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In the last few decades, the drug overdose epidemic has worsened dramatically. The number of deaths from drug overdoses has skyrocketed, particularly among White people and people who live in rural areas. This aspect of the epidemic has gotten a lot of attention, because the rate has been increasing so quickly. However, it is not the whole story of the drug overdose epidemic.

A new NIH analysis  of drug overdose deaths shows that the epidemic is huge and national, affecting people of all racial and ethnic groups, in cities, suburbs, small towns, and rural areas, and rates of drug overdose are rising among almost all groups. Most U.S. overdose deaths involve opioids, a group of drugs that includes illegal drugs like heroin and prescription pain medicines like oxycodone (OxyContin) and hydrocodone (Vicodin). In 2017, the U.S. Department of Health and Human Services declared the opioid crisis a national public health emergency. Recently, the Centers for Disease Control and Prevention (CDC) published a report on preliminary data showing a significant decline in prescription use-related deaths for the first time since 1990. However, deaths from other opioid use continue to rise.

Opioids bind to receptors on nerve cells in your body. The drugs block pain but can also slow your breathing and digestion. In an opioid overdose, your breathing and heartbeat can slow to a dangerously low rate. An overdose of a stimulant like cocaine or methamphetamines, on the other hand, speeds your heart rate and raises your blood pressure to dangerous levels.

Drug overdoses were increasing very slowly through the 1980s but took off in the late 1990s as prescriptions for opioid pain medicines increased. A second wave of the epidemic began in 2010, when overdose deaths related to heroin started to increase among younger people, predominantly those ages 20 to 40. Meanwhile, several factors contributed to a reduction in overdose deaths related to opioid prescriptions; one study suggests that physicians were cutting back on opioid prescriptions because of worries about overdoses, and people who were already addicted to prescription opioids were switching to heroin.

There are multiple aspects to the issue of drug abuse, including genetic, environmental, social, and socioeconomic factors that contribute to this crisis. By funding research on the opioid crisis, NIMHD hopes to find out more about what is causing the drug overdose epidemic—and how to address it.

Read more on NIMHD.gov.

A new study, published in American Psychologist, examines the impact of official infractions given for minor misconduct, or minor infractions, on students in the American school system. Researchers found that minor infractions negatively impact adolescents who demonstrate a strong attachment to school as a form of support, contribute to increases in adolescents’ misconduct, and are also disproportionately given to African-American students, as opposed to white students.

These findings are concerning as schools in the United States tend to rely on punitive discipline policies as a way to manage student behavior. The results suggest that these discipline tactics are not only ineffective but contribute to racial inequalities and the very behaviors that these modes of punishment are trying to deter.

Rebellious, risky behavior is common in teenagers, as it provides them with a way of gaining a sense of independence from adults, as well as acceptance from their peers, both of which are crucial to adolescent development. Adolescents may break minor, inconsistently enforced rules at school such as violating dress codes, using their cell phones, or joking around during class in an attempt to test boundaries, assert a sense of autonomy, and to impress their peers. Although disruptive to the classroom, minor misconduct may be fundamental to healthy adolescent development.

The U.S. school system typically takes a punitive approach to discipline, imposing official disciplinary actions, such as infractions, suspensions, or detentions, on students who violate rules to deter future misbehavior. While intended to manage classroom behavior, current research demonstrates that disciplinary action has negative consequences. Suspensions are given disproportionately to African American students and to predict worse outcomes in life, including involvement in the criminal justice system.

A key takeaway from the research findings is that current methods of addressing student misbehavior are ineffective, and in fact, harmful to students. The authors suggest that replacing a punitive approach to discipline with interventions that help build positive student-teacher relationships is crucial to resolving this problem. They offer the Consistency Management and Cooperative Discipline program as a potential alternative, as this approach encourages a more active student role in the classroom, through promoting the co-creation of rules by teachers and students.

Additionally, this study highlights the racial disparities present within the educational disciplinary system and shows how discrimination against African American students can contribute to an increase in future defiant behavior, which in turn, can put them at risk for future criminal justice involvement.

Read more on MadInAmerica.com.

Most gay and bisexual men of all racial and ethnic groups are now aware of pre-exposure prophylaxis (PrEP) to prevent HIV, but Black and Latino men are less likely than white men to have discussed PrEP with a health care provider and to have used it within the past year, according to a recent report from the Centers for Disease Control and Prevention (CDC).

As described in the September 20 edition of the CDC’s Morbidity and Mortality Weekly Report (MMWR), an analysis of data from 23 cities showed that 42% of white men who have sex with men (MSM) reported taking PrEP within the past year, compared with 30% of Latino men and 26% of Black men. 

“To expand PrEP use, interventions to increase PrEP awareness, encourage health care providers to discuss PrEP, destigmatize PrEP use and promote racial/ethnic equity in PrEP access are needed,” the study authors concluded.

The Food and Drug Administration approved daily Truvada (tenofovir disoproxil fumarate/emtricitabine) for HIV prevention in 2012. Since then, the number of people using PrEP has risen steadily but unevenly across population groups.

CDC researchers previously reported that in 2015, over 1.1 million people in the United States were at substantial risk of acquiring HIV but only 8% of all eligible individuals were using PrEP, falling to just 3% among Latinos and 1% among African-Americans—the group with the highest rate of new diagnoses. However, these figures included at-risk heterosexual men and women, who are less likely to know about PrEP than gay and bi men.

In the July 12 MMWR, CDC researchers reported that nine out of 10 gay and bi men are aware of PrEP and over a third of those at risk were using it in 2017, up from just 6% five years ago. However, they found that while there were increases in all groups, Black and Latino men were less likely to know about PrEP and less likely to use it than white men.

Read more on POZ.com.

The US suicide rate is up 33% since 1999, but for Native American women and men, the increase is even greater: 139% and 71%, respectively, according to an analysis out this week from the Centers for Disease Control and Prevention’s National Center for Health Statistics.

Suicide disproportionately affects non-Hispanic American Indian and Alaska Natives, according to the CDC. A 2018 CDC report found their suicide rate was more than 3.5 times higher than those among racial and ethnic groups with the lowest rates.

Experts who study Native American suicide blame higher rates of poverty, substance abuse and unemployment as well as geographical isolation, which can make it difficult for people to access mental health care.

Also, American Indian and Alaska Native women experience higher levels of violence than other US women. Nearly 84% experience violence in their lifetime, according to a 2016 report from the National Institute of Justice. This includes 56% who have experienced sexual violence and roughly the same percentage who have experienced physical violence by an intimate partner. Research shows more than a third of women who have been raped have contemplated suicide, and 13% have attempted, according to the National Sexual Violence Resource Center.

Native Americans and Alaska Natives also experience PTSD more than twice as often as the general population, according to SAMHSA.

“You get this historical trauma, and people aren’t able to resolve it. It gets internalized and passed down to future generations,” said Karen Hearod, a member of the Choctaw Nation of Oklahoma and regional administrator at the Substance Abuse and Mental Health Services Administration (SAMHSA).

Read more on USAToday.com.

As the first cases of coronavirus arrive in the state, Colorado health and social services officials say they are striving to make sure lower-income residents and people of color are not disproportionately impacted by the illness and potential economic disruption.

As of the afternoon of March 6, Colorado had reported eight coronavirus cases, most in patients who had recently traveled to highly infected areas. So far, no so-called “community” transmissions are reported, but public health officials expect they will show up. It’s too early to tell the extent to which Coloradans will be impacted. 

National and international studies of past pandemics have revealed inequities by race, ethnicity and income groups in everything from the level of exposure to the pathogen, to health care outcomes during and resulting from treatment, to loss of income and vulnerability to emergency health expenses. A study of the 2009 H1N1 virus outbreak published in the American Journal of Public Health documented major gaps in complications and hospitalization rates among Blacks, Hispanics, Indigenous people and whites, in areas as widespread as Boston, Chicago and Oklahoma.

While Colorado as a whole scores well in experts’ national rankings of public health emergency preparedness (more on that shortly), past experience in addressing broad health challenges shows there will be pockets of the state facing extra health and daily living threats, said Glen Mays, chair of the Department of Health Systems, Management and Policy in the Colorado School of Public Health. Lower-income communities with fewer public resources and higher uninsured rates, or immigrants of color who fear contact with authorities because of documentation issues, are two examples.

“It boils down to these communities being less protected, with fewer resources to be deployed to screen and identify a threat,” Mays said. “When a new thing happens, you have to make choices every day. Ultimately, that means someone’s not going to get served.”

Potential school closures alone raise troubling equity issues, acknowledged Dr. Mark Wallace, public health director for Weld County and board chair of Sunrise federally qualified health clinics in northern Colorado. Around the world, at least 300 million children are now missing school because of coronavirus lockouts.

“We have to be aware that we’re going to leave a bunch of children out in the cold where they won’t get an education, they won’t get food, and they won’t have access to school health centers. It ripples through very quickly,” Wallace said.

“One thing is very clear: we are pretty far from the goal of equal protection when it comes to protecting people from large-scale disease outbreaks, like what coronavirus could become,” Mays said. “Where you live determines to a strong degree how protected you are from hazardous events like novel coronavirus.”

In addition to his position at Colorado School of Public Health, Mays directs the National Health Security Preparedness Index, created by the U.S. Centers for Disease Control and Prevention and supported by the Robert Wood Johnson Foundation. The index tracks multiple measures of states’ preparedness for public health threats, and ratings show how states vary from each other and improve or decline over time.

Read more at ColoradoSun.com.

The statistics are sobering. Rates of depression, anxiety and suicide among teens are on the rise, and by the time children reach the age of 17, more than 70 percent will have experienced at least one traumatic event, such as physical or sexual abuse or witnessing serious violence in their home or community.

Schools and pediatricians say they are seeing more children struggling, with more intensive needs. Too often, many state’s children and families of color suffer at disproportionate levels. Yet despite these facts, people know that children are resilient and that with the right services and supports in place, they can recover from trauma and mental health conditions. People need to know that effective treatments exist.

Not all mental health clinicians are delivering the same treatments for the same concerns. Relatively structured treatments with the highest degree of evidence for producing positive outcomes, or “evidence-based treatments,” can be contrasted with what we refer to as “usual care,” which refers to less structured talk therapy based on a clinician’s education, training and years of clinical experience.

Over the past decade, Connecticut has invested significantly in increasing the availability of EBTs, particularly in models designed to help children and their families recover from trauma. Two examples are Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and the Modular Approach to Therapy with Children (MATCH). Hundreds of mental health clinicians in Connecticut have received specialized training to deliver these and other EBTs to thousands of children across the state from all racial, ethnic and socioeconomic backgrounds.

Since 2009, more than 12,000 children in Connecticut have received one of the nine EBTs that the Child Health and Development Institute has helped to disseminate with help from state grants. We recently examined data from more than 45,000 children receiving two different types of treatment — EBTs and usual care — in 25 Connecticut-based outpatient clinics between 2011 and 2017. Here’s what we found:

Although children receiving both types of treatment showed improvements, the EBTs resulted in higher reductions in problem severity and higher improvements in functioning than usual care. EBTs also reduced or eliminated treatment outcome disparities by race and ethnicity. White, black and Latinx children demonstrated equivalent improvements when they received an EBT, which was not the case for usual care. In some cases, black and Latinx children receiving EBTs had higher rates of improvement than white children.

Read more at the HartfordCourant.com.