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Tag: public health crisis

  • West Virginia HIV Outbreak Is A "Nightmare"

    West Virginia HIV Outbreak Is A "Nightmare"

    Approximately 74 new cases of HIV have been reported in Cabell County since January 2018.

    Despite having many public health policies in place to prevent the spread of disease—including a needle exchange program—one West Virginia county is seeing an alarming spike in new HIV transmissions largely brought about by drug users sharing needles. 

    Seventy-four new cases of HIV have been reported in Cabell County since January 2018, according to Politico. 

    “The ground is fertile,” Judith Feinberg, a professor of behavioral medicine and infectious diseases at West Virginia University, told Politico. “This is the nightmare everyone is worried about.”

    Harm Reduction Efforts

    In 2015, Cabell County started a needle exchange program. It also has drug treatment programs, STI testing and expanded access to PrEP, a treatment regimen that can reduce the risk of contracting HIV if taken daily. All of this is unusual, especially for a rural county. The fact that HIV has taken hold despite these efforts make the outbreak especially concerning. 

    Michael Kilkenny, physician director at Cabell’s health department, said he can’t explain why HIV cases are increasing, despite the county’s efforts. “I have no answer for that. At night, it’s what you ask when you are screaming at the sky,” he said. 

    Jay Adams, an HIV care coordinator at the federal Ryan White HIV/AIDS program, said that the outbreak would have been significantly worse in any other county. 

    “I don’t think this would have been contained with any degree of success in any other county in the state,” he said. 

    High-Risk Counties

    A 2016 report from the Centers for Disease Control and Prevention (CDC) identified counties that were at high risk for new HIV infections because of the prevalence of intravenous drug use. Half of West Virginia’s counties—including Cabell—were on the list.

    Other areas of the country, including Indiana and Massachusetts have seen spikes in HIV infections related to the opioid epidemic. 

    John Wiesman, Washington state health secretary and co-chair the Presidential Advisory Council on HIV/AIDS, said that officials are realizing how much the opioid epidemic is impacting HIV transmission. The Trump administration has aimed to stop new HIV transmissions by 2030, but that is a lofty goal, said Wiesman. 

    “We’re recognizing every day just how big a challenge this is,” he said. “There are a lot of things making this a really difficult task, and one of those is the opioid epidemic. We’ve got all of these overlapping issues coming together, a lot of which are social factors, which is why it is so important to have both a medical approach and a larger health and human services approach to this epidemic.”

    View the original article at thefix.com

  • What Does 2019 Hold For Opioid Lawsuits?

    What Does 2019 Hold For Opioid Lawsuits?

    Many are looking at the settlements with Big Tobacco to see how the opioid settlements—if there are any—might take shape.

    During 2018, as opioid overdose rates continued to soar, municipalities from around the country vowed to hold drug manufacturers and distributors accountable. This year, 2019, will show how many of the lawsuits around the opioid epidemic will pan out. 

    The plaintiffs — mostly local and county governments from around the country — hope that settlements from the lawsuits will help them recoup some of the costs of treating people addicted to opioids and maybe even help finance better treatment options going forward.

    “We are still in the throes of a public health crisis in Summit County,” Greta Johnson, a county official in Akron, Ohio, told NPR. In order to respond to that crisis, she said, the county needs funds from the major companies that caused or contributed to the epidemic. “We’re confident the court will see it that way as well.”

    Johnson’s argument, echoed in dozens of lawsuits, may sit well with Federal Judge Dan Polster, who is presiding over the largest group of lawsuits out of his Cleveland courtroom. Polster has called the opioid epidemic a “man-made plague,” and called for comprehensive solutions to the issues of addiction and recovery. 

    While defendants will likely try to have certain allegations dismissed on legal technicalities — like the statutes of limitations being up — Richard Ausness, a law professor at the University of Kentucky, told NPR that effort is unlikely to succeed entirely.

    “The judge has made it clear that he wants a settlement ultimately from this, along the lines of the tobacco settlement,” Ausness said. “If that is indeed the way that he feels, he is probably not going to let the defendants off the hook.”

    As the court cases proceed, the public could learn even more about practices that led to millions of Americans becoming hooked on opioids. Attorney Joe Rice, who represents some governments suing Big Pharma, said that he would like to see the information about misleading advertising and other unscrupulous practices become common knowledge. 

    “Our next battle is to get the documents that are being produced made available to the public instead of everything being filed under confidentiality agreements so we can get the facts out,” he said. 

    Many people are looking at the settlements with big tobacco to see how the opioid settlements — if there are any — might take shape. Tobacco companies have paid more than $100 billion in damages to Americans, some of which have been used to fund anti-smoking public health campaigns. A similar settlement with manufacturers and distributors could impact how future generations are educated about drug use.  

    View the original article at thefix.com

  • What’s Actually Happened Since Trump Declared An Opioid Emergency

    What’s Actually Happened Since Trump Declared An Opioid Emergency

    Critics say the emergency declaration was more for show than to actually resolve the crisis.

    A year ago, President Trump declared a national public health emergency because of the opioid epidemic, vowing that doing so would streamline responses to a health crisis that killed more than 70,000 Americans last year.

    However, a new report shows that the declaration has led to little change. 

    The report, prepared by the Government Accountability Office, found that the administration has used just three of 17 available authorities that are activated when the government proclaims a public health crisis. These authorities include, for example, waiving certain administrative processes in order to quicken responses in an emergency.

    The Trump administration used one authority to more quickly field a survey of healthcare providers about their prescription practices. The results of the survey will help inform policy decisions going forward, the administration said.

    Secondly, authorities waived the public notice period for approval of two state Medicaid demonstration projects related to substance use disorder treatment, which was intended to speed up implementation of the projects, allowing the states to test and evaluate new addiction-related services delivered through Medicaid.

    Finally, the Department of Health and Human Services (HHS) increased support for research on opioid use disorder treatments and gave out information on opioid misuse and addiction.

    The Department of Health and Human Services said that more authorities haven’t been used because many of the abilities enabled by the state of emergency declaration are not applicable to the opioid epidemic. Instead, they are designed for response to infectious diseases or natural disaster. 

    “HHS officials determined that many are not relevant to the circumstances presented by the opioid crisis,” the report reads. However, the potential for additional responses will be reviewed. “Officials told GAO they will continue to review the authorities as the opioid crisis evolves and in the context of HHS’s other efforts to address the opioid crisis.”

    Still, critics of the administration say that the fact that so few resources have been utilized shows that the administration’s declaration was more for show than in hope of solving the problem. 

    “Communities are desperately in need of more help to address the opioid epidemic. President Trump, as this report shows, has broken his promises to do his part,” Senator Elizabeth Warren (D-MA) said in a statement reported by Vox. “I’ve asked this administration time and time again to show what actions they are taking to meaningfully address this crisis. No response. To me, it looks like empty words and broken promises. Hand-waving about faster paperwork and speeding up a few grants is not enough — the Trump Administration needs to do far more to stop the opioid epidemic.”

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    View the original article at thefix.com

  • Lack Of Mental Health Resources A Global Issue

    Lack Of Mental Health Resources A Global Issue

    “All countries can be thought of as developing countries in the context of mental health,” says a new global mental health report.

    A lack of resources for those dealing with mental health issues is a major problem around the world, a new report has found. 

    The report by the Lancet Commission on Global Mental Health, which took three years to compile, was released last week at a London summit. 

    The report, which is 45 pages long, details the state of mental health treatment around the world. According to the authors—28 mental health researchers, clinicians and advocates from five continents—there are “pitifully small” levels of financial support from governments and assistance groups when it comes to mental health research and care. 

    Low-income communities, according to NPR, are being hit particularly hard. The report states that in developing countries, only one in 27 people with depression receive the necessary treatment. And in countries with more money, the care isn’t necessarily better. In fact, the report states that “all countries can be thought of as developing countries in the context of mental health.”

    The financial aspect, according to the report, is the main problem. The Lancet Commission states that funding availability is “alarmingly low” when compared to what was spent on other diseases in 2013 in comparison to mental illness.

    For example, for every year of healthy life lost to mental illness, the report found that global health donors had provided $0.85. But for HIV/AIDS, they had provided $144 for every year, and $48 for TB and malaria.

    According to psychiatrist Julian Eaton, part of the reason for the lack of funding has to do with cultural differences. 

    “In the academic world there has been an ongoing sometimes quite angry debate about whether it’s appropriate to export Western ideas about mental ill health to other countries,” Eaton told NPR.

    The stigma surrounding mental health issues also plays a role. Janice Cooper, who runs the Carter Center’s mental health center in Liberia, tells NPR that stigma is a problem in developing and developed countries. 

    “There’s ignorance, there’s the perception of contagion, there’s the notion that in some quarters this is not important,” she said. 

    According to NPR, the Commission recruited 15 youth leaders from around the world to spread messages about mental health on social media and get younger generations discussing it.

    Twenty-five-year-old Grace Gatera of Rwanda is one of the 15. She says the conflict in the country resulted in PTSD for her, as well as two suicide attempts. She tells NPR that the government doesn’t make mental health a priority. 

    “It’ll be like let’s deal with this crisis and deal with the crisis that comes after that and maybe when we get time we’ll talk about mental health,” she said. 

    Eaton says that despite the report’s findings, she and other commissioners were excited to receive the support for the summit from some international and British government organizations in addition to some private ones. They were also encouraged when royals Prince William and Kate Middleton, Duchess of Cambridge, attended the summit. 

    “But people are yet to sign the checks,” Eaton said.

    View the original article at thefix.com