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Policy & Practice
Federal Mental Health Focus
Six federal agencies–including the departments of Education, Health and Human Services, Justice, and Labor–have come together to provide resources to mental health patients and families. The agencies' report, called “Transforming Mental Health Care in America. The Federal Action Agenda: First Steps,” outlines ways in which the agencies are working to help mental health patients. Measures include reducing suicides by implementing the National Strategy for Suicide Prevention developed by HHS, helping states develop the infrastructures needed for comprehensive state mental health plans, developing plans for a mental health workforce that is better qualified to be culturally sensitive, and expanding a program to develop tool kits on evidence-based mental health care for distribution to providers and consumers.
Meth Crisis Continues
The methamphetamine crisis has meant major problems for law enforcement and child welfare workers, according to two new surveys by the National Association of Counties. The first survey, which included responses from 500 local law enforcement agencies, found that 87% reported an increase in methamphetamine-related arrests beginning 3 years ago. More than half the counties said methamphetamine was their largest drug problem, with an estimated one-fifth of jail inmates incarcerated because of meth-related crimes. In the second survey, which involved child welfare officials in more than 300 counties, 40% of respondents reported increased out-of-home placements because of methamphetamine addiction in the past year, and nearly two-thirds of officials agreed that the nature of the meth-using parent increased the difficulty of family reunification.
Merck Loses First Vioxx Lawsuit
A jury in Texas last month awarded $253 million to the widow of a man who died after taking Vioxx (rofecoxib). The plaintiff charged that the drug maker Merck & Co. failed to warn physicians about the danger posed by Vioxx, that the drug was improperly designed, and that the company's negligence caused the death of the plaintiff's husband, Robert Ernst. Merck executives plan to appeal the verdict on the grounds that the jury was allowed to hear testimony that was both irrelevant and not based on reliable science, the company said. “While we are disappointed with the verdict, this decision should be put in its appropriate context,” Kenneth C. Frazier, Merck's senior vice president and general counsel, said in a statement. “This is the first of many trials. Each case has a different set of facts. Regardless of the outcome in this single case, the fact remains that plaintiffs have a significant legal burden in proving causation.” The award included $24 million in actual damages and $229 million in punitive damages. But the punitive damages could be reduced to about $2 million, according to Merck, since punitive damages are limited under Texas law.
New Buprenorphine Program
A new program is available to assist physicians who prescribe or dispense buprenorphine to opioid-addicted patients, the Substance Abuse and Mental Health Services Administration has announced. The Physician Clinical Support System, which is cosponsored by SAMHSA and by the American Society of Addiction Medicine, is a national network of 45 trained physician mentors who have expertise in addiction treatment. They are supported by a medical director and five physician experts in buprenorphine use. The network's physicians provide services via telephone, e-mail, and in person. Information about the network, which provides its services for free, is available by e-mailing the network staff at
Guide to Alcoholism for Clinicians
Physicians have a new tool to help them identify and care for patients with heavy drinking and alcohol use disorders. About 3 in 10 U.S. adults drink at levels that increase their risk for physical, mental health, and social problems. Of those heavy drinkers, about one in four currently has alcohol dependence problems that often go undetected in medical and mental health care settings. The National Institute on Alcohol Abuse and Alcoholism recently released a new guide called “Helping Patients Who Drink Too Much: A Clinician's Guide,” which offers guidance for conducting brief interventions and managing patient care. If a patient drinks heavily (five or more drinks in a day for men or four or more for women), the guide shows physicians how to look for symptoms of alcohol abuse or dependence. The guide is at
High Cost of Smoking Deaths
Smoking deaths cost the country $92 billion in lost productivity on an annual basis, from 1997 to 2001, the Centers for Disease Control and Prevention reported. This reflects an increase of about $10 billion from the annual mortality losses for the years 1995 through 1999. An estimated 438,000 premature deaths occurred each year from 1997 to 2001 as a result of smoking and exposure to secondhand smoke. At its annual meeting, the American Medical Association's House of Delegates took measures to discourage tobacco use. It also voted to support increases in federal, state, and local excise taxes on tobacco. Such increases in the excise taxes should be used to fund the treatment of those with tobacco-related illnesses and to support counteradvertising efforts, the resolution stated.
Federal Mental Health Focus
Six federal agencies–including the departments of Education, Health and Human Services, Justice, and Labor–have come together to provide resources to mental health patients and families. The agencies' report, called “Transforming Mental Health Care in America. The Federal Action Agenda: First Steps,” outlines ways in which the agencies are working to help mental health patients. Measures include reducing suicides by implementing the National Strategy for Suicide Prevention developed by HHS, helping states develop the infrastructures needed for comprehensive state mental health plans, developing plans for a mental health workforce that is better qualified to be culturally sensitive, and expanding a program to develop tool kits on evidence-based mental health care for distribution to providers and consumers.
Meth Crisis Continues
The methamphetamine crisis has meant major problems for law enforcement and child welfare workers, according to two new surveys by the National Association of Counties. The first survey, which included responses from 500 local law enforcement agencies, found that 87% reported an increase in methamphetamine-related arrests beginning 3 years ago. More than half the counties said methamphetamine was their largest drug problem, with an estimated one-fifth of jail inmates incarcerated because of meth-related crimes. In the second survey, which involved child welfare officials in more than 300 counties, 40% of respondents reported increased out-of-home placements because of methamphetamine addiction in the past year, and nearly two-thirds of officials agreed that the nature of the meth-using parent increased the difficulty of family reunification.
Merck Loses First Vioxx Lawsuit
A jury in Texas last month awarded $253 million to the widow of a man who died after taking Vioxx (rofecoxib). The plaintiff charged that the drug maker Merck & Co. failed to warn physicians about the danger posed by Vioxx, that the drug was improperly designed, and that the company's negligence caused the death of the plaintiff's husband, Robert Ernst. Merck executives plan to appeal the verdict on the grounds that the jury was allowed to hear testimony that was both irrelevant and not based on reliable science, the company said. “While we are disappointed with the verdict, this decision should be put in its appropriate context,” Kenneth C. Frazier, Merck's senior vice president and general counsel, said in a statement. “This is the first of many trials. Each case has a different set of facts. Regardless of the outcome in this single case, the fact remains that plaintiffs have a significant legal burden in proving causation.” The award included $24 million in actual damages and $229 million in punitive damages. But the punitive damages could be reduced to about $2 million, according to Merck, since punitive damages are limited under Texas law.
New Buprenorphine Program
A new program is available to assist physicians who prescribe or dispense buprenorphine to opioid-addicted patients, the Substance Abuse and Mental Health Services Administration has announced. The Physician Clinical Support System, which is cosponsored by SAMHSA and by the American Society of Addiction Medicine, is a national network of 45 trained physician mentors who have expertise in addiction treatment. They are supported by a medical director and five physician experts in buprenorphine use. The network's physicians provide services via telephone, e-mail, and in person. Information about the network, which provides its services for free, is available by e-mailing the network staff at
Guide to Alcoholism for Clinicians
Physicians have a new tool to help them identify and care for patients with heavy drinking and alcohol use disorders. About 3 in 10 U.S. adults drink at levels that increase their risk for physical, mental health, and social problems. Of those heavy drinkers, about one in four currently has alcohol dependence problems that often go undetected in medical and mental health care settings. The National Institute on Alcohol Abuse and Alcoholism recently released a new guide called “Helping Patients Who Drink Too Much: A Clinician's Guide,” which offers guidance for conducting brief interventions and managing patient care. If a patient drinks heavily (five or more drinks in a day for men or four or more for women), the guide shows physicians how to look for symptoms of alcohol abuse or dependence. The guide is at
High Cost of Smoking Deaths
Smoking deaths cost the country $92 billion in lost productivity on an annual basis, from 1997 to 2001, the Centers for Disease Control and Prevention reported. This reflects an increase of about $10 billion from the annual mortality losses for the years 1995 through 1999. An estimated 438,000 premature deaths occurred each year from 1997 to 2001 as a result of smoking and exposure to secondhand smoke. At its annual meeting, the American Medical Association's House of Delegates took measures to discourage tobacco use. It also voted to support increases in federal, state, and local excise taxes on tobacco. Such increases in the excise taxes should be used to fund the treatment of those with tobacco-related illnesses and to support counteradvertising efforts, the resolution stated.
Federal Mental Health Focus
Six federal agencies–including the departments of Education, Health and Human Services, Justice, and Labor–have come together to provide resources to mental health patients and families. The agencies' report, called “Transforming Mental Health Care in America. The Federal Action Agenda: First Steps,” outlines ways in which the agencies are working to help mental health patients. Measures include reducing suicides by implementing the National Strategy for Suicide Prevention developed by HHS, helping states develop the infrastructures needed for comprehensive state mental health plans, developing plans for a mental health workforce that is better qualified to be culturally sensitive, and expanding a program to develop tool kits on evidence-based mental health care for distribution to providers and consumers.
Meth Crisis Continues
The methamphetamine crisis has meant major problems for law enforcement and child welfare workers, according to two new surveys by the National Association of Counties. The first survey, which included responses from 500 local law enforcement agencies, found that 87% reported an increase in methamphetamine-related arrests beginning 3 years ago. More than half the counties said methamphetamine was their largest drug problem, with an estimated one-fifth of jail inmates incarcerated because of meth-related crimes. In the second survey, which involved child welfare officials in more than 300 counties, 40% of respondents reported increased out-of-home placements because of methamphetamine addiction in the past year, and nearly two-thirds of officials agreed that the nature of the meth-using parent increased the difficulty of family reunification.
Merck Loses First Vioxx Lawsuit
A jury in Texas last month awarded $253 million to the widow of a man who died after taking Vioxx (rofecoxib). The plaintiff charged that the drug maker Merck & Co. failed to warn physicians about the danger posed by Vioxx, that the drug was improperly designed, and that the company's negligence caused the death of the plaintiff's husband, Robert Ernst. Merck executives plan to appeal the verdict on the grounds that the jury was allowed to hear testimony that was both irrelevant and not based on reliable science, the company said. “While we are disappointed with the verdict, this decision should be put in its appropriate context,” Kenneth C. Frazier, Merck's senior vice president and general counsel, said in a statement. “This is the first of many trials. Each case has a different set of facts. Regardless of the outcome in this single case, the fact remains that plaintiffs have a significant legal burden in proving causation.” The award included $24 million in actual damages and $229 million in punitive damages. But the punitive damages could be reduced to about $2 million, according to Merck, since punitive damages are limited under Texas law.
New Buprenorphine Program
A new program is available to assist physicians who prescribe or dispense buprenorphine to opioid-addicted patients, the Substance Abuse and Mental Health Services Administration has announced. The Physician Clinical Support System, which is cosponsored by SAMHSA and by the American Society of Addiction Medicine, is a national network of 45 trained physician mentors who have expertise in addiction treatment. They are supported by a medical director and five physician experts in buprenorphine use. The network's physicians provide services via telephone, e-mail, and in person. Information about the network, which provides its services for free, is available by e-mailing the network staff at
Guide to Alcoholism for Clinicians
Physicians have a new tool to help them identify and care for patients with heavy drinking and alcohol use disorders. About 3 in 10 U.S. adults drink at levels that increase their risk for physical, mental health, and social problems. Of those heavy drinkers, about one in four currently has alcohol dependence problems that often go undetected in medical and mental health care settings. The National Institute on Alcohol Abuse and Alcoholism recently released a new guide called “Helping Patients Who Drink Too Much: A Clinician's Guide,” which offers guidance for conducting brief interventions and managing patient care. If a patient drinks heavily (five or more drinks in a day for men or four or more for women), the guide shows physicians how to look for symptoms of alcohol abuse or dependence. The guide is at
High Cost of Smoking Deaths
Smoking deaths cost the country $92 billion in lost productivity on an annual basis, from 1997 to 2001, the Centers for Disease Control and Prevention reported. This reflects an increase of about $10 billion from the annual mortality losses for the years 1995 through 1999. An estimated 438,000 premature deaths occurred each year from 1997 to 2001 as a result of smoking and exposure to secondhand smoke. At its annual meeting, the American Medical Association's House of Delegates took measures to discourage tobacco use. It also voted to support increases in federal, state, and local excise taxes on tobacco. Such increases in the excise taxes should be used to fund the treatment of those with tobacco-related illnesses and to support counteradvertising efforts, the resolution stated.
Policy & Practice
Kids Miss Smoking/Addiction Link
Nearly one-third of children aged 10–12 years believe that they can smoke without becoming addicted, according to a survey of 418 families by the Group Health Cooperative's Center for Health Studies, Seattle. Terry Bush, Ph.D., and colleagues surveyed the preteens on their attitudes and beliefs about smoking over a 20-month period and found that the percentage agreeing with the statement “people can smoke a few cigarettes without becoming addicted” rose from 27% at the beginning of the study to 31% at the end. The percentage agreeing that “if you smoked, you could stop anytime you wanted to” dropped from 27% to 20% during that same period. The researchers found that two factors associated with positive attitudes toward smoking were lack of family cohesiveness and having a parent who smoked. The study appeared in the July/August issue of the American Journal of Health Promotion (2005;19:410–7).
Drinking, Drugging, Driving
One in three adult drivers aged 21–25 years has driven while under the influence of alcohol or drugs in the past year, according to a report from the Substance Abuse and Mental Health Services Administration. Using data from the 2002 and 2003 National Surveys on Drug Use and Health, the agency also found that among all adult drivers, 16% drove under the influence of alcohol alone, 4% drove under the influence of drugs alone, and 3% drove under the influence of both. “These new data show just how much work remains to be done to keep impaired drivers off the road,” said SAMHSA Administrator Charles Curie. The report also noted a gender difference: 22% of male drivers aged 21 years or older reported driving under the influence of alcohol or drugs in 2002 and 2003, compared with 11% of females.
APA Critical on Guantanamo Bay
The American Psychiatric Association says it is “troubled” by reports of alleged medical ethics violations in the treatment of prisoners at the Guantanamo Bay facility. The APA “clearly recommends that psychiatric physicians practice in accordance with the APA ethics guidelines,” the organization said in a statement. For example, the guidelines state that “ethical considerations in medical practice preclude the psychiatric evaluation of any person charged with criminal acts prior to access to, or availability of, legal counsel. The only exception is the rendering of care to the person for the sole purpose of medical treatment.” The APA said it expects to come out with more specific policies “in the near future.”
Antipsychotics in Nursing Homes
Physicians are prescribing antipsychotic drugs to nursing home patients at an increasingly high rate, according to a study published in the Archives of Internal Medicine. Becky A. Briesacher, Ph.D., of the University of Massachusetts, Worcester, and her colleagues examined data on more than 1,200 patients from the Medicare Current Beneficiary Survey for 2000 and 2001 and found that nearly 28% had received prescriptions for antipsychotic therapy–the highest rate reported in nearly a decade. Of those prescriptions, about one-third were for inappropriate indications such as impaired memory or depression without psychotic features. (Arch. Intern. Med. 2005;165:1280–5). “This study raises questions about the current uses of antipsychotics in nursing homes and the role of prescribing guidelines,” the authors wrote. “Now is an opportune time to evaluate this policy as Medicare readies itself to inherit Medicaid's growing costs and concerns over the widespread prescribing of atypical [antipsychotics] to frail nursing home residents.”
NIH Extends Disclosure Deadline
Officials at the Department of Health and Human Services are giving National Institutes of Health employees more time to report prohibited financial interests and to divest stock. In its announcement of the extension, HHS wrote that the department is considering issuing revisions to its current ethics regulations. In February, the agency issued regulations prohibiting NIH employees from engaging in consulting relationships with organizations that are substantially affected by NIH decisions. NIH employees who are required to file financial disclosure statements also are prohibited from acquiring or holding financial interests, such as stocks, in these affected organizations. NIH employees now have until Oct. 3 to file financial disclosure reports and until Jan. 2, 2006, to divest themselves of prohibited financial interests. This is the second extension offered to NIH employees. “There's no doubt in my mind that at the end of the day the advice that NIH gives has to be completely untainted, completely unimpeachable, and completely trusted,” Director Elias A. Zerhouni, M.D., said during a teleconference sponsored by the Kaiser Family Foundation.
Health Insurance Statistics
The ranks of the uninsured appear to be leveling off, according to a survey conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. In 2004, 42 million Americans of all ages were without health insurance, about the same level as in 1997, the first year this survey began tracking these statistics. In addition, one in five working-age adults (those aged 18–64 years) were without health insurance last year, a number that had been steadily rising in recent years but also leveled off in 2004. The survey showed continued improvements in coverage for children: 7 million children under 18 years of age were without health insurance in 2004, compared with 10 million children in 1997.
Kids Miss Smoking/Addiction Link
Nearly one-third of children aged 10–12 years believe that they can smoke without becoming addicted, according to a survey of 418 families by the Group Health Cooperative's Center for Health Studies, Seattle. Terry Bush, Ph.D., and colleagues surveyed the preteens on their attitudes and beliefs about smoking over a 20-month period and found that the percentage agreeing with the statement “people can smoke a few cigarettes without becoming addicted” rose from 27% at the beginning of the study to 31% at the end. The percentage agreeing that “if you smoked, you could stop anytime you wanted to” dropped from 27% to 20% during that same period. The researchers found that two factors associated with positive attitudes toward smoking were lack of family cohesiveness and having a parent who smoked. The study appeared in the July/August issue of the American Journal of Health Promotion (2005;19:410–7).
Drinking, Drugging, Driving
One in three adult drivers aged 21–25 years has driven while under the influence of alcohol or drugs in the past year, according to a report from the Substance Abuse and Mental Health Services Administration. Using data from the 2002 and 2003 National Surveys on Drug Use and Health, the agency also found that among all adult drivers, 16% drove under the influence of alcohol alone, 4% drove under the influence of drugs alone, and 3% drove under the influence of both. “These new data show just how much work remains to be done to keep impaired drivers off the road,” said SAMHSA Administrator Charles Curie. The report also noted a gender difference: 22% of male drivers aged 21 years or older reported driving under the influence of alcohol or drugs in 2002 and 2003, compared with 11% of females.
APA Critical on Guantanamo Bay
The American Psychiatric Association says it is “troubled” by reports of alleged medical ethics violations in the treatment of prisoners at the Guantanamo Bay facility. The APA “clearly recommends that psychiatric physicians practice in accordance with the APA ethics guidelines,” the organization said in a statement. For example, the guidelines state that “ethical considerations in medical practice preclude the psychiatric evaluation of any person charged with criminal acts prior to access to, or availability of, legal counsel. The only exception is the rendering of care to the person for the sole purpose of medical treatment.” The APA said it expects to come out with more specific policies “in the near future.”
Antipsychotics in Nursing Homes
Physicians are prescribing antipsychotic drugs to nursing home patients at an increasingly high rate, according to a study published in the Archives of Internal Medicine. Becky A. Briesacher, Ph.D., of the University of Massachusetts, Worcester, and her colleagues examined data on more than 1,200 patients from the Medicare Current Beneficiary Survey for 2000 and 2001 and found that nearly 28% had received prescriptions for antipsychotic therapy–the highest rate reported in nearly a decade. Of those prescriptions, about one-third were for inappropriate indications such as impaired memory or depression without psychotic features. (Arch. Intern. Med. 2005;165:1280–5). “This study raises questions about the current uses of antipsychotics in nursing homes and the role of prescribing guidelines,” the authors wrote. “Now is an opportune time to evaluate this policy as Medicare readies itself to inherit Medicaid's growing costs and concerns over the widespread prescribing of atypical [antipsychotics] to frail nursing home residents.”
NIH Extends Disclosure Deadline
Officials at the Department of Health and Human Services are giving National Institutes of Health employees more time to report prohibited financial interests and to divest stock. In its announcement of the extension, HHS wrote that the department is considering issuing revisions to its current ethics regulations. In February, the agency issued regulations prohibiting NIH employees from engaging in consulting relationships with organizations that are substantially affected by NIH decisions. NIH employees who are required to file financial disclosure statements also are prohibited from acquiring or holding financial interests, such as stocks, in these affected organizations. NIH employees now have until Oct. 3 to file financial disclosure reports and until Jan. 2, 2006, to divest themselves of prohibited financial interests. This is the second extension offered to NIH employees. “There's no doubt in my mind that at the end of the day the advice that NIH gives has to be completely untainted, completely unimpeachable, and completely trusted,” Director Elias A. Zerhouni, M.D., said during a teleconference sponsored by the Kaiser Family Foundation.
Health Insurance Statistics
The ranks of the uninsured appear to be leveling off, according to a survey conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. In 2004, 42 million Americans of all ages were without health insurance, about the same level as in 1997, the first year this survey began tracking these statistics. In addition, one in five working-age adults (those aged 18–64 years) were without health insurance last year, a number that had been steadily rising in recent years but also leveled off in 2004. The survey showed continued improvements in coverage for children: 7 million children under 18 years of age were without health insurance in 2004, compared with 10 million children in 1997.
Kids Miss Smoking/Addiction Link
Nearly one-third of children aged 10–12 years believe that they can smoke without becoming addicted, according to a survey of 418 families by the Group Health Cooperative's Center for Health Studies, Seattle. Terry Bush, Ph.D., and colleagues surveyed the preteens on their attitudes and beliefs about smoking over a 20-month period and found that the percentage agreeing with the statement “people can smoke a few cigarettes without becoming addicted” rose from 27% at the beginning of the study to 31% at the end. The percentage agreeing that “if you smoked, you could stop anytime you wanted to” dropped from 27% to 20% during that same period. The researchers found that two factors associated with positive attitudes toward smoking were lack of family cohesiveness and having a parent who smoked. The study appeared in the July/August issue of the American Journal of Health Promotion (2005;19:410–7).
Drinking, Drugging, Driving
One in three adult drivers aged 21–25 years has driven while under the influence of alcohol or drugs in the past year, according to a report from the Substance Abuse and Mental Health Services Administration. Using data from the 2002 and 2003 National Surveys on Drug Use and Health, the agency also found that among all adult drivers, 16% drove under the influence of alcohol alone, 4% drove under the influence of drugs alone, and 3% drove under the influence of both. “These new data show just how much work remains to be done to keep impaired drivers off the road,” said SAMHSA Administrator Charles Curie. The report also noted a gender difference: 22% of male drivers aged 21 years or older reported driving under the influence of alcohol or drugs in 2002 and 2003, compared with 11% of females.
APA Critical on Guantanamo Bay
The American Psychiatric Association says it is “troubled” by reports of alleged medical ethics violations in the treatment of prisoners at the Guantanamo Bay facility. The APA “clearly recommends that psychiatric physicians practice in accordance with the APA ethics guidelines,” the organization said in a statement. For example, the guidelines state that “ethical considerations in medical practice preclude the psychiatric evaluation of any person charged with criminal acts prior to access to, or availability of, legal counsel. The only exception is the rendering of care to the person for the sole purpose of medical treatment.” The APA said it expects to come out with more specific policies “in the near future.”
Antipsychotics in Nursing Homes
Physicians are prescribing antipsychotic drugs to nursing home patients at an increasingly high rate, according to a study published in the Archives of Internal Medicine. Becky A. Briesacher, Ph.D., of the University of Massachusetts, Worcester, and her colleagues examined data on more than 1,200 patients from the Medicare Current Beneficiary Survey for 2000 and 2001 and found that nearly 28% had received prescriptions for antipsychotic therapy–the highest rate reported in nearly a decade. Of those prescriptions, about one-third were for inappropriate indications such as impaired memory or depression without psychotic features. (Arch. Intern. Med. 2005;165:1280–5). “This study raises questions about the current uses of antipsychotics in nursing homes and the role of prescribing guidelines,” the authors wrote. “Now is an opportune time to evaluate this policy as Medicare readies itself to inherit Medicaid's growing costs and concerns over the widespread prescribing of atypical [antipsychotics] to frail nursing home residents.”
NIH Extends Disclosure Deadline
Officials at the Department of Health and Human Services are giving National Institutes of Health employees more time to report prohibited financial interests and to divest stock. In its announcement of the extension, HHS wrote that the department is considering issuing revisions to its current ethics regulations. In February, the agency issued regulations prohibiting NIH employees from engaging in consulting relationships with organizations that are substantially affected by NIH decisions. NIH employees who are required to file financial disclosure statements also are prohibited from acquiring or holding financial interests, such as stocks, in these affected organizations. NIH employees now have until Oct. 3 to file financial disclosure reports and until Jan. 2, 2006, to divest themselves of prohibited financial interests. This is the second extension offered to NIH employees. “There's no doubt in my mind that at the end of the day the advice that NIH gives has to be completely untainted, completely unimpeachable, and completely trusted,” Director Elias A. Zerhouni, M.D., said during a teleconference sponsored by the Kaiser Family Foundation.
Health Insurance Statistics
The ranks of the uninsured appear to be leveling off, according to a survey conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. In 2004, 42 million Americans of all ages were without health insurance, about the same level as in 1997, the first year this survey began tracking these statistics. In addition, one in five working-age adults (those aged 18–64 years) were without health insurance last year, a number that had been steadily rising in recent years but also leveled off in 2004. The survey showed continued improvements in coverage for children: 7 million children under 18 years of age were without health insurance in 2004, compared with 10 million children in 1997.
Policy & Practice
APA Wary of Florida Law
A recently enacted Florida law that is expected to reduce the number of drugs the state's Medicaid program will pay for “puts people with mental illness at serious risk,” according to the American Psychiatric Association. The APA expressed concern about the limited number of drugs allowed in each therapeutic category; although the association's press release said only the two most cost-effective drugs were allowed, Jonathan Burns, press secretary for the state's Agency for Health Care Administration, said two drugs was the minimum number permitted and that there was no maximum. The “most harmful aspect of the law is a requirement that–each year–a patient must first fail on the cheapest mandated medications before the patient is given access to the medication his or her physician believes is optimal, even where the patient has been successfully treated with the physician-chosen medication,” the APA noted. But Mr. Burns said that once a physician has gotten prior authorization to put a patient on one of the formulary drugs, “that's the medication the patient uses. We're not going to ask physicians to put patients back on medications that they've already tried and haven't worked for them.” He did acknowledge, however, that some drugs currently on the formulary will be eliminated and no patients will be “grandfathered in,” so that some patients may have to change medications. The new formulary, which allows the state to negotiate with drug manufacturers, is expected to save millions of dollars.
Drug Misuse Death Rates
Baltimore and Albuquerque had the highest death rates from drug misuse of 32 metropolitan areas surveyed, with more than 200 deaths per 1 million people, according to a Substance Abuse and Mental Health Services Administration report. Minneapolis-St. Paul and Buffalo, N.Y., had the lowest rates, at 53 and 56 deaths per million, respectively, according to data from SAMHSA's Drug Abuse Warning Network. “Amazingly, the vast majority of people who need but do not receive treatment for a serious drug or alcohol problem don't even recognize they have a problem,” SAMHSA Administrator Charles Curie said. “We must encourage those in need to enter and remain in treatment before it's too late, before they become a mortality statistic.”
The OxyContin Wars
The federal Drug Enforcement Administration's efforts to stop illegal use of the prescription painkiller OxyContin have “cast a chill over the doctor-patient candor necessary for successful treatment,” Ronald T. Libby, Ph.D., a political science professor at the University of North Florida, wrote in a policy analysis for the Cato Institute, a libertarian think tank. The DEA's campaign includes elevating OxyContin to the status of other schedule II substances and using “aggressive undercover investigation, asset forfeiture, and informers,” he notes. “By demonizing physicians as drug dealers and exaggerating the health risks of pain management, the federal government has made physicians scapegoats for the failed drug war,” Dr. Libby wrote. When asked for comment, a DEA spokeswoman referred to a recent statement by DEA Administrator Karen Tandy. “We employ a balanced approach that recognizes both the unquestioned need for responsible pain medication, and the possibility … of criminal drug trafficking,” Ms. Tandy said, noting that physicians “are an extremely small part of the problem.”
Medicare Mental Health Drugs
The Centers for Medicare and Medicaid Services is requiring all health plans serving Medicare patients to include all antidepressant and antipsychotic drugs on their formularies starting in 2006, when the new Medicare drug benefit takes effect. In a document released in early June, the agency noted that in earlier guidance on the Medicare drug plan, it stated that “a majority” of drugs in these categories–as well as anticonvulsants, anticancer drugs, immunosuppressants, and HIV/AIDS drugs–would have to be on plan formularies and that beneficiaries should have uninterrupted access to all drugs in that class. But in training sessions and in answering user calls, “CMS has consistently explained that this meant that access to 'all or substantially all' drugs in these specific categories needed to be addressed by plan formularies,” the document stated. “This is because the factors described in our formulary guidance indicated that interruption of therapy in these categories could cause significant negative outcomes to beneficiaries in a short time frame.”
The Chosen Profession
“Be a physician” is the most common career advice that Americans give young adults, according to a Gallup poll of 1,003 adults aged 18 years and older. Twenty percent of survey respondents recommended that young women become doctors, while 17% suggested medicine as a career for young men. By comparison, only 11% and 8% suggested that women and men choose careers in computers, respectively. Nursing continues to be viewed as a women's profession: 13% thought women should choose nursing, but that choice did not even make the top five careers for men. Medicine has always been cited as a top career choice for men, although the percentages have been rising steadily over the years for women, as more pursue careers as physicians. “These poll results offer great encouragement for a profession facing a diversity gap and a workforce deficit,” said Jordan Cohen, M.D., president of the Association of American Medical Colleges.
APA Wary of Florida Law
A recently enacted Florida law that is expected to reduce the number of drugs the state's Medicaid program will pay for “puts people with mental illness at serious risk,” according to the American Psychiatric Association. The APA expressed concern about the limited number of drugs allowed in each therapeutic category; although the association's press release said only the two most cost-effective drugs were allowed, Jonathan Burns, press secretary for the state's Agency for Health Care Administration, said two drugs was the minimum number permitted and that there was no maximum. The “most harmful aspect of the law is a requirement that–each year–a patient must first fail on the cheapest mandated medications before the patient is given access to the medication his or her physician believes is optimal, even where the patient has been successfully treated with the physician-chosen medication,” the APA noted. But Mr. Burns said that once a physician has gotten prior authorization to put a patient on one of the formulary drugs, “that's the medication the patient uses. We're not going to ask physicians to put patients back on medications that they've already tried and haven't worked for them.” He did acknowledge, however, that some drugs currently on the formulary will be eliminated and no patients will be “grandfathered in,” so that some patients may have to change medications. The new formulary, which allows the state to negotiate with drug manufacturers, is expected to save millions of dollars.
Drug Misuse Death Rates
Baltimore and Albuquerque had the highest death rates from drug misuse of 32 metropolitan areas surveyed, with more than 200 deaths per 1 million people, according to a Substance Abuse and Mental Health Services Administration report. Minneapolis-St. Paul and Buffalo, N.Y., had the lowest rates, at 53 and 56 deaths per million, respectively, according to data from SAMHSA's Drug Abuse Warning Network. “Amazingly, the vast majority of people who need but do not receive treatment for a serious drug or alcohol problem don't even recognize they have a problem,” SAMHSA Administrator Charles Curie said. “We must encourage those in need to enter and remain in treatment before it's too late, before they become a mortality statistic.”
The OxyContin Wars
The federal Drug Enforcement Administration's efforts to stop illegal use of the prescription painkiller OxyContin have “cast a chill over the doctor-patient candor necessary for successful treatment,” Ronald T. Libby, Ph.D., a political science professor at the University of North Florida, wrote in a policy analysis for the Cato Institute, a libertarian think tank. The DEA's campaign includes elevating OxyContin to the status of other schedule II substances and using “aggressive undercover investigation, asset forfeiture, and informers,” he notes. “By demonizing physicians as drug dealers and exaggerating the health risks of pain management, the federal government has made physicians scapegoats for the failed drug war,” Dr. Libby wrote. When asked for comment, a DEA spokeswoman referred to a recent statement by DEA Administrator Karen Tandy. “We employ a balanced approach that recognizes both the unquestioned need for responsible pain medication, and the possibility … of criminal drug trafficking,” Ms. Tandy said, noting that physicians “are an extremely small part of the problem.”
Medicare Mental Health Drugs
The Centers for Medicare and Medicaid Services is requiring all health plans serving Medicare patients to include all antidepressant and antipsychotic drugs on their formularies starting in 2006, when the new Medicare drug benefit takes effect. In a document released in early June, the agency noted that in earlier guidance on the Medicare drug plan, it stated that “a majority” of drugs in these categories–as well as anticonvulsants, anticancer drugs, immunosuppressants, and HIV/AIDS drugs–would have to be on plan formularies and that beneficiaries should have uninterrupted access to all drugs in that class. But in training sessions and in answering user calls, “CMS has consistently explained that this meant that access to 'all or substantially all' drugs in these specific categories needed to be addressed by plan formularies,” the document stated. “This is because the factors described in our formulary guidance indicated that interruption of therapy in these categories could cause significant negative outcomes to beneficiaries in a short time frame.”
The Chosen Profession
“Be a physician” is the most common career advice that Americans give young adults, according to a Gallup poll of 1,003 adults aged 18 years and older. Twenty percent of survey respondents recommended that young women become doctors, while 17% suggested medicine as a career for young men. By comparison, only 11% and 8% suggested that women and men choose careers in computers, respectively. Nursing continues to be viewed as a women's profession: 13% thought women should choose nursing, but that choice did not even make the top five careers for men. Medicine has always been cited as a top career choice for men, although the percentages have been rising steadily over the years for women, as more pursue careers as physicians. “These poll results offer great encouragement for a profession facing a diversity gap and a workforce deficit,” said Jordan Cohen, M.D., president of the Association of American Medical Colleges.
APA Wary of Florida Law
A recently enacted Florida law that is expected to reduce the number of drugs the state's Medicaid program will pay for “puts people with mental illness at serious risk,” according to the American Psychiatric Association. The APA expressed concern about the limited number of drugs allowed in each therapeutic category; although the association's press release said only the two most cost-effective drugs were allowed, Jonathan Burns, press secretary for the state's Agency for Health Care Administration, said two drugs was the minimum number permitted and that there was no maximum. The “most harmful aspect of the law is a requirement that–each year–a patient must first fail on the cheapest mandated medications before the patient is given access to the medication his or her physician believes is optimal, even where the patient has been successfully treated with the physician-chosen medication,” the APA noted. But Mr. Burns said that once a physician has gotten prior authorization to put a patient on one of the formulary drugs, “that's the medication the patient uses. We're not going to ask physicians to put patients back on medications that they've already tried and haven't worked for them.” He did acknowledge, however, that some drugs currently on the formulary will be eliminated and no patients will be “grandfathered in,” so that some patients may have to change medications. The new formulary, which allows the state to negotiate with drug manufacturers, is expected to save millions of dollars.
Drug Misuse Death Rates
Baltimore and Albuquerque had the highest death rates from drug misuse of 32 metropolitan areas surveyed, with more than 200 deaths per 1 million people, according to a Substance Abuse and Mental Health Services Administration report. Minneapolis-St. Paul and Buffalo, N.Y., had the lowest rates, at 53 and 56 deaths per million, respectively, according to data from SAMHSA's Drug Abuse Warning Network. “Amazingly, the vast majority of people who need but do not receive treatment for a serious drug or alcohol problem don't even recognize they have a problem,” SAMHSA Administrator Charles Curie said. “We must encourage those in need to enter and remain in treatment before it's too late, before they become a mortality statistic.”
The OxyContin Wars
The federal Drug Enforcement Administration's efforts to stop illegal use of the prescription painkiller OxyContin have “cast a chill over the doctor-patient candor necessary for successful treatment,” Ronald T. Libby, Ph.D., a political science professor at the University of North Florida, wrote in a policy analysis for the Cato Institute, a libertarian think tank. The DEA's campaign includes elevating OxyContin to the status of other schedule II substances and using “aggressive undercover investigation, asset forfeiture, and informers,” he notes. “By demonizing physicians as drug dealers and exaggerating the health risks of pain management, the federal government has made physicians scapegoats for the failed drug war,” Dr. Libby wrote. When asked for comment, a DEA spokeswoman referred to a recent statement by DEA Administrator Karen Tandy. “We employ a balanced approach that recognizes both the unquestioned need for responsible pain medication, and the possibility … of criminal drug trafficking,” Ms. Tandy said, noting that physicians “are an extremely small part of the problem.”
Medicare Mental Health Drugs
The Centers for Medicare and Medicaid Services is requiring all health plans serving Medicare patients to include all antidepressant and antipsychotic drugs on their formularies starting in 2006, when the new Medicare drug benefit takes effect. In a document released in early June, the agency noted that in earlier guidance on the Medicare drug plan, it stated that “a majority” of drugs in these categories–as well as anticonvulsants, anticancer drugs, immunosuppressants, and HIV/AIDS drugs–would have to be on plan formularies and that beneficiaries should have uninterrupted access to all drugs in that class. But in training sessions and in answering user calls, “CMS has consistently explained that this meant that access to 'all or substantially all' drugs in these specific categories needed to be addressed by plan formularies,” the document stated. “This is because the factors described in our formulary guidance indicated that interruption of therapy in these categories could cause significant negative outcomes to beneficiaries in a short time frame.”
The Chosen Profession
“Be a physician” is the most common career advice that Americans give young adults, according to a Gallup poll of 1,003 adults aged 18 years and older. Twenty percent of survey respondents recommended that young women become doctors, while 17% suggested medicine as a career for young men. By comparison, only 11% and 8% suggested that women and men choose careers in computers, respectively. Nursing continues to be viewed as a women's profession: 13% thought women should choose nursing, but that choice did not even make the top five careers for men. Medicine has always been cited as a top career choice for men, although the percentages have been rising steadily over the years for women, as more pursue careers as physicians. “These poll results offer great encouragement for a profession facing a diversity gap and a workforce deficit,” said Jordan Cohen, M.D., president of the Association of American Medical Colleges.