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New legislation being pushed to empower EMTs may soon change the way first responders in California help patient get care while trying to ease the overcrowding of emergency rooms. A bill as proposed will allow paramedics to bring a patient to sobering centers and mental health clinics, instead of taking them to the ER. So should EMTs take patients to these alternative facilities to receive more specific forms of care?
Giving EMTs Options
When dealing with a situation, law enforcement personnel are permitted to transport individuals who are intoxicated or experiencing a mental health crisis to sobering centers or mental health clinics if deemed appropriate. Sometimes this is the best place for a patient, depending on the specific circumstances. However, under current state law in California, Emergency Medical Technicians (or EMTs) and paramedics must bring patients to the emergency room.
Some argue that requiring EMTs and paramedics to transport these patients to the ER is not only contributing to overcrowding in emergency rooms but also it is often not the best place for them. Los Angeles County Supervisor Janice Hahn is one of many who believes this is a “common sense” option for EMTs. Hahn states,
“The bottom line is that if people like you and I can take an individual to a sobering center or a mental health urgent care center, why can’t a highly trained medical professional do the same?”
Supervisor Janice Hahn has sponsored the new bill, hoping to give EMTs more options that better serve the individual. Hahn states,
“Our mental health urgent care centers and the sobering center at Skid Row were designed to provide humane, compassionate care, tailored to meet the needs of their patients,”
In cases involving law enforcement, this option allows police to choose specialized facilities instead of booking people in jail. This allows for people who may be dealing with alcohol, drugs or mental health issues to sober up and receive on-the-spot treatment without facing charges. According to Hahn, California paramedics and EMTs have their hands tied, and it is impacting hospitals and individuals.
Assembly Bill 1795
The new legislation is Assembly Bill 1795. This proposal would allow local emergency medical services agencies to lay out plans for transporting patients to:
- Designated behavioral health facilities
- Sobering centers that meet specific standards
Keep in mind, these patients will have to meet specific criteria in order to qualify. The bills recently amended language also states:
The bill would authorize a city, county, or city and county to designate, and contract with, a sobering center to receive patients, and would establish sobering center standards.
However, the bills current language also states that patients can instruct EMTs to take them to the emergency room and that it does not authorize them to initiate an involuntary detention of the patient.
This legislation also has support from Assemblyman Mike Gipson. He wrote an op-ed in February for the Compton Herald to support the measure. Gipson states,
“No one will deny that our emergency rooms are drastically over-crowded. Although they may be well-equipped to handle trauma, disasters or emergency physical health conditions—they are not as well-equipped to serve patients who have mental health care needs or substance abuse problems.”
Recently, Hahn herself planned a trip to Sacramento to advocate for the bill. And she isn’t the only one getting behind it. The bill is also co-sponsored by:
- Los Angeles County
- California Hospital Association
- California Ambulance Association
Another supporter of the proposal is Mitch Katz, the director of the county’s Department of Health Services. Katz points out that not only could this give EMTs the power to take patients to a more suitable facility, but that these options can also be much less expensive than taking patients to an emergency room.
While hospitals, EMTs and paramedics are a crucial part of saving lives in cases of overdose and other emergencies, when it comes to getting people a means to effective treatment unique to their needs, there are better options. Giving EMTs a resource to offer substance abuse and mental health treatment options could make a huge difference in the fight against addiction. Anything that connects people with effective treatment is an important step in the right direction.
We want to hear what you think- should EMTs take patients to sobering centers and/or mental health clinics?
Communities in many other parts of the country have begun to work on better ways to connect people struggling with substance abuse or mental health conditions with specialized treatment. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
When we talk about national addiction recovery, what we mean is acknowledging how we as a country and a culture are recovering in our communities. How are we supporting those in addiction treatment? What services are we making available? How is our economy recovering? What are we doing to prevent the spread of addiction?
So if we are taking away resources that not only treat those already struggling, but also prevent more people from suffering, how do we expect to ever escape the devastation caused by the opioid epidemic and rise of overdose deaths?
One of the most divisive issues facing America today is access to healthcare and the extent to which health coverage should or should not be provided. The debate has gone on for a long time, and in the shuffle of each proposal, it seems mental health and addiction services are constantly threatened. Recently there have been more attacks on addiction treatment access. So how is the possibility of more decreases in health coverage going to hurt national addiction recovery?
The Parity Protections
Once upon a time in 2008, the Mental Health Parity and Addiction Equity Act (MHPAEA) created guidelines that required health insurers to treat mental health and addiction coverage exactly the same as they would with medical and surgical care options. So this means that prior to the MHPAEA those who were lucky enough to have health insurance still could not be guaranteed to receive equitable benefits for mental health or substance abuse care.
These protections were even further expanded by the Affordable Care Act (ACA) and legislation put forth by Congress in 2016 with the 21st Century Cures Act, which includes tougher enforcement of parity requirements.
Since the Trump administration stepped in adamantly proclaiming the goal or repealing and replacing the ACA there has been a lot of concern about whether or not any new proposals will decrease health coverage for mental health and addiction services. Many addiction and mental health advocates worry that parity protections and enforcement will also lose their power.
As of yet, politicians are still hoping for a compromise that will keep the protections and resources for treating addiction and mental health intact.
BCBS Cuts Mental Health Coverage
One instance of concerning changes in policy has come out of Minnesota. Just this September the largest insurance carrier in the area, Blue Cross Blue Shield, is making drastic decreases to payments to mental health providers.
We are talking about cuts in addiction and mental health coverage to the tune of that’s 33%!
This decision came after a recent survey showed that the individual therapy costs of Minnesota had exceeded the national average for the last two years. But mental health professionals immediately spoke out against this move. Protests actually took place on Thursday the 14th outside the headquarters of Blue Cross Blue Shield in Eagan, MN. Many advocates and protesters are saying these kinds of cuts will put mental health clinics out of business.
The insurance provider is now under fire as caregivers insist this change will discourage necessary, extended psychotherapy services. People in Minnesota see decisions like that of BCBS as being a violation of the protections offered by parity.
If this kind of policy shift within insurance providers becomes a trend, we could see a dramatic decrease in the people getting substance abuse and mental health treatment. These changes can hurt our national addiction recovery by slowly cutting off the people who need every chance they can get, especially during a devastating opioid epidemic.
Threats within Medicaid
Believe it or not, Medicaid is currently the single largest payer for behavioral health services in America. Threats to the Medicaid health coverage of services like this could do critical damage.
At one point the Trump administration and congressional leaders seemed partial to the idea of turning Medicaid into a block grant program. This strategy would give states a fixed amount of money to provide healthcare for low-income residents. However, policy experts say that means states would have to:
- Reduce eligibility
- Narrow the scope of benefits
- Impose cost-sharing requirements
All of which would also impact the number of people seeking substance abuse and mental health treatment.
Recently GOP representatives and the Trump administration began the work of fundamentally altering state Medicaid programs. Some of these new requirements include governors pushing for:
So again, there is the very real possibility of more hurdles being put in-between those who need help and the already limited resources available to them.
Stigma Influencing Policy
The bigger part of this issue is that these shifts are happening in a way that shows how stigma is influencing policy. We are only further hurting our national addiction recovery by letting this idea that addiction is a moral failing or class issue limit what we are willing to provide to those who need help.
The reason behavioral and mental health services are so crucial is because the cause of addiction is not just the drugs themselves. The vast majority of recovery advocates endorse the concept that addiction develops from multiple factors, such as:
- Lack of access to resources
- Poor social networks
So in fact, by limiting coverage to mental health services, the problem could be magnified.
Mental health services like behavioral therapy being lost with a decrease in coverage means that more children and young adults could go without the support systems. What this does is puts more people in the exact circumstances where we see substance abuse and addiction grow.
So in essence, not only could these constant threats to addiction and mental health coverage be taking away treatment for those already addicted, but it also takes away from prevention programs in communities that fight to keep addiction rates down.
National Addiction Recovery Effects Everyone
If we have any hope of having sustainable national addiction recovery then it is vital that our country continues to push for mental health parity in every discussion about healthcare. If we ever hope to overcome the demoralization of communities we have to fight for mental health and addiction services.
This isn’t about treating the individual’s symptoms with just medications either. Access to other crucial elements like housing, medical care, and basic preventative measures all contribute to the overall mental health of any individual.
When people have better access to the specific levels of care they need, we empower them to contribute to the better communities we need for healthy nation-wide recovery.
People struggling with substance abuse and mental health disorders deserve comprehensive and compassionate treatment, and we should all fight to protect coverage that makes treatment more available. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-800-951-6135
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Author: Shernide Delva
If you thought all the attention surrounding the opioid epidemic would result in immediate progress, think again.
According to experts, things are going to get a lot worse before they get better.
But just how bad will it get?
Leading public experts agree the epidemic of people dying from opioids could reach up to a half million over the next decade.
Experts at ten universities were asked to project the death toll from opioid overdoses over the next decade. If the worst-case scenario plays out, by 2027, we could be losing 250 people every day to heroin/painkillers in the United States. Right now, that number is closer to 100 deaths per day.
Even scarier, substances like fentanyl and carfentanil, which are many times stronger than heroin, continue to drive up the death toll.
Recent statistics from the Centers for Disease Control and Prevention (CDC) estimate that in 2015, at least 33,000 people died from a fatal opioid overdose. Nearly half of those deaths involved prescription opioids like OxyContin or Percocet.
Still, there is hope that the death toll won’t continue to rise as fast as it currently is. In the best case scenario, STAT predicts 21,300 opioid deaths in 2027 which is lower than 2015 numbers. However, getting to this point will require major investments in evidence-based treatment.
Regardless, all experts agree on one fact: the opioid epidemic will get worse over the next decade before any improvement occurs.
Here are the 10 Opioid Epidemic Scenarios Projected by 2027
The worst scenario: In this scenario, the death toll projection for 2027 is 93,613, an 183% increase from 2015.
In this scenario, the drug overdose total will continue to climb at a steady rate as they have for decades. This scenario assumes that opioid deaths will continue to make up roughly the same percentage of all drug deaths.
In this scenario, the death toll projection for 2027 is 70,239 opioid deaths. This change would be an 112% increase since 2015.
This scenario assumes that opioid use climbs for the foreseeable future, but it takes into consideration the potential progress from reducing opioid prescriptions and other interventions.
In this scenario, the forecast for 2027 is 56,118 opioid deaths. This change would be a 70% jump since 2015.
This scenario assumes that total opioid deaths will rise slightly because of increasing fatal heroin and fentanyl overdoses. The influx of fentanyl and heroin will offset any improvement in prescription opioid abuse.
In this scenario, the opioid deaths forecast for 2027 is 46,740. This would be a 41% increase since 2015.
This scenario assumes that the death toll will increase due to fentanyl and lack of naloxone access. The decline of deaths would occur due to fewer doctors overprescribing opioids due to increase awareness.
In this scenario, the death forecast for 2027 is 45,000. This would be a 36% increase since 2015.
This scenario assumes an increase due to fentanyl use and a reduction in prescription opioid abuse. After several years, this scenario assumes that doctors will begin to prescribe painkillers more responsibly.
In this scenario, the opioid death forecast for 2027 is 44,843. This forecasted change would be a 36% increase since 2015.
This scenario assumes a sharp increase in deaths for the first few years before the effects of interventions and funding through the 21st Century Cures Act kicks into gear, driving the numbers down.
In this scenario, opioid deaths for 2027 is 40,652. This would be a 23% increase since 2015.
This scenario assumes opioid deaths will increase until a combination of intervention strategies like increase naloxone access, decreased prescription opioids, and increased treatment access lower fatal overdoses.
In this scenario, opioid deaths for 2027 is 40,000. This change would be a 21% increase since 2015.
This scenario assumes that heroin laced with synthetic opioids will cause opioid deaths to rise for several years. This rise will peak and then later decline as drug users either fatally overdose or seek treatment.
In this scenario, the death forecast for 2027 is 25,000. This is a 24% reduction since 2015.
This scenario assumes heroin laced with synthetic opioids will result in increased fatal overdoses for several years. Only after this increase will numbers start to decline, as increased naloxone access, addiction treatment, and more supervised injection sites reduce the numbers significantly, resulting in an overall decrease.
– The best scenario: In this scenario, the death forecast for 2027 is 21,300. This is a 36% reduction since 2015.
This scenario assumes that doctors will prescribe fewer opioids, and states will embrace prescription drug monitoring programs. Insurers will begin to enact reforms to increase treatment access.
Overall, all scenarios projected by experts agree that the opioid epidemic will get worse before it gets better if it gets better at all.
The experts agree that opioid deaths won’t begin to slow down until at least 2020. It takes time for governmental efforts to kick in and for education and public awareness to result in positive change.
“It took us about 30 years to get into this mess,” said Robert Valuck, a professor at the University of Colorado-Denver’s School of Pharmacy and Pharmaceutical Sciences. “I don’t think we’re going to get out of it in two or three.”
The opioid epidemic costs the US economy nearly $80 billion annually, according to federal officials. STAT notes that the US already spends about $36billion on addiction treatment, yet only 10% of the estimated 2.2 million Americans with opioid use disorder ever seek help.
This epidemic is not going off the radar anytime soon. Plenty of people are still deep into their addiction and need treatment immediately. If this sounds like you or someone you know, please call now. We want to help.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
Does anyone else remember that episode in Game of Thrones when Cersei Lannister (played by the amazing Lena Headey) was marched naked through the streets of King’s Landing for the “walk of atonement”? During this public ritual punishment, the Queen Mother is followed by Septa Unella, who rings a bell to attract the attention of the crowd while repeatedly crying out “Shame!” to encourage the people to leer and jeer at Cersei.
Remember how well that worked out… for everyone… especially Septa Unella?
Well, in case you are one of those people who have never watched this show and have no clue what I’m talking about… SHAME!
But seriously, the thought of it drives home a big point about how people try to use shame and disgrace to modify the behaviors they disapprove of. People in modern times, outside of the 7 kingdoms, will say stuff like “shame on you” or “you should be ashamed of yourself” in an attempt to deter someone from doing something they do not agree with. Sometimes, with good intentions, parents use this tactic as an alternative to physical punishment. Other times people will use shame to manipulate and control others.
But does shame really work? In the case of shaming people with addiction, it doesn’t seem to go far at all.
Shame VS Guilt
One thing people first have to understand is the difference between shame and guilt. Some would say that someone who has no shame is someone who lacks humility or a conscience. People may say that if you don’t feel ashamed, you must think you are too good for others or have no consideration of others. However, that is not necessarily the case.
When someone feels guilt, that is something from within that compels us to see the fault in our own actions. Guilt is based on your own view of something you have said or done that has been harmful to others. It is the consciences way of keeping us in check. Guilt and shame are not the same thing.
Shame is how we experience the disapproval of others. It is the adverse emotional response to being singled out and judged by others for being wrong or doing wrong. So guilt tells us that we know something we are doing is wrong, but shame is the outside world telling us it is wrong even if we don’t feel that inside.
To sum it up:
Acting with clear knowledge that a behavior is unacceptable is what typically inspires feelings of guilt. Thus, it is associated with a specific behavior and is not likely associated with psychological distress such as depression.
Shame can relate specifically to one’s entire self. It says “I am wrong” instead of “my choice was wrong”. This can put people at risk of developing unhealthy conditions like:
Why Shaming Doesn’t Work
Shaming someone into changing is manipulating their fear or social isolation or criticism to control their behavior. Our connection to each other is so crucial for out well-being, both psychologically and physically, that it can often be used against us. For some people the level of social rejection from shaming will scare them into avoiding that emotional punishment. Yet there is still an issue with this method at its core.
It’s like in that movie Inception, when Leonardo DiCaprio taught us all how to dream within a dream (I’ve been watching a lot of TV lately). At one point they talk about how an idea implanted in the mind won’t take if the mind knows it wasn’t organic; if it didn’t come from within.
Shame can be like that. If you tell someone that they should be ashamed of themselves for using drugs, they might stop because they need the social connection. However, if they do not themselves see that their drug use is harming themselves and others, then shaming them will drive them into hiding to avoid persecution.
For many who suffer with substance use disorder the addiction itself has an extreme emotional attachment of some kind. If the individual is motivated enough to use drugs, or believes they are capable of control without consequence, the shame will only result in them hiding their problems even more and further isolating themselves.
Shame and Stigma and the Self
The shame of the stigma of addiction can be counterproductive to an addict getting help. Ultimately, shame can drive stigma and further damage the individual’s chances of personal development. People can internalize shame and sabotage their self-worth, which often causes people to care less about their own safety.
If their choices are being dictated by anxiety then the destructive habits can increase as the shame drives them to remove themselves from those who disapprove of them. This isn’t only true for addiction. Shame can influence other adverse actions, such as:
Shaming people with addiction or people with mental health disorders is only supporting the stigma that make them feel separated from us. Telling an addict to be ashamed of themselves for their addiction may force them to do something, but this strategy is vastly ineffective when compared to compassion and support.
Research has shown shame is especially damaging when inflicted by someone who the individual is deeply connected to. Parents, family members, spouses and loved ones who shame each other create lasting imprints on one another. That strong emotional leverage can create an even deeper divide between us and the ones we love by diminishing our self-worth.
So shaming our loved ones who struggle with addiction may be less likely to inspire them to get help and more likely to scare them away from asking us for help when they need it.
No Pain No Shame
So to clarify, shaming someone may seem like it gets the job done, but in reality it is not effective at motivating healthy behaviors. In fact, shaming someone creates social withdrawal and undermines self-esteem. For someone struggling with substance use disorder, there is probably already enough feelings of disconnect of self-defeatism without being shamed.
Again, this doesn’t mean you can’t communicate with someone about how their behavior is impacting you. Setting boundaries and being honest is still important, but doing so in a compassionate way is more conducive to encouraging someone to do the right thing for the right reasons.
If we want to avoid hurting one another, we should avoid trying to shame each other into doing what we want. Shaming people with addiction isn’t going to heal their affliction. Making them feel separate and alone will not inspire the kind of change that creates stronger bonds. Focusing on celebrating good deeds can help a lot more than dwelling on every bad one and holding it over someone’s head.
Nurturing recovery is more powerful than shaming addiction.
Having a family member who has suffered can be harder on you than you know. Too many people don’t know how to get the help they need for their loved ones, and too many of our loved ones suffer for too long because they are afraid of the affects that the ones they care about most will face. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-800-951-6135
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Author: Shernide Delva
It’s the moment many were waiting for…
Today, May 3rd, Gov. Rick Scott issued a statewide public health emergency over the opioid epidemic. This declaration is in response to multiple requests from local officials and residents. Furthermore, more than $27 million will be distributed immediately to communities throughout the state of Florida to reduce the devastation of the opioid epidemic.
In a press release, Governor Scott said,
“Today, I issued an executive order which allows the state to immediately draw down more than $27 million in federal grant funding which will immediately be distributed to communities across the state to deal with the opioid epidemic. HHS Secretary Dr. Tom Price awarded the Opioid State Targeted Response Grant to Florida, and I want to thank the Trump Administration for their focus on this national epidemic. I have also directed State Surgeon General Dr. Celeste Philip to declare a Public Health Emergency and issue a standing order for Naloxone in response to the opioid epidemic in Florida.”
Rick Scott initiated four opioid listening workshops that took place earlier this week. The first workshop was held at West Palm Beach on May 1st. Three other opioid workshops were held later in the week in Manatee and Orange counties.
The Early Stages
Originally, Governor Rick Scott created the opioid workshops to gather information about the opioid epidemic on a more local level. Both public figures and members of the community joined to discuss potential plans of action. The meetings were capped at 90-minutes. Those in attendance were uncertain of the action that would take place from those meetings.
Therefore, those in attendance called on the governor to declare the opioid epidemic as a public health emergency in order to expedite funding efforts.
Shortly after the Zika virus entered South Florida, it was declared a public health crisis, yet the opioid epidemic did not receive the same treatment, despite overdose fatalities reaching an all-time high.
“If we were able to move that quickly on (the Zika) issue, why can’t we move more quickly on this (heroin) issue?’’ Palm Beach County Commissioner Melissa McKinley stated during the opioid workshop held in West Palm Beach.
Now, upon hearing this news from Gov. Rick Scott, McKinley feels a sense of relief.
“Today I feel relief. relief that the voices of so many were finally heard. For the pain of loss so many families have faced, to those struggling to overcome addiction,” she said.
“I am hopeful that the governor’s direction to declare a public health crisis in response to the opioid epidemic will open the door to a truly meaningful plan to fight this disease.”
The Palm Beach Post published an investigative report titled “Heroin: Killer of a Generation” in which they profiled all 216 people who died of an opioid overdose in its coverage are in 2015. The goal was to draw attention to the magnitude of the addiction epidemic in a way statistic simply could not do.
Looking at the statement Gov. Rick Scott released, a few key things are happening:
- More than $27 million in federal grant funding which will immediately be distributed to communities across the state to deal with the opioid epidemic.
- Dr. Celeste Philip is ordered by Gov. Rick Scott to declare a Public Health Emergency.
- Naloxone will receive a standing order in response to the opioid epidemic in Florida
The opioid epidemic is taking away lives throughout the nation. Every 15 hours last year, someone died of an opioid overdose in Palm Beach County. Is this a step in the right direction? What should the next step be?
This epidemic does not discriminate. Everyone is affected. If you are struggling with addiction, please reach out. Do not wait. Your life depends on it. We are here to help. Call now.
CALL NOW 1-800-951-6135