As The Coronavirus Spreads, Americans Lose Ground Against Other Health Threats

For much of the 20th century, medical progress seemed limitless.

Antibiotics revolutionized the care of infections. Vaccines turned deadly childhood diseases into distant memories. Americans lived longer, healthier lives than their parents.

Yet today, some of the greatest success stories in public health are unraveling.

Even as the world struggles to control a mysterious new viral illness known as COVID-19, U.S. health officials are refighting battles they thought they had won, such as halting measles outbreaks, reducing deaths from heart disease and protecting young people from tobacco. These hard-fought victories are at risk as parents avoid vaccinating children, obesity rates climb, and vaping spreads like wildfire among teens.

Things looked promising for American health in 2014, when life expectancy hit 78.9 years. Then, life expectancy declined for three straight years — the longest sustained drop since the Spanish flu of 1918, which killed about 675,000 Americans and 50 million people worldwide, said Dr. Steven Woolf, a professor of family medicine and population health at Virginia Commonwealth University.

Although life expectancy inched up slightly in 2018, it hasn’t yet regained the lost ground, according to the Centers for Disease Control and Prevention.

“These trends show we’re going backwards,” said Dr. Sadiya Khan, an assistant professor of cardiology and epidemiology at Northwestern University Feinberg School of Medicine.

While the reasons for the backsliding are complex, many public health problems could have been avoided, experts say, through stronger action by federal regulators and more attention to prevention.

“We’ve had an overwhelming investment in doctors and medicine,” said Dr. Sandro Galea, dean of the Boston University School of Public Health. “We need to invest in prevention — safe housing, good schools, living wages, clean air and water.”

The country has split into two states of health, often living side by side, but with vastly different life expectancies. Americans in the fittest neighborhoods are living longer and better — hoping to live to 100 and beyond — while residents of the sickest communities are dying from preventable causes decades earlier, which pulls down life expectancy overall.

Superbugs — resistant to even the strongest antibiotics — threaten to turn back the clock on the treatment of infectious diseases. Resistance occurs when bacteria and fungi evolve in ways that let them survive and flourish, in spite of treatment with the best available drugs. Each year, resistant organisms cause more than 2.8 million infections and kill more than 35,000 people in the U.S.

With deadly new types of bacteria and fungi ever emerging, Dr. Robert Redfield, the CDC director, said the world has entered a “post-antibiotic era.” Half of all new gonorrhea infections, for example, are resistant to at least one type of antibiotic, and the CDC warns that “little now stands between us and untreatable gonorrhea.”

That news comes as the CDC also reports a record number of combined cases of gonorrhea, syphilis and chlamydia, which were once so easily treated that they seemed like minor threats compared with HIV.

The United states has seen a resurgence of congenital syphilis, a scourge of the 19th century, which increases the risk of miscarriage, permanent disabilities and infant death. Although women and babies can be protected with early prenatal care, 1,306 newborns were born with congenital syphilis in 2018 and 94 of them died, according to the CDC.

Those numbers illustrate the “failure of American public health,” said Dr. Cornelius “Neil” Clancy, a spokesperson for the Infectious Diseases Society of America. “It should be a global embarrassment.”

The proliferation of resistant microbes has been fueled by overuse, by doctors who write unnecessary prescriptions as well as farmers who give the drugs to livestock, said Dr. William Schaffner, a professor of preventive medicine at Vanderbilt University Medical Center in Nashville, Tennessee.

Although new medications are urgently needed, drug companies are reluctant to develop antibiotics because of the financial risk, said Clancy, noting that two developers of antibiotics recently went out of business. The federal government needs to do more to make sure patients have access to effective treatments, he said. “The antibiotic market is on life support,” Clancy said. “That shows the real perversion in how the health care system is set up.”

A Slow Decline

A closer look at the data shows that American health was beginning to suffer 30 years ago. Increases in life expectancy slowed as manufacturing jobs moved overseas and factory towns deteriorated, Woolf said.

By the 1990s, life expectancy in the United states was falling behind that of other developed countries.

The obesity epidemic, which began in the 1980s, is taking a toll on Americans in midlife, leading to diabetes and other chronic illnesses that deprive them of decades of life. Although novel drugs for cancer and other serious diseases give some patients additional months or even years, Khan said, “the gains we’re making at the tail end of life cannot make up for what’s happening in midlife.”

Progress against overall heart disease has stalled since 2010. Deaths from heart failure — which can be caused by high blood pressure and blocked arteries around the heart — are rising among middle-aged people. Deaths from high blood pressure, which can lead to kidney failure, also have increased since 1999.

“It’s not that we don’t have good blood pressure drugs,” Khan said. “But those drugs don’t do any good if people don’t have access to them.”

Addicting A New Generation

While the United states never declared victory over alcohol or drug addiction, the country has made enormous progress against tobacco. Just a few years ago, anti-smoking activists were optimistic enough to talk about the “tobacco endgame.”

Today, vaping has largely replaced smoking among teens, said Matthew Myers, president of the Campaign for Tobacco-Free Kids. Although cigarette use among high school students fell from 36% in 1997 to 5.8% today, studies show 31% of seniors used electronic cigarettes in the previous month.

FDA officials say they’ve taken “vigorous enforcement actions aimed at ensuring e-cigarettes and other tobacco products aren’t being marketed or sold to kids.” But Myers said FDA officials were slow to recognize the threat to children.

With more than 5 million teens using e-cigarettes, Myers said, “more kids are addicted to nicotine today than at any time in the past 20 years. If that trend isn’t reversed rapidly and dynamically, it threatens to undermine 40 years of progress.”

Ignoring Science

Where children live has long determined their risk of infectious disease. Around the world, children in the poorest countries often lack access to lifesaving vaccines.

Yet in the United states — where a federal program provides free vaccines — some of the lowest vaccination rates are in affluent communities, where some parents disregard the medical evidence that vaccinating kids is safe.

Studies show that vaccination rates are drastically lower in some private schools and “holistic kindergartens” than in public schools.

It could be argued that vaccines have been a victim of their own success.

Before the development of a vaccine in the 1960s, measles infected an estimated 4 million Americans a year, hospitalizing 48,000, causing brain inflammation in about 1,000 and killing 500, according to the CDC.

By 2000, measles cases had fallen to 86, and the United states declared that year that it had eliminated the routine spread of measles.

“Now, mothers say, ‘I don’t see any measles. Why do we have to keep vaccinating?’” Schaffner said. “When you don’t fear the disease, it becomes very hard to value the vaccine.”

Last year, a measles outbreak in New York communities with low vaccination rates spread to almost 1,300 people — the most in 25 years — and nearly cost the country its measles elimination status. “Measles is still out there,” Schaffner said. “It is our obligation to understand how fragile our victory is.”

Health-Wealth Disparities

To be sure, some aspects of American health are getting better.

Cancer death rates have fallen 27% in the past 25 years, according to the American Cancer Society. The teen birth rate is at an all-time low; teen pregnancy rates have dropped by half since 1991, according to the Department of Health and Human Services. And HIV, which was once a death sentence, can now be controlled with a single daily pill. With treatment, people with HIV can live into old age.

“It’s important to highlight the enormous successes,” Redfield said. “We’re on the verge of ending the HIV epidemic in the U.S. in the next 10 years.”

Yet the health gap has grown wider in recent years. Life expectancy in some regions of the country grew by four years from 2001 to 2014, while it shrank by two years in others, according to a 2016 study in JAMA.

The gap in life expectancy is strongly linked to income: The richest 1% of American men live 15 years longer than the poorest 1%; the richest women live 10 years longer than the poorest, according to the JAMA study.

“We’re not going to erase that difference by telling people to eat right and exercise,” said Dr. Richard Besser, CEO of the Robert Wood Johnson Foundation and former acting director of the CDC. “Personal choices are part of it. But the choices people make depend on the choices they’re given. For far too many people, their choices are extremely limited.”

The infant mortality rate of black babies is twice as high as that of white newborns, according to the Department of Health and Human Services. Babies born to well-educated, middle-class black mothers are more likely to die before their 1st birthday than babies born to poor white mothers with less than a high school education, according to a report from the Brookings Institution.

In trying to improve American health, policymakers in recent years have focused largely on expanding access to medical care and encouraging healthy lifestyles. Today, many advocate taking a broader approach, calling for systemic change to lift families out of the poverty that erodes mental and physical health.

“So many of the changes in life expectancy are related to changes in opportunity,” Besser said. “Economic opportunity and health go hand in hand.”

Several policies have been shown to improve health.

Children who receive early childhood education, for example, have lower rates of obesity, child abuse and neglect, youth violence and emergency department visits, according to the CDC.

And earned income tax credits — which provide refunds to lower-income people — have been credited with keeping more families and children above the poverty line than any other federal, state or local program, according to the CDC. Among families who receive these tax credits, mothers have better mental health and babies have lower rates of infant mortality and weigh more at birth, a sign of health.

Improving a person’s environment has the potential to help them far more than writing a prescription, said John Auerbach, president and CEO of the nonprofit Trust for America’s Health.

“If we think we can treat our way out of this, we will never solve the problem,” Auerbach said. “We need to look upstream at the underlying causes of poor health.”

By: Liz Szabo, Kaiser Health News
Title: As The Coronavirus Spreads, Americans Lose Ground Against Other Health Threats
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Published Date: Wed, 11 Mar 2020 06:57:53 +0000

At New Horizon Drug Rehab, we understand addiction. If you or a family member are afflicted with addiction or substance abuse we can help. We work with the top centers throughout the US to provide the best detox and addiction treatments available.

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Debra DiGiovanni: It's Not the Weed That's Making You Funny

Debra DiGiovanni, an award-winning Canadian comedian living in Los Angeles, is easy to love. She boasts a growing list of accomplishments, including hosting the Genie Awards alongside Sandra Oh and appearing on the 5th season of Last Comic Standing and Conan. Last year, her album Lady Jazz received a Juno Award nomination for Comedy Album of the Year, and she recently co-wrote and sold a digital series to Comedy Central. DiGiovanni is an absolute murderer on stage, whether performing at a small venue in Silverlake or a sold-out arena.

Despite her rigorous road schedule, she agreed to meet with me to discuss her sobriety. Her West Hollywood apartment smells like shampoo and feels like a hug. There is a jigsaw puzzle in progress on the coffee table.

You have been doing comedy for 20 years, and just celebrated 4 years sober. Can you tell me, just in terms of your career, what it was like, what happened, and what it is like now?

When I turned 33, I stopped drinking. The minute I quit, my marijuana just got to a [whole new] level. When I got successful enough that I didn’t have a day job anymore, it started to get really bad. Don’t get me wrong, I would smoke a joint before I went to the office, but this was like, I have nothing but a show tonight – so why not smoke all day? I gave up on relationships, friendships got really small. Only comedy brought me out of my apartment. 

In 2011, I started cancelling and lying. The bullshit stories make me embarrassed to even think about right now. Just ‘cause I wanted to sit home and smoke. Giving up thousands of dollars – and I did that dozens of times. I would say I fell, I got hit by a car. I had a sling at home just in case I had to go to the store and anyone saw me. It took me five more years to quit.

I moved to L.A. in 2014. If I thought that I smoked before — it got to a level where that’s all I did. So, it was Christmas 2015 and it just started to — by the grace of God — it just started to taste bad. Like my body was starting to go we gotta stop now. I always had lung problems, I always had vocal problems, I was always sick. I would get a cold and it would turn into a lung infection.

I started looking online, asking how do I quit marijuana? I started looking at 12-step programs. I remember seeing a quote: the sneaky thing about marijuana, as opposed to heroin or coke or even alcohol – it may not kill you quick but you don’t go anywhere. [It’s like] treading water — you don’t go under, but you don’t go forward. And that really struck me. Eventually, you’re going to get tired and go under.

Then I chose a deadline. It was Christmas of 2015, and I had cancelled on my family to go home, like I did every year [because] I would realize I can’t go for a week without smoking. I bought copious amounts of pot and said: when this is done, then I’m done.

And all I did for ten days was smoke and watch TV and eat. On January 4, I woke up with two days’ worth left. I called my best friend on FaceTime and took all my stuff, all my accoutrements, and threw it all in the dumpster. [I] tore my medical card up in front of her, flushed the weed down the toilet, and said I’m done. She cried and then I cried.

Since I’ve been sober — I’m on stage all the time, [and] I have a very nice reputation. I’m on Step 8 and I look forward to The Promises. They say [when you’re through with] Step 9, they start coming true. First three months of being sober I thought were gonna kill me. People who don’t think you detox from marijuana: you’re wrong. I could feel it coming out of my body and I’d be sick. I had weeks of night terrors. You don’t really dream when you’re high all the time, you just sleep. [So there was] a lot of emotional stuff and crying.

At the beginning, I lost a lot of friends. Or people just thought I should only take a year off [from weed]. And I was worried about my creativity. [But] I can say this: I am a better comedian now. I’m sharper, I remember things, I know where I am, I’m not mumbling. Every day I wake up and thank god I’m sober.

My mother passed away in January of 2018. She and I had a very hard relationship my whole life. She got really sick in the middle of 2016. I was six months sober when all her cancers came back. I told my super Christian conservative parents I’m a drug addict and they both looked at me and said Okay. Can we help? I was able to ask my mother for forgiveness and she did the same with me and then I got to spend 18 months with her before she died. I went home for Christmas and got to spend this fantastic Christmas with Mom. I left on the 28th and on the 29th she started to slip in and out of consciousness for the next nine days and then she passed. That was all God.

Did you ever feel like there was a wall between you and the audience or you and the world when you were high?

Yeah, and I wanted it. I wanted that wall. I was there, but there wasn’t a real connection and it was sort of like looking at them through tissue paper. I’m from Canada and I had quite a bit of success there. And there was no real enjoyment of my success. Nothing mattered. I didn’t care. I was always numb. So [when I received] big accolades, [I] would be like yeah great. That’s heartbreaking to think about now. I would win an award and show up high off my ass like…thanks. And just want to get out of there to continue getting high. 

Did you take time off comedy when you first got sober?

Not long, but a couple of weeks. The first two weeks I was severely debilitated. I didn’t know how to function. There was a commercial in the 90’s for quitting smoking — about relearning to live without cigarettes — the whole thing was a guy getting up in the morning to get ready for work and putting the iron on his face and the juice on his shirt; as the commercial goes along, now he’s ironing his shirt. Thankfully I’m a comedian and there were days where I didn’t need to function. I didn’t book anything, so I [could] stay home. I would go to a meeting and talk to whoever and cry. It came out a lot in tears. I would go for walks.

And I was scared to perform without marijuana. It wasn’t just the detox. I had 16 days under my belt and my best friend was like you gotta go sometime. And I was truly shocked that I was still able to tell jokes. It felt foreign. And it just kept getting better. 

Was there a transition period, do you feel like your material changed?

Yeah, I don’t talk about marijuana anymore. But you know I don’t really talk about being sober yet either. I have one joke about it — you will not be surprised to hear – [that] doesn’t go over very well. If I say I don’t smoke marijuana, I get booed sometimes. I am very open about it, I will tell anyone who wants to know. Even if you don’t want to know, I will tell you. I don’t do a lot of sober stuff on stage, but a lot of my jokes were about marijuana. I kind of have those moments where I wonder if I made my personality marijuana. There’s moments when I wonder if that’s all that I was, a stoner. And I am so much more than that. There’s a chunk [of material] that’s gone. I’m also about truth. If it’s not happening, I’m not gonna talk about it onstage.

Last February was your first Conan appearance. Are you happy that it didn’t happen earlier?

It wouldn’t have happened earlier. I just know that. I’m so glad. All these things that I get to do now: I’m there, I’m experiencing them. I remember them. [Before], everything was a glazed blur. There’s footage of me at the Canadian TV awards — like the Emmys. I won one and I don’t remember a second of my acceptance speech because I was so high. Now I’m here: good, bad, or otherwise.

What is your favorite thing about being sober in comedy?

All my jokes are now being written for everybody, rather than just focusing on potheads. I love always being on time. I’ll show up and the host isn’t there yet and that’s not me – I was always late. I love not running out to get high. I love not focusing on who I’m going to smoke a joint with while I’m on stage. The whole thing was get high with these people get high with those people — that was just it, really, the only concern. When can I get this over with so I can go home and get high? It was just a little blip rather than what I wanted to do. Like, okay I’m doing comedy tonight but when can I get high? Being present is what I love. Watching other comics. I never used to do that, I was always outside. 

What is the most challenging thing about being totally sober in comedy?

The camaraderie is gone. I know I miss out on bonding because [of] being sober and my age. After shows now, I chat with everyone, I hug everyone, and then I go home. I don’t find drunk and high people that stimulating to be around. Especially drunk people. I can hang around two rounds and then, when everyone’s on their third or fourth drink, that’s when I’m gonna go. They don’t even know I’m there. And I don’t even need to say goodbye – they don’t even know I’m leaving. I am way more of a lunch and coffee person. You wanna have brunch? I’m your girl. A party is not for me anymore. I have those moments where I have to accept that. That’s not who I am anymore. I was always the girl who had weed. That was my position. When that position was taken away from me, there was a little bit of — I don’t know what I bring to this anymore, I don’t know who I am in this community anymore. I’m okay now, but in the first couple of years I couldn’t be around pot smokers. Now I can. But only to a certain extent. Also, I don’t want to smell like pot anymore. But for the first year and a half the minute someone would start smoking I’d be like okay I gotta go

What advice would you give to a comedian in their first year of sobriety?

Reach out to other comedians you know who are sober because there’s just a ton of us. It’s a good community. You are not alone. I don’t know a single sober comedian that wouldn’t have a cup of coffee with you. I’ve befriended comedians on Twitter who said “I’m sober” and then we talked — never met them in real life but we are friendly because of the bonding of sobriety. Especially alcohol — there’s a gang of comics who go to AA now together. I’ve mostly stopped going to AA now because I’m focused on another addiction, but there’s a ton.

My suggestion is: You are just as funny; you will be funnier. I know there are no guarantees but I can almost promise you that you will be funnier. It’s not the weed that’s making you funny. It’s just not. And reach out. And take time off. Take time off if you need to take time off, but if a month has gone by, reach out and get back on stage because you’re going to find out who you are now and it’s going to be glorious and you’re really gonna look back and go “I’m so glad I’m sober!”

And — we need you! We need as many sobers as we can get!

By: Rebecca Rush
Title: Debra DiGiovanni: It's Not the Weed That's Making You Funny
Sourced From:
Published Date: Tue, 10 Mar 2020 05:45:34 +0000

At New Horizon Drug Rehab, we understand addiction. If you or a family member are afflicted with addiction or substance abuse we can help. We work with the top centers throughout the US to provide the best detox and addiction treatments available.

Call Now: (877) 747-9974

They Fell In Love Helping Drug Users. But Fear Kept Him From Helping Himself.

She was in medical school. He was just out of prison.

Sarah Ziegenhorn and Andy Beeler’s romance grew out of a shared passion to do more about the country’s drug overdose crisis.

Ziegenhorn moved back to her home state of Iowa when she was 26. She had been working in Washington, D.C., where she also volunteered at a needle exchange — where drug users can get clean needles. She was ambitious and driven to help those in her community who were overdosing and dying, including people she had grown up with.

“Many people were just missing because they were dead,” said Ziegenhorn, now 31. “I couldn’t believe more wasn’t being done.”

She started doing addiction advocacy in Iowa city while in medical school — lobbying local officials and others to support drug users with social services.

Beeler had the same conviction, born from his personal experience.

“He had been a drug user for about half of his life — primarily a longtime opiate user,” Ziegenhorn said.

Beeler spent years in and out of the criminal justice system for a variety of drug-related crimes, such as burglary and possession. In early 2018, he was released from prison. He was on parole and looking for ways to help drug users in his hometown.

He found his way to advocacy work and, through that work, found Ziegenhorn. Soon they were dating.

“He was just this really sweet, no-nonsense person who was committed to justice and equity,” she said. “Even though he was suffering in many ways, he had a very calming presence.”

People close to Beeler describe him as a “blue-collar guy” who liked motorcycles and home carpentry, someone who was gentle and endlessly curious. Those qualities could sometimes hide his struggle with anxiety and depression. Over the next year, Beeler’s other struggle, with opioid addiction, would flicker around the edges of their life together.

Eventually, it killed him.

People on parole and under supervision of the corrections system can face barriers to receiving appropriate treatment for opioid addiction. Ziegenhorn said she believes Beeler’s death is linked to the many obstacles to medical care he experienced while on parole.

About 4.5 million people are on parole or probation in the U.S., and research shows that those under community supervision are much more likely to have a history of substance use disorder than the general population. Yet rules and practices guiding these agencies can preclude parolees and people on probation from getting evidence-based treatment for their addiction.

A Shared Passion For Reducing Harm

From their first meeting, Ziegenhorn said, she and Beeler were in sync, partners and passionate about their work in harm reduction — public health strategies designed to reduce risky behaviors that can hurt health.

After she moved to Iowa, Ziegenhorn founded a small nonprofit called the Iowa Harm Reduction Coalition. The group distributes the opioid-overdose reversal drug naloxone and other free supplies to drug users, with the goal of keeping them safe from illness and overdose. The group also works to reduce the stigma that can dehumanize and isolate drug users. Beeler served as the group’s coordinator of harm reduction services.

“In Iowa, there was a feeling that this kind of work was really radical,” Ziegenhorn said. “Andy was just so excited to find out someone was doing it.”

Meanwhile, Ziegenhorn was busy with medical school. Beeler helped her study. She recalled how they used to take her practice tests together.

“Andy had a really sophisticated knowledge of science and medicine,” she said. “Most of the time he’d been in prison and jails, he’d spent his time reading and learning.”

Beeler was trying to stay away from opioids, but Ziegenhorn said he still used heroin sometimes. Twice she was there to save his life when he overdosed. During one episode, a bystander called the police, which led to his parole officer finding out.

“That was really a period of a lot of terror for him,” Ziegenhorn said.

Beeler was constantly afraid the next slip — another overdose or a failed drug test — would send him back to prison.

An Injury, A Search For Relief

A year into their relationship, a series of events suddenly brought Beeler’s history of opioid use into painful focus.

It began with a fall on the winter ice. Beeler dislocated his shoulder — the same one he’d had surgery on as a teenager.

“At the emergency room, they put his shoulder back into place for him,” Ziegenhorn said. “The next day it came out again.”

She said doctors wouldn’t prescribe him prescription opioids for the pain because Beeler had a history of illegal drug use. His shoulder would dislocate often, sometimes more than once a day.

“He was living with this daily, really severe constant pain — he started using heroin very regularly,” Ziegenhorn said.

Beeler knew what precautions to take when using opioids: Keep naloxone on hand, test the drugs first and never use alone. Still, his use was escalating quickly.

A Painful Dilemma 

The couple discussed the future and their hope of having a baby together, and eventually Ziegenhorn and Beeler agreed: He had to stop using heroin.

They thought his best chance was to start on a Food and Drug Administration-approved medication for opioid addiction, such as methadone or buprenorphine. Methadone is an opioid, and buprenorphine engages many of the same opioid receptors in the brain; both drugs can curb opioid cravings and stabilize patients. Studies show daily maintenance therapy with such treatment reduces the risks of overdose and improves health outcomes.

But Beeler was on parole, and his parole officer drug-tested him for opioids and buprenorphine specifically. Beeler worried that if a test came back positive, the officer might see that as a signal that Beeler had been using drugs illegally.

Ziegenhorn said Beeler felt trapped: “He could go back to prison or continue trying to obtain opioids off the street and slowly detox himself.”

He worried that a failed drug test — even if it was for a medication to treat his addiction — would land him in prison. Beeler decided against the medication.

A few days later, Ziegenhorn woke up early for school. Beeler had worked late and fallen asleep in the living room. Ziegenhorn gave him a kiss and headed out the door. Later that day, she texted him. No reply.

She started to worry and asked a friend to check on him. Not long afterward, Beeler was found dead, slumped in his chair at his desk. He’d overdosed.

“He was my partner in thought, and in life and in love,” Ziegenhorn said.

It’s hard for her not to rewind what happened that day and wonder how it could have been different. But mostly she’s angry that he didn’t have better choices.

“Andy died because he was too afraid to get treatment,” she said.

Beeler was services coordinator for the Iowa Harm Reduction Coalition, a group that works to help keep drug users safe. A tribute in Iowa city after his death began, “He died of an overdose, but he’ll be remembered for helping others avoid a similar fate.” (COURTESY OF SARAH ZIEGENHORN)

How Does Parole Handle Relapse? It Depends

It’s not clear that Beeler would have gone back to prison for admitting he’d relapsed and was taking treatment. His parole officer did not agree to an interview.

But Ken Kolthoff, who oversees the parole program that supervised Beeler in Iowa’s First Judicial District Department of Correctional Services, said generally he and his colleagues would not punish someone who sought out treatment because of a relapse.

“We would see that that would be an example of somebody actually taking an active role in their treatment and getting the help they needed,” said Kolthoff.

The department doesn’t have rules prohibiting any form of medication for opioid addiction, he said, as long as it’s prescribed by a doctor.

“We have people relapse every single day under our supervision. And are they being sent to prison? No. Are they being sent to jail? No,” Kolthoff said.

But Dr. Andrea Weber, an addiction psychiatrist with the University of Iowa, said Beeler’s reluctance to start treatment is not unusual.

“I think a majority of my patients would tell me they wouldn’t necessarily trust going to their [parole officer],” said Weber, assistant director of addiction medicine at the University of Iowa’s Carver College of Medicine. “The punishment is so high. The consequences can be so great.”

Weber finds probation and parole officers have “inconsistent” attitudes toward her patients who are on medication-assisted treatment.

“Treatment providers, especially in our area, are still very much ingrained in an abstinence-only, 12-step mentality, which traditionally has meant no medications,” Weber said. “That perception then invades the entire system.”

Attitudes And Policies Vary Widely

Experts say it’s difficult to draw any comprehensive picture about the availability of medication for opioid addiction in the parole and probation system. The limited amount of research suggests that medication-assisted treatment is significantly underused.

“It’s hard to quantify because there are such a large number of individuals under community supervision in different jurisdictions,” said Michael Gordon, a senior research scientist at the Friends Research Institute, based in Baltimore.

A national survey published in 2013 found that about half of drug courts did not allow methadone or other evidence-based medications used to treat opioid use disorder.

A more recent study of probation and parole agencies in Illinois reported that about a third had regulations preventing the use of medications for opioid use disorder. Researchers found the most common barrier for those on probation or parole “was lack of experience by medical personnel.”

Faye Taxman, a criminology professor at George Mason University, said decisions about how to handle a client’s treatment often boil down to the individual officer’s judgment.

“We have a long way to go,” she said. “Given that these agencies don’t typically have access to medical care for clients, they are often fumbling in terms of trying to think of the best policies and practices.”

Increasingly, there is a push to make opioid addiction treatment available within prisons and jails. In 2016, the Rhode Island Department of Corrections started allowing all three FDA-approved medications for opioid addiction. That led to a dramatic decrease in fatal opioid overdoses among those who had been recently incarcerated.

Massachusetts has taken similar steps. Such efforts have only indirectly affected parole and probation.

“When you are incarcerated in prison or jail, the institution has a constitutional responsibility to provide medical services,” Taxman said. “In community corrections, that same standard does not exist.”

Taxman said agencies may be reluctant to offer these medications because it’s one more thing to monitor. Those under supervision are often left to figure out on their own what’s allowed.

“They don’t want to raise too many issues because their freedom and liberties are attached to the response,” she said.

Richard Hahn, a researcher at New York University’s Marron Institute of Urban Management who consults on crime and drug policy, said some agencies are shifting their approach.

“There is a lot of pressure on probation and parole agencies not to violate people just on a dirty urine or for an overdose” said Hahn, who is executive director of the institute’s Crime & Justice Program.

The federal government’s Substance Abuse and Mental Health Services Administration calls medication-assisted treatment the “gold standard” for treating opioid addiction when used alongside “other psychosocial support.”

Addiction is considered a disability under the Americans with Disabilities Act, said Sally Friedman, vice president of legal advocacy for the Legal Action Center, a nonprofit law firm based in New York city.

She said disability protections extend to the millions of people on parole or probation. But people under community supervision, Friedman said, often don’t have an attorney who can use this legal argument to advocate for them when they need treatment.

“Prohibiting people with that disability from taking medication that can keep them alive and well violates the ADA,” she said.

This story is part of a partnership between NPR and Kaiser Health News.

By: Will Stone, Kaiser Health News
Title: They Fell In Love Helping Drug Users. But Fear Kept Him From Helping Himself.
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Published Date: Mon, 09 Mar 2020 06:32:53 +0000

At New Horizon Drug Rehab, we understand addiction. If you or a family member are afflicted with addiction or substance abuse we can help. We work with the top centers throughout the US to provide the best detox and addiction treatments available.

Call Now: (877) 747-9974

Demi Lovato: Snapshot of Recovery

Singing the national anthem at the NFL Championship game is considered a great honor, even if it can be rather unforgiving in terms of criticism. This year the honor was given to Demi Lovato, singer, pop-culture icon, mental health activist, and, perhaps most notably, a person in recovery for substance abuse.

Of Singing and Substance Abuse

It appears as though the media and the public have had a positive reaction to Lovato’s singing of the national anthem. Her release of a new single, “Anyone,” a few weeks earlier have marked a sort of career revival for Lovato. This is significant, considering that the musician was considering leaving her music career behind after a near-fatal overdose two years ago.

Before the overdose, Lovato had been in recovery for nearly six years. In various interviews, she admitted to abusing alcohol and cocaine, mentioning that she frequently smuggled it onto planes and into other venues. Lovato’s addiction problem became so bad that it began to affect her career and her ability to perform. Regardless, the singer’s return to the public scene provides a stark lesson regarding the nature of recovery. Relapses may be devastating, but they are not always absolute. One can come back from a relapse and still live and flourish in recovery.

A History of Substance Abuse

From the start of her career, Demi Lovato struggled with mental health challenges. She ultimately found herself in an inpatient rehab facility. Following her treatment, Lovato maintained sobriety and went on to hit several career highs. While in recovery, Lovato released some of her top-selling albums, built a loyal and energetic fanbase, and became involved with mental health activism, even going on to speak about the topic at the 2016 Democratic National Convention.

In July of 2018, Lovato suffered an overdose from oxycodone laced with fentanyl. She was rushed to a hospital and revived with naloxone. The overdose occurred after six years of sobriety for Lovato. Following the overdose, Lovato thanked her fans for her support, but went on an extended hiatus. Her performance at the NFL Championship game marks her return to her music career, and is a testament to the process of recovery.

People Like us…

Demi Lovato is an example of how living in recovery can be empowering. Despite various mental health and substance abuse challenges, and a near-fatal relapse, Lovato has chosen to reclaim her career and her life in recovery. While her continuing involvement in mental health activism remains unconfirmed, Lovato’s story provides an honest snapshot of the recovery process.Woman inspired to take the journey to recovery after hearing that demi lovato in recovery

Yet, Lovato is but one example of a person making their way in recovery. Everyday people face the specter of relapse, the niggling little temptations to break sobriety. It’s important to remember that recovery is a journey. Sometimes the journey gets tough. But the will to keep going, regardless of the challenges, is the key to finding peace and freedom from addiction.

By: Timothy Esteves
Title: Demi Lovato: Snapshot of Recovery
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Published Date: Tue, 04 Feb 2020 19:24:24 +0000

At New Horizon Drug Rehab, we understand addiction. If you or a family member are afflicted with addiction or substance abuse we can help. We work with the top centers throughout the US to provide the best detox and addiction treatments available.

Call Now: (877) 747-9974

Victims of the Opioid Crisis

As you probably know by now, we are in the midst of an opioid crisis.  Experts have estimated 10.3 million Americans aged 12 and older misused opioids last year, including 9.9 million prescription pain reliever abusers and 808,000 heroin users.  Additionally, the U.S. Department of Health & Human Services has reported that more than 130 people died every day from opioid-related drug overdoses in 2016 and 2017.

Unfortunately, my friend’s younger brother falls into these sobering statistics.  A star football player in college, he went on to be a successful engineer in his twenties and early thirties.   But as the years went on, his old football injuries kept nagging him, resulting in chronic pain he dealt with on a daily basis.  He turned to pain pills for relief, but soon began abusing them.  It wasn’t long until his addiction got so out of control that he couldn’t hold a job and would disappear for days at a time.   The last time his family lost contact with him they found him a week later, having overdosed on heroin.   No one – and I mean no one – ever thought something like this could happen to someone like him.

But my friend’s brother is not an exception.  Opioid addiction can happen to anyone, and many who wind up using are not your stereotypical addict often portrayed in the media.  They can be doctors, stay-at-home moms or even senior citizens.  What makes opioids so addictive is that they bind to receptors in the brain and spinal cord, disrupting pain signals.  They also activate reward areas of the brain by releasing the hormone dopamine, creating that addictive feeling of euphoria or a “high.”

Thankfully, however, our country has opened its eyes to this real epidemic affecting society and started taking action.  In 2016, the 21st Century Cures Act was passed, allocating $1 billion in opioid crisis grants to states in order to provide funding for expanded treatment and prevention programs.  The following year, the Opioid Fraud and Abuse Detection Unit within the Department of Justice was launched, which has aimed to prosecute individuals who commit opioid-related health care fraud.  Then, in 2018, President Trump signed opioid legislation into law, called the SUPPORT for Patients and Communities Act, which aimed at promoting research to find new, non-addictive pain management drugs.  The legislation also expanded access to treatment for substance use disorders for Medicaid patients.  Finally, national opiate litigation has been underway, with drug makers, such as Purdue Pharma, Teva Pharmaceuticals and McKesson Corporation, being held accountable for their role in the opioid crisis.

By: Natalie Baker
Title: Victims of the Opioid Crisis
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Published Date: Wed, 08 Jan 2020 16:07:58 +0000

At New Horizon Drug Rehab, we understand addiction. If you or a family member are afflicted with addiction or substance abuse we can help. We work with the top centers throughout the US to provide the best detox and addiction treatments available.

Call Now: (877) 747-9974