Friday, February 22, 2013

Number of Deadly Drug Overdoses Rises for 11th Year

This article comes from Joint Together a web based newletter.
 
The number of deadly drug overdoses in the United States increased for the 11th consecutive year, according to new government data. More than 22,000 people died of overdoses involving

Sunday, February 10, 2013

Treatment for Opiate Dependent individuals

You can get a copy of this TIP43 by calling 1-877-726-4727

http://www.ncbi.nlm.nih.gov/books/NBK64164/


The State Methadone Treatment Guidelines


Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs




Treatment Improvement Protocol (TIP) Series, No. 43

Center for Substance Abuse Treatment.
Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2005.
Report No.: (SMA) 05-4048

The following dialog user interface control may not be accessible. Tab to the next button to revert the control to an accessible version.
Destroy user interface controlCopyright and Permissions

The following dialog user interface control may not be accessible. Tab to the next button to revert the control to an accessible version.
Destroy user interface controlCite this Page
Order print copy from SAMHSA



This TIP, Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs, incorporates the many changes in medication-assisted treatment for opioid addiction (MAT) that have occurred over the most active decade of change since the inception of this treatment modality approximately 40 years ago. The TIP describes the nature and dimensions of opioid use disorders and their treatment in the United States, including basic principles of MAT and historical and regulatory developments. It presents consensus panel recommendations and evidence-based best practices for treatment of opioid addiction in opioid treatment programs (OTPs). It also examines related medical, psychiatric, sociological, and substance use disorders and their treatment as part of a comprehensive maintenance treatment program. The TIP includes a discussion of the ethical considerations that arise in most OTPs, and it provides a useful summary of areas for emphasis in successfully administering MAT in OTPs.

Friday, February 1, 2013

Emergency Room because of Buprenorphine

This article comes from an email I received from

I have not yet, evaluated this article using my critical thinking skills I learned by reading Critical Thinking About Research: Psychology and Related Professions, written by Dr. Julian Meltzoff  I highly recommended to advocates, patients and professionals who wants to improve their skills as consumers of research documents in psychology and related professions (i.e. social worker, counseling, psychiatric nurse, etc). 
This is not a book on research design or high level statistics. I consider it a book of concepts 
and ways of evaluating scientific documents.  I am alarmed by the little number of professionals that actually understand Evidence Based Treatment (which really means Scientific Researched modalities for validity and reliability.  Clinicians in mental health know next to nothing about science.  They sound like they do by throuhing around some statistics and using buzzwords and impressive language. But in close examination, I have come to realized they are actually in full of rubbish (to put it mildly).  Another book that open my eyes on this Evidence Based Treatment movement, which I see may clinicians holding it or taking it as if it was another fad. Which is actually how they now practice. Clinicians are currently practicing by fads and agreement not by evidence. The other book is "Whores of the Courts: Fraud of Psychiatric Testimony and the Rape of American Justice by Dr. Margaret A. Hagen. both books are not fad, but the a growing number of scientifically based well researched, cited and documented record of the practice of a health system going nuts. Ignoring not only the science they claim to practice but the critical Code of Ethics necessary for the welfare of their patients.
 
Clinicians are actually joyfully oblivious to the harm they are producing to substance use and mental health patients. Unfortunately it is not an exception, but a rule, the conditions are prevalent not only a few examples.

Please help me think about this article, and make some comments on what you read.


Emergency departments reported a significant rise in the number of visits related to the opioid addiction medication buprenorphine between 2005 and 2010, according to a new government report.

Emergency

Saturday, January 19, 2013

Mental ill budget Cuts

NAMI

National Alliance of Mental Illness

http://www.nami.org/template.cfm?section=about_the_issue

America’s Mental Health Care Future


As a nation, the U.S. is the third highest spender on health care per person, yet our health outcomes rank 37th compared to other nations. We can do better. Even though the economy is in dire condition, our nation will recover. Our nation’s health care system is undergoing a complete overhaul to prepare for better times ahead. A uniquely American approach based on the Patient Protection and Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act (Parity Act) will bring the insurance industry into line and strengthen public/private partnerships. However, NAMI’s advocacy is needed to prevent harmful consequences and ensure the right care at the right time and in the right place to give every child and adult living with mental illness the chance to succeed in the family, school, workplace and community.


Budget Advocacy


Budget cuts today are dismantling state mental health care systems at levels never faced before. NAMI's top advocacy priority is to protect and strengthen state and local public mental health services. (more)


The High Costs of Cutting Mental Health


The costs of cutting the state mental health budgets are high. The lives of the one in four Americans who experiences a mental illness at some point is at stake. Treatment works -- if you can get it.

Without treatment, more people will end up hospitalized, in shelters, on the street, in jail or dead. These are costs that are too high to pay.

Our fact sheets illustrate the impact of an inadequate mental health system on our communities . We can't afford to neglect our investment. Advocates are encouraged to print and use these in their efforts with elected public policy makers, the media and others.


Policy Webinars & Presentations



Managed Care, Medicaid and Mental Health



Mental Health Block Grant


The Substance Abuse and Mental Health Services Administration (SAMHSA) has developed two policy framework documents to provide guidance to state mental health authorities and community stakeholders regarding allocation of Mental Health Block Grant (MHBG) and Substance Abuse Prevention and Treatment block grant (SAPT) funding.

Wednesday, January 2, 2013

Does Relapse rate increase during holidays.

From Substance Matter by Dr. Mark Willenbring

It is the grand believe of 12 Step Programs that the Holydays is a great risk to alcoholics and people
with substance dependences.  Here is a study on that matter.
 
http://mattsub.blogspot.com/2012/12/do-relapse-rates-rise-around-holidays.html


Do relapse rates rise around the holidays?
Mark Willenbring, MD at Substance Matters: - 1 week ago

Many people assume that the time between Thansksgiving and the winter solstice holidays are the most difficult time of the year for people in recovery. Temptations are harder to avoid, what with office and holiday parties, family gatherings, and so forth. Many people with alcohol dependence come from families with many heavy drinkers, so alcohol may be flowing freely, and there may be others who are intoxicated. (Ever notice how boring and obnoxious intoxicated people can be if you're not intoxicated yourself?) So cue-induced craving is certainly an issue, whether your cues are vis... more »

Wednesday, December 19, 2012

Electronic Mail to a Disability Advocacy Attorney

I don't know if you sent this information exclusively to me or is it written in your blog for all of your subscribers.

As you may have noted this is a long time concern of mine.

[INFORMATION LEFT BLANK AS TO NOT TO IDENTIFY THE AUTHOR OF THIS EMAIL.  THE NAME OF THE ATTORNEY IS ALSO LEFT BLANK FOR HIS PRIVACY] 

I was not "Grandfather In" but rather I had to test and passed the licesing board examination in the first sitting (most candidates sit for the test a number of times before they pass it.).  I knew that their were some "missing links" but I thought is was the result of early science.  I was wrong, the field  is over 100 years old in 1879 with the first psychology laboratory at University of Leipzig founded by German physiologist  Wilhelm Wundt who used scientific research methods to investigate reaction times.  Outlined many of the major connections between the science of physiology and the study of human thought and behavior.  Science numerous laboratories have been founded at many universities and private enterprises worldwide.

It was not until I became a patient that I realized how wide spread the lack of science is behind the practice of psychotherapy and treatment.  The professions  have been lacking understanding of or total misconception of the sciences, not many evidence based treatment have been implemented. So is not that the science and appropriate protocols do not exist, but rather that the great majority of it is being outright ignored by the great majority of practitioners.  Guess who suffers? You have no idea how devastating such poor treatment can be to patients who comes to psychological treatment expecting the same kind of treatment you and I expect from the family practitioner that prescribe you an antibiotic for an infection, a medication for AIDS, physical therapy for an amputee etc. The latter have been rigorously tested while treatment for mental health and substance abuse is frequently based on junk science.  Mental Health is in better condition, for the most part, they receive empathetic responses from counselors which are frequently known to be

Nevertheless, as I have sat in the advisory board this has been biggest of concerns. The lack of relevant scientific standards. One would wonder why these issues has not come  up earlier.  The fact is that I am not alone regarding these concerns.  Professionals with a lot more credentials than I have been bringing these issues up at conferences  and American Psychological Association committees.  For the most part, their concerns seem to be falling in "deaf ears".  The committees etc. have a tendency to politically and politely compensate at the expense of patients receiving appropriate medical protocols.

The lack of scientific standards is pervasive and entrenched for the last one hundred years or so. Many of my colleagues who taken the science posture some of them seen that it maybe futile as the Am. Psychological Association and is allied professions have a tendency of not policing themselves well as they do not want to loose the membership fees that they so much needed to survive as an organization.  Most of my colleague believe that the problem will not be resolve until they receive external help from the legal professions in "search for the truth" and evidence. 

I have yet to read  these "Lawyer's Guide to Understanding Psychiatry" so I can not give you a full impression or review. But there are two issues that come up for me right away. There maybe accurate information in the book, but I am also wondering whether the physician author who wrote the book maybe "protecting the profession". Altough here the subject seem to be

Mine and colleagues concern are:

-Most information our society claims to understand about psychology, starting with the legacy left behind by Sigmund Freud and all his theoretical followers  is based on armchair speculation, hunches, "educational intuition", and "Case Study" the substantial majority  of these claims are hypothesis that have never been tested.

-In many cases rigorous quantitative empirical research do not support  the treatment approach used.  Nevertheless these speculations become popular believe systems that are frequently fallible.  They are mainly fads and we do not know whether they are effective, much less safe (i.e. when a patient commits  suicide we have assumed it is due to the nature of his mental illness, or the substance they were using like alcohol.  We have never questioned  whether it was the wrong treatment provide for the patients condition. Specially in alcohol and substance used disorder where treatment is frequently forceful, confrontational, and  abundantly  religious (even when public funds are used). Where the approaches are riddle with guilt and other emotionally badgering. Hoping to elicit some type of catharsis. When treatment fails, the patients is assumed to be responsible.  No other treatment approach blames the patient for the outcome, the outcome is always the responsibility of the professional not the patient.,
-When I reported a number of abuses to Department of Children and Family, even though they agreed on a number of violations. They could not denied because the evidence was so solid (I had an inch and half thick of patient's notes, treatment plans, discharge notes, and other documents with the patients names etc.) They have a total disregard for patients' privacy and confidentially. They openly discussed other patients' issues in front of other patients and used patients to harass other patients like me who had submitted a grievance (another issue for which they were found to violate).  This is a violations that I have witnessed frequently within a lot of the social service organizations.

-Yet even though I have a police report that stated that I was assaulted by staff member the staff was the aggressor and in fact the staff member ripped my cell phone from my hand and broke it in half because I was taking photos and videos of the staff misbehavior. Department of Children and Family did a superficial investigation. Took the staff members word at face value, the staff member provided them with a spook patient.  They blame me for the assault.  I had requested a Grievance Committee from the county or a Hearing from DCF and both of my request were ignored (I have copies of emails sent to authorities).

-I belong to a group who are openly stigmatized, discriminated against and outright bigotry behavior is not rare. We are thought to be thiefs, outright lies, manipulators and all sort of other negative characteristics. We would be consider clients with a limited capacity to be a witness. Yet longitudinal studies done Hester Reid and William Miller from University of New Mexico (2003 Handbook of Alcoholism Treatment Approach, please read thrugh this short book review(I have read all 3 volumes and own two of them http://www.jsad.com/jsad/downloadarticle/Handbook_of_Alcoholism_Treatment_Approaches_Effective_Alternatives/352.pdf  ) have found that alcoholics and substance dependent persons have the same kinds of personalities that you will find in the general populations

I didn't realized it was so pervasive (and I am part of the community) until I read an article by Dr Scott Lilienfled assistant professor from Emory University in Atlanta, Ga. He is a frequent contributor to Scientific America http://www.scientificamerican.com/author.cfm?id=1371 ,  I was in treatment years ago and I thought at the time it was an issue of lack of professional ethics by this individual facility. The name of the article "Assault on Scientific Mental Health" in

-                           


Nevertheless, as I have sat in the advisory board this has been biggest of concerns. The lack of relevant scientific standards. One would wonder why these issues has not come  up earlier.  The fact is that I am not alone regarding these concerns.  Professionals with a lot more credentials than I have been bringing these issues up at conferences  and American Psychological Association committees.  For the most part, their concerns seem to be falling in "deaf ears".  The committees etc. have a tendency to politically and politely compensate at the expense of patients receiving appropriate medical protocols.

The lack of scientific standards is pervasive and entrenched for the last one hundred years or so. Many of my colleagues who taken the science posture some of them seen that it maybe futile as the Am. Psychological Association and is allied professions have a tendency of not policing themselves well as they do not want to loose the membership fees that they so much needed to survive as an organization.  Most of my colleague believe that the problem will not be resolve until they receive external help from the legal professions in "search for the truth" and evidence. 

I have yet to read  these "Lawyer's Guide to Understanding Psychiatry" so I can not give you a full impression or review. But there are two issues that come up for me right away. There maybe accurate information in the book, but I am also wondering whether the physician author who wrote the book maybe "protecting the profession". Altough here the subject seem to be

Mine and colleagues concern are:

-Most information our society claims to understand about psychology, starting with the legacy left behind by Sigmund Freud and all his theoretical followers  is based on armchair speculation, hunches, "educational intuition", and "Case Study" the substantial majority  of these claims are hypothesis that have never been tested.

-In many cases rigorous quantitative empirical research do not support  the treatment approach used.  Nevertheless these speculations become popular believe systems that are frequently fallible.  They are mainly fads and we do not know whether they are effective, much less safe (i.e. when a patient commits  suicide we have assumed it is due to the nature of his mental illness, or the substance they were using like alcohol.  We have never questioned  whether it was the wrong treatment provide for the patients condition. Specially in alcohol and substance used disorder where treatment is frequently forceful, confrontational, and  abundantly  religious (even when public funds are used). Where the approaches are riddle with guilt and other emotionally badgering. Hoping to elicit some type of catharsis. When treatment fails, the patients is assumed to be responsible.  No other treatment approach blames the patient for the outcome, the outcome is always the responsibility of the professional not the patient.,
-When I reported a number of abuses to Department of Children and Family, even though they agreed on a number of violations. They could not denied because the evidence was so solid (I had an inch and half thick of patient's notes, treatment plans, discharge notes, and other documents with the patients names etc.) They have a total disregard for patients' privacy and confidentially. They openly discussed other patients' issues in front of other patients and used patients to harass other patients like me who had submitted a grievance (another issue for which they were found to violate).  This is a violations that I have witnessed frequently within a lot of the social service organizations.

-Yet even though I have a police report that stated that I was assaulted by staff member the staff was the aggressor and in fact the staff member ripped my cell phone from my hand and broke it in half because I was taking photos and videos of the staff misbehavior. Department of Children and Family did a superficial investigation. Took the staff members word at face value, the staff member provided them with a spook patient.  They blame me for the assault.  I had requested a Grievance Committee from the county or a Hearing from DCF and both of my request were ignored (I have copies of emails sent to authorities).

-I belong to a group who are openly stigmatized, discriminated against and outright bigotry behavior is not rare. We are thought to be thiefs, outright lies, manipulators and all sort of other negative characteristics. We would be consider clients with a limited capacity to be a witness. Yet longitudinal studies done Hester Reid and William Miller from University of New Mexico (2003 Handbook of Alcoholism Treatment Approach, please read thrugh this short book review(I have read all 3 volumes and own two of them http://www.jsad.com/jsad/downloadarticle/Handbook_of_Alcoholism_Treatment_Approaches_Effective_Alternatives/352.pdf  ) have found that alcoholics and substance dependent persons have the same kinds of personalities that you will find in the general populations

I didn't realized it was so pervasive (and I am part of the community) until I read an article by Dr Scott Lilienfled assistant professor from Emory University in Atlanta, Ga. He is a frequent contributor to Scientific America http://www.scientificamerican.com/author.cfm?id=1371 ,  I was in treatment years ago and I thought at the time it was an issue of lack of professional ethics by this individual facility. The name of the article "Assault on Scientific Mental Health" in