Patients with addiction or mental-health
related problems accounted for 12.5 percent of all hospital
emergency-room visits by adults in 2007, according to a
report from the U.S. Agency for Healthcare Research and
Quality.
The Los Angeles Times
reported July 9 that 12 million ER visits annually were
caused by addictions or mental illness; of these, 66 percent
involved mental-health problems, 25 percent involved alcohol
or other drug abuse, and 9 percent involved both. The
hospitalization rate for these patients were 41 percent,
more than 2.5 times the rate for other patients.
The most common causes of addiction and
mental-health admissions to emergency departments were mood
disorders, anxiety disorders, alcohol disorders, drug
disorders, schizophrenia and other psychoses, and
intentional self-harm.
Police Challenged by Crashes Involving
Prescription Drugs
Car crashes involving prescription
drugs are often harder to detect and prosecute than those
involving alcohol or illicit drugs, the New York Times reported.
Drunk-driving crashes are declining, but
law-enforcement officials say that more people are being
charged with driving under the influence of prescription
drugs. However, unlike with alcohol, there’s no standard
for intoxication for prescription painkillers, anti-anxiety
medications, and other legal drugs. Also, taking such drugs
(alone or in combination with other substances or alcohol)
has widely different effects on different people —all of
which makes prosecuting such offenses harder. "How do
we balance between people who legitimately need their
prescriptions and protecting the public?" said Mark
Neil of the National Traffic Law Center. "It becomes a
very delicate balance."
Blood-alcohol content is the standard to
measure drunk driving, and some states have made any
detectable level of illicit drugs the presumption for
intoxication. But that won’t work for prescription drugs,
which are legal.
Police departments are training officers
to detect impairment by prescription drugs, and experts said
that prevention and education also must play a role.
"We have a pretty clear message in this country that
you don’t drink and drive," said U.S. drug czar Gil
Kerlikowske. "We need very much to have a similar
message when it comes to drugs."
In court, people accused of driving under
the influence of prescription drugs often claim they
didn’t realize they were impaired. Prosecutors counter
that such drugs have warning labels that should be heeded,
but juries often sympathize with the drivers.
"Because most people on the jury will
also likely be taking prescription drugs for some ailment,
whether it’s Lipitor or allergy pills or whatever it might
be, they might think, ‘I don’t want that to become
criminal,’" said Maryland attorney general Douglas
Gansler.
Proposed BP Funding Levels of Gulf Oil Spill
Behavioral Health Needs
Responding to calls from the Obama
Administration and the Gulf Coast states, BP recently
announced its intention to contribute $52 million to help
address the immense behavioral health (substance abuse and
mental health) needs of Gulf Coast area residents and
workers struggling to recover their livelihood in the
aftermath of the Deepwater Horizon oil spill.
As discussed in the recent Institute of
Medicine (IOM) Letter Report: Assessing the Effects of the
Gulf of Mexico Oil Spill on Human Health, the oil spill has
"disrupted delicate social, economic, and psychological
balances in communities across the region." From the
fishing community to the local tourism industry, individuals
in affected areas face an uncertain economic future, causing
significant anger and resentment.
In addition to the stress resulting from a
potentially permanent disruption of their livelihoods,
residents are and will remain concerned about the immediate
and long-term effects of the oil spill on their health. The
long-term effects of the cleanup efforts on the workers are
not yet known.
These factors combined indicate a
substantial behavioral health need. Already disaster
coordinators in the affected states are reporting that some
individuals in the impacted areas are exhibiting early signs
of substance abuse and dependence, psychiatric disorders,
suicidal tendencies, and familial breakdown, including
divorce and abuse. The impact can be especially severe on
children.
These stress reactions are real and can
lead to debilitating health conditions, including conditions
traditionally considered "physical" as well as
mental and substance use disorders. Congress recognized that
behavioral health disorders are equivalent to other health
conditions when it passed the Mental Health Parity and
Addiction Equity Act of 2008 (MHPAEA), providing that
medical and behavioral health needs are not separate
entities and, thus, should not be treated as such.
If behavioral health conditions are left
untreated, we can expect that the mental health status of
these individuals and their families will worsen that the
cost associated with other health conditions, domestic
violence, criminal justice, education, and lost productivity
will increase.
The states are critical leaders in the
effort to address behavioral health issues. BP has rightly
recognized the role of the states and the critical need for
behavioral health services, and has opened a dialogue to
continue to find ways to help those struggling to get by.