Addiction and substance abuse are the main reason for homelessness, the charity says

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More than 70% of detox clients in the Simon Dublin community last year cited addiction and substance abuse as the main reason for being homeless.

The increase in demand for the detox service of the charity caused the waiting times to almost double, from 29 days in 2018 to 76 days in 2020.

The organization’s 2020 annual review, released Thursday, said the average age of clients in residential detox services has dropped from 49 to 44 in the past five years.

Fifty-four per cent of all people in Dublin Simon’s emergency accommodation by 2020 have been homeless for more than three years, with 42 per cent for more than five years.

Dublin Simon Community provided services to 7,617 people in Dublin, Kildare, Wicklow, Meath, Louth, Cavan and Monaghan last year.

Sam McGuinness, chief executive, said the homeless population “is experiencing the worst crisis we could ever have imagined.”

“While some of the successes we’ve achieved make me happy, there are people struggling to rebuild their lives because they’re dealing with addiction, waiting longer to access alcohol and other drug detox services, and getting to the bottom. deep in the little ones more than ever, ”he said.

“Many of these people spend five years or more in emergency accommodation and are desperate to get out of homelessness.

Advice

“The human toll is evident in the growth in demand for advice and support outside the crisis hours, with a total of 3,875 interventions by the Dublin Simon Community Sure Steps advisory team, both in services diurnal as out of hours.

“In 2020 we worked with 7,617 adults and children and we have achieved very positive results. Nearly 2,900 adults and children received support from our income maintenance teams, which was facilitated by the increased availability of housing released in the rental market due to the Covid-19 “pandemic.

There was a 23% increase in demand for primary care and primary care services from the charity, with 938 people accessing the services in 2020. These include residential detoxification services, addiction recovery and care services. subsequent, blood-borne virus services and counseling.

The charity’s Intermediate Residential Care Center, Step-Up-Step-Down, marked its second full year of operation last year in collaboration with Safetynet Primary Care and HSE.

The service supported acute hospitals by providing up to 20 medical beds on the island of Usher, freeing up public hospital beds for use by Covid-19 patients during the pandemic.

Risk

Majella Darcy, head of clinical governance and therapeutic services for the Dublin Simon community, said more health care is needed for those suffering from homelessness.

“When the pandemic started, we were faced with a situation where we knew that the most common reason for entering our Step-Up Step-Down unit the previous year was a respiratory condition. This meant that the homeless population had an exceptionally high risk of infection and a poor outcome, ”he said.

“We moved quickly to adapt the way we provided services, ensuring the safety of our vulnerable customers and front-line healthcare staff.

“We have been hugely successful in keeping people safe during this Covid crisis, but we need to make sure we can meet the demand for addiction treatment, particularly drug stabilization and mental health supports that at the moment they are so urgent. “

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Webisode 15 – Methadone, EKG Testing and the QT Interval

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Feds award $1.6 billion in funds to address overdose and addiction crises in communities

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Photo: Shana Novak/Getty Images

In a push to prevent drug overdoses, the federal government is providing more than $1.6 billion in investments for communities across the country to address the addiction and overdose crisis. Funds are awarded by the US Department of Health and Human Services through the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA).

Investments made through SAMHSA’s State Opioid Response (SOR) and Tribal Opioid Response (TOR) grant programs, as well as HRSA’s Rural Community Opioid Response programs, are aimed at helping communities seek to leverage a range of tools from prevention to harm reduction. , to treatment and recovery supports for people in need.

According to data from the Centers for Disease Control and Prevention, more than 107,000 Americans died of drug overdoses in 2021, an increase of more than 15% from 2020.

HHS Secretary Xavier Becerra said the agency’s strategy to end the overdose crisis is to provide access to evidence-based, person-centered care.

“Through these grants, we are investing in hope,” he said.

WHAT IS THE IMPACT?

Investments include four types of funding for states and communities.

The first is SAMHSA’s SOR grant program. SOR provides formulary funding to states and territories to increase access to FDA-approved medications for the treatment of opioid use disorder (OUD) and to support services for prevention, harm reduction, treatment and recovery support for TOU and other co-occurring substance use disorders (SUDs). ). The program also supports ongoing care for stimulant misuse and use disorders, including those involving cocaine and methamphetamine.

SOR helps reduce overdose deaths and close the treatment needs gap in the United States by giving states and territories flexibility to fund evidence-based practices and supports in different settings to meet local community needs.

In addition to implementing service delivery models that enable the full spectrum of treatment and recovery support services, as well as prevention, education and harm reduction services, SOR provides funds for states and territories to purchase and distribute naloxone to increase the availability and accessibility of the medicine. .

The SOR grant amounts to $1,439,500,000 to be awarded to 58 states and territories. Funding includes a reserve for states with the highest OUD-related death rates.

And then there’s SAMHSA’s TOR Grant Program TOR addresses the overdose crisis in tribal communities by increasing access to FDA-approved medications for the treatment of opioid misuse and supporting prevention services, reducing harm, treatment and recovery support for opiate and stimulant misuse related to mental and substance use conditions.

CDC data also shows that the rate of drug overdose deaths among Native Americans and Alaska Natives is 75 percent higher than the national average. TOR supports the American Indian and Alaska Native (CWD) Cultural Wisdom Statement, which elevates the importance of tribal identities, culture, spiritual beliefs, and practices to enhance well-being.

TOR recipients are encouraged to incorporate traditional approaches into their grantmaking activities. The TOR grant totals $54,976,150 and is awarded to 102 tribal entities.

In addition, $16.6 million in related funding will go to the SOR/TOR technical assistance program, whose national network of consultants provides free educational resources and training to states, communities, and individuals in prevention services, crime reduction harm, treatment and recovery for OUD and SUD.

Another $6.5 million will go to Regional Rural Opioid Technical Assistance Centers, which develop and disseminate training and technical assistance for rural communities to address opioid issues affecting those communities.

Finally, HRSA announced investments of more than $104 million to expand substance use treatment and prevention services, including OUD medications, in rural communities across the country as part of its Program of Opioid Response in Rural Communities, a multi-year initiative aimed at reducing substance use disorder morbidity and mortality in rural Americans.

THE BIGGEST TREND

In President Biden’s first State of the Union, he called addressing the opioid crisis and overdose epidemic a top priority of his administration, and earlier this year he released his National Drug Control Strategy to expand access to treatment for addiction and overdose and to disrupt drug trafficking. .

HHS invested nearly $15 million in June in 29 rural community organizations to address psychostimulant misuse and related overdose deaths. Overdose deaths from psychostimulant drugs, including methamphetamine, rose from 547 in 1999 to 23,837 in 2020, an increase exacerbated by the COVID-19 pandemic, according to the National Institute on Drug Abuse.

With the investment, HHS has provided a total of more than $400 million for the Rural Community Opioid Response Program (RCORP) initiative, HRSA said. This is a multi-year initiative aimed at reducing morbidity and mortality from substance use, including opioid use, in high-risk rural communities.

Through SAMHSA, HHS also recently announced $55 million in funding for its Tribal Opioid Response grant program that addresses the overdose crisis in tribal communities.

Both programs address opioid and stimulant misuse, as reflected in the President’s proposed FY 2023 budget for HHS on drug-related programs and initiatives that totaled $21.1 billion . The funding helps support the National Drug Control Strategy.

Last month, the White House released the administration’s plan to address methamphetamine and its impact on public health and safety.

IN THE REGISTRY

“All Americans deserve access to culturally sensitive prevention, treatment and recovery services and supports,” said Dr. Miriam E. Delphin-Rittmon, HHS Assistant Secretary for Mental Health and Substance Use and leader of SAMHSA. “SAMHSA remains committed to fighting overdose and reminding the nation that there is hope: treatment is effective and recovery is possible.”

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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Can science stop a drinking crisis? Addiction experts at CU Anschutz are counting on you

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As the nation grapples with a substance abuse crisis that shatters lives every day, scientists and doctors at the University of Colorado Anschutz Medical Campus are working diligently in their labs and clinics, hoping to prevent tragedies of addiction

While deaths from fentanyl and heroin flood the headlines and capture the attention of the research campus, another longtime killer is claiming an increasing number of lives. Alcohol use disorder (AUD) claims more than 95,000 Americans each year, with deaths increasing 25% between 2019 and 2020. The largest increase in fatalities occurred among people 25 at 44 years old.

Impressed early in his career by how addictive and ubiquitous drinking was, Joseph Schacht, PhD, an associate professor in the Division of Addiction Science, Prevention and Treatment in the CU Department of Psychiatry, has avoiding alcohol toxicity a primary goal.

“You talk to people clinically, and they know it’s bad, that it hurts them, and yet they can’t stop doing it,” said Schacht, a licensed clinical psychologist and principal investigator at the Translational Addiction Imaging Laboratory (TrAIL) at CU Anschutz. “I found that really compelling. I felt like I wanted to make a difference clinically to help people like that.”

With statistics suggesting that half of all American families have at least one member with AUD, Schacht’s target group is large. “Everyone knows someone affected by alcohol or is affected themselves.”

For Schacht and his colleagues at the Academic Medical Research Campus, which is home to UCHealth’s Center for Addiction, Addiction and Rehabilitation (CeDAR), the state’s top-rated recovery center, science has many the answers

Leveraging science in recovery

Also a clinical neuroscientist, Schacht combines psychology and neuroscience in his search for new drugs aimed at curbing alcohol consumption. “Unfortunately, there hasn’t been much progress on that front,” Schacht said, noting that the last Food and Drug Administration approval of this drug was in 2006, and that the three drugs available have not they work for everyone. “We need better treatments and more.”

Scientists today have an advanced biological understanding of AUD, a term adopted by the medical field to emphasize that alcoholism is a disease, not a character flaw. With better tools and a wealth of data at their fingertips, researchers are focusing on recovery techniques with a more personalized and technology-based approach.

In Schacht’s lab, for example, NIH-funded researchers compare before-and-after brain scans of trial participants, looking for evidence that their experimental drugs work based on their knowledge of the AUD brain.

Once people develop AUD from binge drinking, their brains become more sensitive to the mood-altering “rewards” of alcohol and things associated with drinking (bars, parties, frothy mugs of beer , etc.). Schacht’s team monitors this “alcohol cue reactivity” by scanning the brains of study participants while showing them alcohol-related images.

Brain changes trigger AUD behaviors

“What we find is consistent with research from many other animal model studies that indicate that the parts of the brain that process reward are hyperactive in the AUD brain. So it’s somewhat primed to respond to things that predict alcohol.”

An AUD brain also gets smaller with age, losing critical functions, especially in the prefrontal cortex, Schacht said, referring to the part of the brain primarily responsible for controlling behavior.

“So there’s this big reward signal that says, ‘This feels good.’ Go find it. And then you have this reduced control system that’s not able to say, “Don’t do it, because you have to pick up your kids from school or because you have to be able to go to work in the morning.” ” Schacht said. “It’s like the gas gets too hard and the brakes fail.”

Customizing the recovery approach

In their lab in the new Anschutz Health Sciences Building (AHSB), Schacht’s team tailors experimental drugs to these neurological differences. Two of the drugs being tested at the Colorado Institute of Clinical and Translational Sciences at the AHSB they aim to make alcohol less rewarding. “They’re meant to take your foot off the accelerator a little bit and make you want less alcohol.”

With one such drug, scientists are taking a “pharmacogenetic approach,” personalizing treatment by identifying a specific genetic subgroup of people for whom the drug should be most effective.

A third drug aims to improve control and is also being tested in participants with attention deficit hyperactivity disorder (ADHD), as scientists work to learn more about the bidirectional relationship between AUD and other attention disorders. mental health

“Having AUD increases the risk of many other psychiatric disorders: depression, anxiety, ADHD,” Schacht said. Conversely, having these mental health disorders increases the risk of AUD and other substance use disorders, with the risk two to four times higher in people with ADHD, he said.

Importance of science-based care

Schacht’s research is an example of the recovery-related science and innovation taking place on the CU Anschutz campus — science that translates into classrooms and clinics, changing the course of substance use recovery.

“We are an academic medical center,” said Patrick Fehling, MD, associate clinical professor of psychiatry and psychiatrist at CeDAR, nationally recognized for its outpatient and inpatient treatment programs for all substance use disorders.

As the largest center of its kind in the region, CU Anschutz offers patients strategic, science-based care in an environment that meets all medical needs “right down the street,” Fehling said.

CeDAR’s full-time on-site staff of physicians, nurses, medical fellows, and students leverages these resources and provides progressive care that meets current research and trends.

“We are currently building a truly cutting-edge protocol for liver transplant recipients,” Fehling said. Alcohol consumption has overtaken hepatitis as the leading cause of liver transplants today. Many of these patients, especially last year, were in their 20s and 30s.

“After they stabilize here, they’ll get a transplant, and then they’ll come back and live in our program for a couple of months for alcohol recovery treatment,” Fehling said.

Current research covers all stages of recovery, potentially easing the lifelong journey and slowing the toll alcohol can take on people’s health. “That’s the goal,” Schacht said. “We hope to catch people before we get to that point and intervene.”

Other promising areas of recovery research include:

Neuromodulation: Noninvasive neuromodulation studies, including transcranial magnetic stimulation (TMS), are common in treatment research for substance use disorders, with TMS already cleared by the FDA for smoking cessation therapy. Invasive neuromodulation, or deep brain stimulation used for Parkinson’s disease and able to target deep structures in the brain, has shown early promise. Joseph Sakai, MD, associate professor in the department of psychiatry and physician in the TMS Clinic at CU Anschutz, recently received a grant to study deep brain stimulation for methamphetamine addiction.

cannabis: Kent Hutchison, PhD, professor of psychiatry, is the principal investigator of a study with Schacht that tests whether increasing cannabidiol levels in people who already use cannabis can help them reduce their alcohol consumption. Preclinical studies suggest that cannabidiol, a non-psychoactive component of cannabis, has a reduced craving effect. Researchers are also preparing for a study testing cannabidiol as an aid to help people who want to reduce their cannabis use.

Smart device technology: Computing tools, wearable devices, and mobile technology have spawned many studies in health care, including for long-term substance use recovery. At the Peters Mile High Lab for Emotional Wellness and Addiction Recovery on campus, for example, researchers are studying devices that offer guided breathing exercises to help people maintain emotional wellness and prevent physical relapse triggers. Devices that identify spikes in blood pressure and sweating, for example, are also being studied to help predict moments of high-risk relapse, leading to quicker intervention.

To participate in a TRAIL breathalyzer study, call (303) 724-2424 or email alcoholstudy@ucdenver.edu. Check the CU Anschutz Research Studies Page for further testing.

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Hospitals face an urgent need to treat addictions in emergency services

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• Research

• September 17, 2021

The UCSF study shows that emergency visits and hospitalizations made by patients with addictions increased by 30% in 2014-2018

By Elizabeth Fernandez

A growing percentage of emergency visits and hospitalizations in the United States before the pandemic involved patients with alcohol and other substance use disorders, according to a study by researchers at UC San Francisco. The authors say hospitals need to develop better ways to identify and treat these patients.

The study, led by Leslie Suen, MD, MAS, of the UCSF Department of Medicine, found that from 2014 to 2018 visits to the emergency department (ED) by adults with alcohol use disorders and substances increased by 30%. Hospitalizations among patients with these disorders increased by 57%.

The authors found that during the study period, one in 11 ED visits and one in nine hospitalizations each year involved one person with some alcohol-related disorder or another.

“These statistics are comparable to common conditions such as heart failure, but hospitals and EDs are rarely as well equipped to treat addiction as they are to treat cardiovascular disease,” said Suen, a member of the University’s National Clinic Program. Columbia University (Philip R. Lee). Institute for Health Policy Studies.

“These data suggest that there is an urgent need for hospitals to develop hospital-based intervention systems to provide addiction treatment to those accessing emergency care and hospitalization. Models already exist that offer addiction services to the hospital, including the UCSF addiction care team at San Francisco General Hospital ”.

The study was published on September 13, 2021 in the Journal of General Internal Medicine.

The researchers found that patients with alcohol and other substance use disorders who entered the emergency department were more likely to have Medicaid health insurance, have depression, be homeless, receive mental health treatment, and have injuries. and trauma.

“Illness and death from complications from alcohol and other substance use are on the rise nationwide,” Suen noted. “Hospitals are a place where we can begin to reverse this trend, but we need to be prepared to identify and treat these patients while they are in the hospital and continue to follow and treat them after medical discharge.”

For the study, the researchers analyzed data from the National Hospital’s Outpatient Medical Care Survey, an annual survey administered by the National Center for Health Statistics. Alcohol use disorder and other substance use disorders were identified from patients ’medical records.

“Our estimate of alcohol and substance use disorders among ED visits is higher than in some other recent studies,” Suen said. “This is possible because our study is the first to use full reviews of medical charts, which are more likely to reflect the true prevalence of these disorders, rather than relying solely on billing diagnostic codes.”

UCSF co-authors are Leslie Suen, MD, MAS; Anil N. Makam, MD, MAS; Hannah R. Snyder, MD; Daniel Repplinger, MD; Margot B. Kushel, MD; Marlene Martin, MD; and Oanh Kieu Nguyen, MD, MAS. The study was supported by the National Heart, Lung and Blood Institute. The authors do not declare any conflict of interest.

The University of California, San Francisco (UCSF) is focused exclusively on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate education in life sciences, and health professions. excellence in patient care. UCSF Health, which serves as UCSF’s premier academic medical center, includes top-tier specialized hospitals and other clinical programs and has affiliations throughout the Bay Area.

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Comment: Gerrymandering, an addicted cop can’t break – TheStatehouseFile.com

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By John Krull
TheStatehouseFile.com

INDIANAPOLIS: Some decisions are too important to leave to politicians.

The main decision is how we citizens decide who will represent us. This process is called “redistricting” which is a cure for insomnia.

John Krull, editor, TheStatehouseFile.com

But it is important, perhaps more than any other question.

This is because we will probably not be able to solve any of our problems if we do not solve the redistriction first. The only way to do that is to return power to the people, reminding those who hold public office that they only do so with the consent of the governed.

Indiana state lawmakers have been working on the redistricting process for months.

Predictably, they have made a mess of it, evoking maps of legislative districts only piracy and that the most rabid partisans could tolerate, let alone.

Some of his piracies are blatantly political.

They redrawed the map of the fifth district of the Indiana Congress, which has become competitive because voters have sent dangerous signals that were moderate and independent, to another Republican stronghold. U.S. Rep. Victoria Spartz, R-Indiana, captured the office last fall, but her fellow Republicans feared she might be vulnerable.

Perhaps this is because one of Spartz’s first congressional acts was to look for a photo opportunity with a marginal figure U.S. Rep. Marjorie Taylor Greene, R-Georgia, who turns so far right that she has fallen from the far margin of the ground floor in which she believes.

Some of the drafts of the map makers were personal, even petty.

Republicans drafted the map to make one of their own, Indiana Rep. John Jacob, R-Indianapolis, easier to challenge. Jacob’s politics are more conservative than Genghis Khan’s and he has all the personal charm of a viper. His great regret in life is that he did not live during the Crusades. Nothing would give him more pleasure than to march to reclaim the Holy Land from the infidels.

Before becoming a legislator, he appeared in the Statehouse to harangue lawmakers, even those who were reliable votes in favor of life, as murderers because they did not share their extreme views on abortion.

Surprisingly, some Republicans don’t find a constant diet of screams of fire from Jacob’s hell in the caucus so enjoyable and want him to leave.

But it is not fair to point out either the Indiana Republicans or the Hoosiers for having indulged in the demands of war.

The truth is that it is happening almost everywhere in the country.

Both parties — Democrats in blue states and Republicans in red — are guilty of abusing their power and drawing up maps that allow them to choose their voters, rather than allowing voters to choose their leaders.

This is because, for politicians, exploding is more addictive than crack and nicotine combined.

Without an intervention, they will not give up on it.

This is a problem for the rest of us, as gerrymandering distorts the process of self-government to the point of making it unrecognizable.

There are Hoosier Republican lawmakers who have begun to advance the argument that cutting and chopping maps had nothing to do with the creation of their major legislative majorities. They say it’s better for Republican “ideas” to be better.

This dispute is absurd.

In the 2020 election, then-President Donald Trump and Indiana Gov. Eric Holcomb captured about 57 percent of the vote in Indiana. Indiana Attorney General Todd Rokita captured 58%.

Still, the Indiana House ended up being 71% Republican and the Indiana Senate 78%.

Does this mean that Republican “ideas” from GOP House candidates were 14% better than those of Trump or Holcomb and 13% stronger than those of Rokita? And that the ideas of Republican Senate candidates were 20% more appealing than those of GOP candidates across the state?

What makes livestock farming a serious problem is that it erodes public confidence in government, the instrument through which we are supposed to resolve our differences.

It’s no coincidence that as gerrymandering went from being a dark art to becoming a dark science, Americans started squealing instead of talking to each other. Because huge bands of the public — left, right, and center — feel that no one in power listens to or speaks for them, we have begun to shout all the time in desperate attempts to be heard.

That will not change if we leave redistriction in the hands of politicians.

Decisions that are important should belong to the citizens — and to us alone.

John Krull is director of the Pulliam School of Journalism at Franklin College and editor of TheStatehouseFile.com, a news website run by journalism students at Franklin College.

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Source: http://thestatehousefile.com/commentary-gerrymandering-an-addiction-pols-just-cant-break/

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