Payors increasingly require accountability for outcomes for substance abuse treatment

The New York Times had a interesting article published on 12/22/08 entitled, "Drug Rehabilitation or Revolving Door?" which discusses the fact that 20 billion dollars per year is spent on substance abuse treatment and there doesn't seem to be clear evidence that it works.

There has been a movement toward evidenced based practice methods to standardize treatment and produce better outcomes.

My problem has been that often in substance abuse treatment there is a one size fits all attitude which counselors articulate defensively as "A drug is a drug is a drug" and yet we are learning continually that drugs are different in many important ways as treatment increasingly is.

The other problem is that for some folks substance abuse is an acute illness which responds well to treatment and for others it is more chronic and persistant and will require ongoing treatment for most of the patient's life much like diabetes or high blood pressure. In this context payors expectations may be unrealistic and inappropriate. Patients require care not cure.

If you would like to read more, you can access the New York Times article by clicking here.

Proper treatment for ADD in adolescence with stimulant medication reduces substance abuse problems

A Massachusetts General Hospital study found that girls with ADHD who were treated with medication were less likely to develop substance abuse disorders according to an article on Reuters Health Day on October 6, 2008. Here is a snippet from that article:

Stimulant treatment for attention-deficit hyperactivity disorder (ADHD) significantly cuts the odds that adolescent girls will smoke, drink alcohol or use drugs, a new Massachusetts General Hospital study shows.
The finding parallels previous studies in boys, the team note.
People with ADHD are at significantly increased risk for cigarette smoking and substance abuse. In the past, there were concerns that treatment of ADHD with stimulant drugs such as Ritalin might increase the risk of drug or alcohol abuse.
But in several studies of boys and young men with ADHD, researchers have found that stimulant treatment actually decreases the risk and delays the onset of substance abuse in adolescence. It does not affect the risk of using tobacco, alcohol, or drugs in adulthood, however.
The same researchers set out to see how stimulant treatment for ADHD affects the risk of substance abuse in adolescent girls.

This is an interesting finding for I have found recently many adult clients who tell me that they started drinking and drugging in their early teen years, like 12 and 13. When I carefully question them about their school experience it becomes pretty clear that they have ADD and as one man in his 40s told me, "My parents didn't believe in medication." He said he has been smoking pot since he was 13.

There is an uninformed opinion among many health care providers and lay people that the treatment of ADD symptoms with medications will lead to substance abuse when in fact the opposite is the case.

Amethyst initiative of college presidents to lower drinking age to 18 is bad policy. Support 21!

John McCardell, the President Emeritus of Middlebury College in Vermont founded the Amethyst Intiative to roll back the drinking age to 18. He got 130 college Presidents to sign on to this initiative which was sparked tremendous controversy and the Support 21 campaign.

The states were encouraged by the feds to increase the drinking age to 21 over the last several years with threats to withhold 10% of their federal highway dollars if they didn't.

The public health information is very clear that raising the drinking age has saved many lives and the other negative consequences of adolescent drinking.

For more information go to the CADCA web site by clicking here.

20% of U.S. population binge drink at least once per year

Overall, about 20% of the U.S. population over 18 reports having 5 or more drinks (the definition of binge drinking) on one or more days in the last year.



The 20 -45 year old age group was almost twice as high at around 40% or almost half.



Here is the bar chart displaying the data from the 2007 study.






Click on the imgage to enlarge for easier reading.

For more information click here.

Everyday Heroes Consent Form

Here at GCASA we guard people's confidentiality. At times it is very helpful, in carrying our GCASA's mission, to have testimonials and people taking public positions on issues that affect GCASA's mission and the health of our community.

One such effort that is gathering steam is the Everyday Heroes project. If you are interested in being an Everyday Hero, please copy and paste the consent form, fill it in and get it signed and send it to Kevin Keenan, Prevention Educator, GCASA, 430 East Main Street, Batavia, NY 14030.

If you would like more information you can email Kevin at kkeenan@gcasa.org, or call him at 585-815-1876.

Click on image to enlarge.

United States will not meet its 12% goal for smoking prevalence by 2010

Reuters HealthDay reported on November 13, 2008 on a report in the CDC Journal, Morbity and Mortality Report, which says that the United States will not meet its Healthy People 2010 goal of 12% prevalence rate for smoking in the United States. Here is a snippet from the Reuters HealthDay article:

It's unlikely the United States will meet its Healthy People 2010 objective of reducing the adult smoking rate to 12 percent or less, say experts at the U.S. Centers for Disease Control and Prevention.

That failure will mean continued high levels of smoking-related health problems, deaths and lost productivity will still plague the nation, according to a number of CDC studies released Thursday.

Smoking is a leading cause of preventable death and disease in the United States, but comprehensive tobacco control programs could prevent millions of premature deaths and save the nation billions.

In one study, researchers analyzed data from the 2007 National Health Interview Survey. They found that 19.8 percent (43.4 million) of American adults were current cigarette smokers, a level somewhat lower than in 2006 (20.8 percent), 2005 (20.9 percent), and 2004 (20.9 percent).

I believe that only Utah has met the 12% goal. New York State depending on the report seems to be at about 16%.

At GCASA we continue to work on smoking cessation, and the prevention of untaking. We are moving in the right direction as far as we can detect from our data but it will take a while longer to eliminate this nasty addiction from our area.

Parent disapproval of teen drinking has significant impact on teen drinking behavior according to GCASA study

The the last two years GCASA has had a contract with Catalyst Research in Kenmore, NY to provide many evaluation and research services for GCASA.

It is the partnership that GCASA has developed with Catalyst Research's two managing partners, Dr. Meghan Guinee, and Dr. Dan Webb, that has enabled GCASA to be so successful in obtaining federal and state grants and win national awards.

Dr. Guinee has done an analysis of GCASA's Prevention Needs Assessment data for Genesee County schools which has led to some interesting findings. For example, in 2006, 17% of the students in 8th, 10th, and 12th grade were considered to be at risk when they reported that their parents would think that its "A little bit wrong or Not Wrong at All" for them to drink. Students who said that their parents would not disapprove of their drinking were three more times likely to report that they drank alcohol in the previous 30 days (25% versus 72%) and four times more likely to have drank heavily in the previous 14 days (13% versus 54%) than students who said their parents would disapprove.

This is a significant finding about how important it is for parents to communicate clearly with their children their disapproval of their use of alcohol. What the data tells us is that if parents clearly communicate their disapproval, the drinking behavior of teens decreases not just a little but very significantly.

So the programmatic question is how can we increase the number of parents who communicate their disapproval clearly to their children?

There are other findings in Dr. Guinee's report which I will report to you in subsequent articles. If you would like a copy of Dr. Guinee's 14 page report entitled "Alcohol Perceptions & Use: PNA Survey Results for Genesee County" let me know.

Behavioral health problems rise when economic times get tough

The American Psychiatric Association issued a press release on October 15, 2008 pointing out that the incidence of psychiatric problems rises in tough economic times.

Here at GCASA, I worry that just when mental health and substance abuse problems will predictably rise because of the unemployment and bleak economic conditions, services will be cut because of lack of funds.

Click on the image to enlarge for easier reading.

Older problem gamblers at higher risk for suicide

Reuters HealthDay reported on 09/28/08 on a study which appears in the September, 2008, issue of Psychology and Aging which found that older problem gamblers over age 55 self excluded themselves from casinos because of a fear of suicide.

Here is a snippet from the HealthDay article:

Older problem gamblers who ask to be barred from casinos are three to four times more likely than younger gambling addicts to do so because they're afraid they'll commit suicide if they don't stop betting, according to a new study.

The study included 1,601 compulsive gamblers who, between 2001 and 2003, asked to be banned from Missouri casinos. On average, those age 55 and older had gambled for 17 years before "self-exclusion," more than twice the length of time reported by younger gamblers.

Gamblers of all ages cited gaining control, needing help, and hitting rock bottom as their primary reasons for seeking self-exclusion. But 14 percent of older gamblers said they sought help because they wanted to prevent themselves from committing suicide. That's a far higher rate than in any other age group, the study found.

SAMSHA finds that over 5 million Americans use self help programs to help deal with substance abuse problems

Reuters HealthDay reported on 11/24/08 on a SAMSHA report that found 5 million Americans particpate in self help programs such as AA. Here is a snippet from the article:

An estimated five million Americans over the age of 12 participate in self-help groups for alcohol and drug abuse each year, including 2.3 million who currently abstain from use of these substance.
That's the finding of a report released Monday by the federal Substance Abuse and Mental Health Services Administration (SAMHSA).

The report, which includes data from 2006 and 2007 nationwide surveys of 67,500 people each year, also found that:
45.3 percent attended a self-help group because of their alcohol use only; 21.8 percent attended because of illicit drug use only, and 33 percent attended because of both alcohol and illicit drug use.
45.1 percent of past year self-help group participants didn't use alcohol or illicit drugs in the past month.
32.7 percent of those who attended a self-help group for alcohol/drug use during the past year also received specialty treatment for their abuse, including treatment received at a hospital as an outpatient, at a rehabilitation facility as an inpatient or outpatient, or at a mental health center.

GCASA encourages people to make use of 12 step and other self help programs.

Leslie Pfalzer graduated from Leadership Genesee on 12/04/08

Leslie Pfalzer, coordinator of Royal Employer Services, GCASA's EAP, graduated from Leadership Genesee on December 4, 2008.

Leslie is in a long line of GCASA's Leadership Genesee Graduates.

GCASA has been very supportive of Leadership Genesee Training which involves a year, once per month, all day long on a Wednesday.

Since Leadership Genesee started in 2001, GCASA has sponsored an employee every year but one, 2002.

GCASA participants have been as follows:

2001 - George Way (dropped out)
2002 - none
2003 - Maryann Bowman
2004- Linda Rost
2005 - Bev Maniace
2006 - John Bennett
2007 - Shannon Ford, Linda Ackley
2008 - Leslie Pfalzer
2009 - Jamie Beedham

Congratulations to all the Leadership Genesee graduates and especially to GCASA's graduates and especially this year to Leslie Pfalzer.

Mental Health Association of Genesee County will hold open house on Tuesday, 12/9/08.

The Mental Health Association of Genesee County will be having an Open House next Tuesday, December 9, 2008 from 5:00 - 7:00 PM at 25 Liberty Street, Batavia, NY.

Click on image to enlarge for easier reading.

Genesee County Office Of The Aging has a good article on problem gambling in their December, 2008 newsletter

In the December, 2008 issue of the Genesee County Office of The Aging newsletter, Ruth Spink, the GCOA services coordinator wrote a good article in gambling.

Click on image to enlarge for easier reading.

GCASA's Senior Spice committee sponsors "All That Glitters" Holiday gathering on December 10, 2008

GCASA's Senior Spice committee is hosting an "All That Glitters" Holiday Gathering which will include dinner and dancing on Wednesday, December 10, 2008 from 5:30 - 8:30 PM at the Bataiva First United Methodist Church on Lewiston Rd., Batavia, NY. Tickets are $11.00.

For more information contact Mike Laycock at 585-815-1874 or Carol Nicometo at 585-815-1873.

Click on image to enlarge for easier reading.