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Equitable Access to Mental Health and Substance Use Care: An Urgent Need

July 18, 2023

Due to the deepening mental health and substance use crisis in the U.S., there's an urgent need for equitable access to care that is timely, clinically effective, and adequately reimbursed by insurers. This need encompasses psychiatrists, psychologists, social workers, other counselors, and treatment facilities as well as mental health and substance use care delivered by primary care providers.Multiple studies, including analyses of insurance claims and surveys of employers and providers, have demonstrated that in-network health insurance coverage for treatment of mental health and substance use conditions remains inadequate and not "on par" with access to in-network health insurance coverage for physical health treatment.This patient-experience survey conducted by NORC (Survey) explored key topics such as: 1) how often mental health or substance use care is needed but not received; 2) how difficult it is to find in-network providers accepting new patients; 3) how often and why patients use out-ofnetwork providers for mental health or substance use care versus physical health care; 4) how often patients feel that mental health or substance use care from PCPs and other physical health providers is insufficient; 5) how often services are denied; and more.

Out of Reach: How Gaps in Medicare Coverage of Substance Use Disorder Care Harm Beneficiaries

June 23, 2023

Retirement should mark an exciting new chapter, not a health care nightmare! More than 4.3 million adults 65+ have a substance use disorder, but very few receive treatment through Medicare. As leaders of the Medicare Addiction Parity Project, Legal Action Center developed an issue brief that includes stories from beneficiaries who have struggled to get the lifesaving addiction treatment they need and recommendations for how to close these dangerous gaps in Medicare coverage.In 2022, RRF Foundation for Aging awarded a two-year grant to Legal Action Center of the City of New York. Inc. in support of advocacy efforts to bring parity in healthcare coverage for older adults on Medicare experiencing substance use disorders.Click "Download" to access this resource.

Pain in the Nation: The Epidemics of Alcohol, Drug, and Suicide Deaths 2023

May 24, 2023

The rate of U.S. deaths due to alcohol, drugs, and suicide climbed 11 percent in 2021, according to a new report released today by Trust for America's Health (TFAH). While an all-time record, 209,225 Americans lost their lives due to alcohol, drugs or suicide last year these deaths are part of a two-decade trend of sharply increasing fatalities due to substance misuse and suicide in the U.S. The 2021 data showed such deaths were up across the U.S. population, with the largest increases occurring among certain populations of color as well as people living in the South, West, and rural regions of the country.

Alcohol Misuse and Gun Violence: An Evidence-Based Approach for State Policy

May 17, 2023

This report summarizes the connection between alcohol and firearm use, reviews existing state laws, and makes a core set of recommendations for addressing the problem at the state level:Limiting access to firearms by persons with a record of alcohol misuseLimiting access to guns when and where alcohol is consumedIf these policy recommendations are to be effective, it is also important to address the environment where alcohol is sold and consumed. We therefore consider additional policies known to be effective in reducing excessive alcohol consumption and its related harms. In the last section, the report reviews key legal considerations that can help policymakers successfully implement the policies recommended in the report.

2022 Minnesota Student Survey Findings and Trends

March 1, 2023

This report summarizes relevant findings from the 2022 Minnesota Student Survey for Minnesota, as well as trends from 2016-2022. Highlighted data include substance use, mental health, and related risk and protective factors.

A Qualitative Evaluation of Advances in Emergency Department Opioid Use Disorder Care in Michigan

January 10, 2023

The United States opioid epidemic claims the lives of tens of thousands of Americans each year due to opioid overdose. Hospital emergency departments (EDs) have been essential in combatting the crisis by stabilizing patients who are experiencing an overdose and other symptoms of their opioid use disorders (OUD). Over time, EDs have also become more involved in providing other addiction treatment services, such as prescribing and administering medications for opioid use disorder (MOUD) and referring their patients to outpatient behavioral health care providers for follow-up treatment. Policymakers have been essential in driving EDs to expand the scope of their addiction medicine services and referrals by creating specialized programs that provide incentivizes to participating hospitals.The following report summarizes advances in opioid use disorder care within EDs in 19 hospitals across 8 health systems in Michigan. These hospitals participated in an initiative created by the Community Foundation for Southeast Michigan (CFSEM) in collaboration with the Michigan Opioid Partnership (MOP), a public-private collaborative with a mission to reduce opioid overdoses in Michigan by improving the access and quality of prevention, treatment, harm reduction, and recovery services. The initiative was supported by State Opioid Response grants from the Michigan Department of Health and Human Services. Vital Strategies, a global public health organization that helps governments strengthen public health, provided support, technical assistance, and resources to improve hospital coordination and designed the evaluation. Specifically, hospitals were provided funding by CFSEM to improve OUD care training, coordination, delivery, and quality in their EDs. Hospitals and health systems funded by CFSEM included the University of Michigan Health System (Michigan Medicine hospital), Trinity Health (Mercy Health Muskegon, Mercy Health St. Mary, St. Joseph Mercy - Ann Arbor, St. Joseph Mercy Chelsea, St. Joseph Mercy Livingston, St. Joseph Mercy Oakland), Henry Ford Health Systems (Henry Ford – Main, Henry Ford - Wynadotte/ Brownstown), Beaumont Health Systems (Beaumont - Royal Oak, Beaumont – Troy, Beaumont – Wayne), Ascension (Ascension St. John Hospital, Ascension Genesys Hospital), Munson Healthcare (Munson Medical Center - Traverse City, Sparrow Health System (Sparrow Hospital - Lansing), Spectrum Health (Spectrum Health Butterworth), War Memorial, and Hurley Medical Center. After receiving funding, hospitals created work plans related to improving opioid use disorder care in their EDs, including by increasing their number of employed X-waivered providers, integrating clinical tracking and support tools into electronic medical records, and connecting patients with behavioral health care providers in the community to establish treatment continuity (i.e., "warm handoffs"). Researchers with the Bloomberg Overdose Prevention Initiative at the Johns Hopkins Bloomberg School of Public Health evaluated hospital improvement in these areas using surveys and qualitative interviews with participants.

A Bitter Pill: Prisons Have Become the Deadly Epicenter of Alabama's Addiction Crisis, Even As the State's Response Begins to Show Signs of Success Elsewhere

September 21, 2022

Every year from 2012-2020, Alabama ranked first in the nation for opioid prescriptions per capita. Since 2014, the opioid addiction has claimed the lives of nearly 7,000 Alabama residents who died by overdose, and disrupted the lives of countless more.Since 2017, many state agencies have collaborated successfully via the Alabama Opioid Overdose and Addiction Council to chart a better path. The state has invested in treatment and peer specialists and reframed addiction as a public health issue, not a moral failing. For people who manage to steer clear of jails and prisons, things are starting to look up. But the combination of harsh criminal laws, the nation's highest opioid prescription rate, and Alabama's under-resourced jails and violent and dysfunctional prisons mean that many of the people who need treatment most are not getting it. Instead, they are dying preventable deaths in record numbers. Something must change.

Exploring How Disparities in Experiences of Violence and Substance Use Between Transgender and Cisgender Students Differ by Gender Expression

August 8, 2022

This report, Exploring How Disparities in Experiences of Violence and Substance Use Between Transgender and Cisgender Students Differ by Gender Expression, explores how a student's perceived gender expression intersects with their gender identity to inform health risk. A robust and growing set of evidence shows that transgender youth face higher rates of violence, substance use and other negative health outcomes. This report looks at both the rates of negative outcomes within transgender students across three categories of gender expression and also at the disparities (or gaps) between cisgender and transgender students across these categories. We use the categories "perceived feminine", "perceived androgynous" and "perceived masculine" to examine gender expression (see Figure 1 on page 6). We recognize that, with few exceptions, transgender perceived feminine youth are both most likely to experience health risks. Additionally, there are larger gaps between cisgender and transgender perceived feminine youth (compared to the gaps between cisgender and transgender perceived masculine youth or cisgender and transgender perceived androgynous students).Previous research developed by Advocates for Youth details the profound health disparities androgynous students, and transgender students, and particularly transgender students of color, endure relative to their gender conforming and cisgender peers. This project extends the previous work and contributes to answering additional questions about how transgender identity and perceived gender expression interact to explain health risks in violence and substance use.

Recent Trends in Mental Health and Substance Use Concerns Among Adolescents

June 28, 2022

Concerns about adolescent mental health and substance use have increased recently, particularly in light of gun violence and the COVID-19 pandemic. In recent years, many adolescents have experienced worsened emotional health, increased stress, and a lack of peer connection. Other mental health and substance use concerns are on the rise – including drug overdose deaths, self-harm, and eating disorders. Simultaneously, adolescents are spending more time on screens and many report adverse experiences such as parental abuse, hunger, and job loss – all of which can be linked to poor mental health outcomes.This brief explores the state of adolescent mental health and substance use in recent years, highlighting differences observed by sex, racial and ethnic groups, and sexual orientation. Throughout this analysis, we define adolescents as individuals ages 12 to 17. Although data on adolescent mental health is limited, where possible, we draw upon data from the 2020 National Survey of Children's Health (NSCH), which asks parents or guardians questions on behalf of their children and adolescents. We also include data from the Centers for Disease Control and Prevention (CDC) and other surveys conducted during the pandemic.

Pain in the Nation: The Epidemics of Alcohol, Drug, and Suicide Deaths 2022

May 24, 2022

COVID-19 has intensified the nation's troubling long-term trends for alcohol, drug, and suicide deaths. Between 2019 and 2020, these deaths increased a stunning 20 percent, driven by a 27 percent increase in the rate of alcohol-induced deaths and a 30 percent increase in drug-induced deaths. Increases were particularly large among communities of color and young adults. The rise in deaths occurred across all states and the District of Columbia, except for New Hampshire. And for the first time, two states--West Virginia and New Mexico--surpassed 100 deaths from alcohol, drugs, and suicide per 100,000 people. 

Curso de Prevencion del Uso de Drogas

May 3, 2022

Presentar los temas del curso "Abuso de drogas y prevención"

A Better Path for Maine: The Case for Decriminalizing Drugs

March 21, 2022

No one should die or have their life derailed because they, or someone they love, uses drugs. But that is what is happening in Maine because of criminalization: There are very real economic and social costs because Maine criminalizes drug use and possession. We talked to more than 150 people -- those who have been arrested for drug crimes, their family members as well as prosecutors, defense attorneys, treatment providers, and harm reduction workers.In these pages, we'll detail the enormous toll that drug laws take on our communities. Our data is pulled from interviews conducted in person, over the telephone, and on Zoom. We also submitted public records requests and reviewed academic public health research, as well as local and national media stories covering drug policy.The report illustrates the harm that criminalization does to individuals and their families and how much money the state has spent to do so. Our recommendations will not only help people who use drugs, but will mean wiser investments of public funds.We hope this report will make a new way in Maine, one that turns away from old systems of punishment and towards an investment in communities and connection.