesn’t necessarily change their perilous condition.

“Risk for overdose is just as high the day after as the day before an overdose,” said Dr. Matt Christiansen, an assistant professor in the Department of Family & Community Health at the Marshall University Joan C. Edwards School of Medicine in West Virginia.

The Science Of Science: Smaller Is Better When It Comes To Building Innovative Teams

A study published in Nature mines large databases and reports that while big teams help drive progress, they are best suited for confirming novel findings, rather than generating them. Public health news also looks at beneficial insects; a failed uterus transplant; chronic inflammation’s toll on memory; income predictors at age 6; and aging-in-place pitfalls.

The Science Of Science: Smaller Is Better When It Comes To Building Innovative Teams

A study published in Nature mines large databases and reports that while big teams help drive progress, they are best suited for confirming novel findings, rather than generating them. Public health news also looks at beneficial insects; a failed uterus transplant; chronic inflammation’s toll on memory; income predictors at age 6; and aging-in-place pitfalls.

The World Braced Itself For A Bird Flu Epidemic. Then Nothing Happened.

A little over a decade ago, the world raced to prepare emergency plans and stockpile medication in anticipation of a major bird flu outbreak. Now, there hasn’t been a single H5N1 human infection detected since February 2017. Where did it go? In other public health news: the measles outbreak, pelvic mesh, intimacy, raw milk, processed foods and more.

Background Checks, Other Campus Reforms Included In Settlement Over USC Gynecologist

The case involves hundreds of students and alumni who have accused Dr. George Tyndall of committing sexual or inappropriate conduct during physical exams. Beyond the monetary damages in the settlement, USC will have to agree to conduct background checks that delve into prior history of sexual harassment, improve employee training, and bolster staffing so that female students always have the option of seeing a female doctor. The university will also be asked to create a position for “an independent women’s health advocate” to ensure complaints about improper sexual or racial conduct are investigated. Meanwhile, six male graduates have filed a lawsuit against another USC doctor.

Where Is The Line Between Getting A Suicidal Person Help And Their Right To Privacy? Experts Wonder If Facebook Is Toeing It

“It’s important to have innovative approaches. But just because people are suicidal and in crisis doesn’t mean they don’t deserve rights,” said Dr. John Torous, the director of the digital psychiatry division at Beth Israel Deaconess Medical Center. In other public health news: race and the medical community, colds, mental health, exercise, allergies, gene-editing and more.

Where Is The Line Between Getting A Suicidal Person Help And Their Right To Privacy? Experts Wonder If Facebook Is Toeing It

“It’s important to have innovative approaches. But just because people are suicidal and in crisis doesn’t mean they don’t deserve rights,” said Dr. John Torous, the director of the digital psychiatry division at Beth Israel Deaconess Medical Center. In other public health news: race and the medical community, colds, mental health, exercise, allergies, gene-editing and more.

Must-Reads Of The Week From Brianna Labuskes

Happy Friday! Also known as the day President Donald Trump is getting his second annual physical. Last year, Dr. Ronny L. Jackson attributed the president’s “excellent health” to good genes and God. Will this year be different with a new physician?

The headliner from this week was obviously the State of the Union address, so let’s get right to it.

Trump’s pledge to end the HIV epidemic was greeted with cautious optimism — laced with a heavy dose of skepticism. The administration’s plan involves targeting HIV hot spots and increasing access to medications that treat and prevent the disease. However, the lack of specific details in Trump’s address have HIV advocates nervous. “To date, this administration’s actions speak louder than words and have moved us in the wrong direction,” said AIDS United.

The Associated Press: Trump Launching Campaign to End HIV Epidemic in US by 2030

Kaiser Health News: Trump Pledges To End HIV Transmission By 2030. Doable, But Daunting.

When it comes to high drug prices, Trump had very simple instructions for Congress: “Do more.” The response, as you can imagine, was mixed. Some Democrats saw it as an invitation to work on an issue that could be one of the few bipartisan successes emerging from the current Congress. Others don’t have any interest in getting on board with the president’s policies — which include capping U.S. drug payments based on prices paid abroad.

Stat: Democrats Can’t Decide How to React to Trump’s Call for ‘More’ on Drug Pricing

Meanwhile, in his address, Trump used a pretty wonky (as in, in the weeds) metric to praise his administration’s efforts on bringing down drug prices. The consumer price index, at best, doesn’t tell the full story of costs, and experts say that, given how complicated the system has become (i.e. with rebates), it has outlived its usefulness.

Stat: Trump Claims Drug Prices Have Fallen. But He’s Cherry-Picking That Data

Recent controversies over abortions provided Trump the perfect opportunity, as he starts to gear up for 2020, to give a little love to a highly valued segment of his base. Virginia’s governor had made comments last week that led to accusations that he supported infanticide; and New York just passed a bill that protects against efforts to roll back Roe v. Wade. Trump used those incidents as a springboard to call on Congress to ban “late-term abortions.” And the language he used in the speech — “All children — born and unborn — are made in the holy image of God” — is being seen as a play for evangelical voters.

The Associated Press: With Anti-Abortion Push, Trump Woos Evangelicals Again

Doctors weighed in on the debate with this reality check: Clinically, there is no such thing as a “late-term abortion.” See what else they say the president got wrong.

The New York Times: What Is Late-Term Abortion? Trump Got It Wrong

Childhood cancer also got a shout-out in the SOTU. Although it has an 80 percent cure rate, scientists say that number is skewed by the tremendous progress that’s been made against childhood leukemia. Other pediatric cancers have a long way to go. (And so they are welcoming the $500 million with open arms and a distinct list of ideas.)

Stat: Scientists Have Ideas to Spend Trump’s Money for Childhood Cancer


Former Rep. John Dingell died on Thursday at age 92. Lawmakers and politicians praised the country’s longest-serving congressman, calling him a “beloved pillar of the Congress” who is leaving behind “a towering legacy.” One common thread in the heartfelt messages was the impact he had on America’s health care. “He had a long tradition of introducing legislation on the first day of each new Congress to guarantee health care for every single American,” former President Barack Obama wrote. “Because of him, we’ve come closer to that vision than ever before. And when we finally achieve it — and we will — we’ll all owe him our gratitude.”

The Washington Post: Colleagues, friends remember John Dingell, an ‘American legend’ and ‘beloved pillar of Congress’


Fresh off their midterm victories, Democrats are wasting no time setting up hearings to secure protections for people with preexisting conditions. Any legislation would be mostly symbolic because it would face an all-but-certain death in the Republican-controlled Senate, but it solidifies talking points that have been successful for Democrats recently.

The New York Times: Democrats Unite to Begin Push to Protect Pre-Existing Condition Coverage


If you’re confused about Trump’s rebate proposal join the (very crowded) club. But here’s the bottom line: Most patients will pay a little more since their premiums will go up (because insurers would no longer be able to apply rebate money from the drugs to lower premiums). However, people who take outrageously expensive medication will get relief. Experts say the trade-off is worth it.

The New York Times: How Trump’s Latest Plan to Cut Drug Prices Will Affect You

How does a drug that, until December, was free to patients now have a $375,000 price tag? Paint Sen. Bernie Sanders (I-Vt.) … curious … to say the least.

Stat: Sanders Calls Price of a Rare Disease Drug ‘Immoral Exploitation’


Court watchers were eagerly awaiting the Supreme Court’s decision on a Louisiana admitting-privileges law — the first real gauge of how the new dynamics of the court will play out with abortion decisions. The Louisiana restrictions are quite similar to ones knocked down in a 2016 ruling, but the court is also more conservative than it was at that time. For now, Chief Justice John Roberts disappointed his conservative colleagues by joining with the liberal justices in issuing a stay on the law. The decision likely means the court will take up the issue in its next term, which starts in October.

The New York Times: Supreme Court Blocks Louisiana Abortion Law


Medicaid expansion advocates were ecstatic last year when ballot initiatives proved a successful way to circumnavigate red-state legislatures that had been blocking changes to the program. This week, a bucket of cold water has doused that enthusiasm as lawmakers in both Utah and Idaho scramble to counter the expansion as much as possible. While the proposals — like adding work requirements — gain popularity in red states across the country, the fact it’s happening at all after voters OK’d the expansion highlights the reality that ballot initiatives can do only so much.

The New York Times: In Utah and Idaho, G.O.P. Looks to Curb Medicaid Expansions That Voters Approved


In a startling, horrifying trend, veterans have been killing themselves in VA parking lots in what experts see as a protest against a system that failed them. The latest was a Marine colonel who, dressed in his uniform blues and medals, sat on top of his military and VA records and shot himself with a rifle outside the Bay Pines Department of Veterans Affairs. “It’s very important for the VA to recognize that the place of a suicide can have great meaning. There is a real moral imperative and invitation here to take a close inspection of the quality of services at the facility level,” said Dr. Eric Caine, director of the Injury Control Research Center for Suicide Prevention at the University of Rochester.

The Washington Post: Parking Lot Suicides at Veterans Hospitals Prompt Calls for Better Staff Training, Prevention Efforts

Meanwhile, USA Today released a comprehensive analysis on the quality of VA hospitals versus civilian ones. Some of the scores came back positive (death rates, on the whole, were lower at VA facilities); others that look at preventable infection rates and bedsores hinted at neglect. USAT offers a very cool look-up tool if you want to see how your clinic fared.

USA Today: Death Rates, ER Waits: Where Every VA Hospital Lags, Leads Other Care


An HHS official is arguing that pulling separated migrant children from their sponsor homes to reunite them with their families would do more harm than good psychologically at this point. Jonathan White, an official leading HHS’ reunification efforts, said in a court filing that it would make more sense for the government to focus on children who were still in custody. The ACLU called the position a “shocking concession that it can’t easily find thousands of children it ripped from parents, and doesn’t even think it’s worth the time to locate each of them.”

The Associated Press: US Sees Limitations on Reuniting Migrant Families


In the miscellaneous file for the week:

• There’s a long history of mistrust between the African-American community and medical professionals, and Virginia Gov. Ralph Northam’s photo involving black face pressed sharply against that never-healed wound. (At the time, Northam was graduating from medical school on his way to becoming a pediatrician.)

The Associated Press: Blackface Photo Reopens Long History of Bigotry in Medicine

• Anecdotal evidence was thick on the ground that women were seeking emergency contraception in the wake of Trump’s election victory. Now there are numbers to back it up.

The Hill: Demand for Certain Forms of Contraception Increased After Trump’s Election: Study

• Could an infamous party drug really help quiet suicidal ideation in the midst of an ever-worsening crisis? This fascinating history on the use of ketamine is well-worth the read.

Bloomberg: Ketamine Could Soon Be Used to Treat Suicidal Ideation

• “It’s like throwing a match into a can of gasoline,” experts say of the measles outbreak in the Pacific Northwest. Are they just the norm now? And why were there so many kids who weren’t vaccinated?

The New York Times: ‘A Match Into a Can of Gasoline’: Measles Outbreak Now an Emergency in Washington State

CNN: Measles Rarely Kills in the US — But When It Does, Here’s How 


I was delighted this morning over the fact that scientists had a major breakthrough in creating a way to take insulin in pill form because of … turtles! Last week hedgehogs, this week turtles. I swear the Breeze isn’t turning into an animal news newsletter (or is it?). Have a great weekend!

Nobel Prize Winning Economist Develops Kidney Transplant ‘Chains’ That Are Saving Lives

Nobel laureate Alvin Roth deserves much of the credit for coming up with a solution for increasing the number of donors and getting people off dialysis sooner. Other public health news focuses on self-harming images; Duchenne muscular dystrophy; hangover prevention; cocktail safety; living alone; breast implants and more.

Nobel Prize Winning Economist Develops Kidney Transplant ‘Chains’ That Are Saving Lives

Nobel laureate Alvin Roth deserves much of the credit for coming up with a solution for increasing the number of donors and getting people off dialysis sooner. Other public health news focuses on self-harming images; Duchenne muscular dystrophy; hangover prevention; cocktail safety; living alone; breast implants and more.