Issue Category: Substance Misuse and Mental Health

New Maps Track Laws Related to Tobacco Pricing Strategies and Syringe Service Programs in US

(Philadelphia, Pa – Novermber 19, 2019)  Two new maps published to LawAtlas.org today — syringe service programs (SSPs) and tobacco pricing strategies — offer a comprehensive look at US laws that address tobacco pricing strategies and access to clean syringes through syringe service programs.

“States have a vital role to play in promoting the health and well-being of their residents. These datasets, along with other resources produced under the Promoting Health and Cost Control (PHACCS) in States initiative, will provide decisionmakers, advocates, and other key stakeholders with the evidence and business case for the adoption of policies that have been shown to improve community health,” said Adam Lustig, MS, Manager and Co-Principal Investigator of the PHACCS initiative.

The maps are the first two legal data resources in a new series created and maintained by the Center for Public Health Law Research at Temple University’s Beasley School of Law (CPHLR)  with the Trust for America’s Health (TFAH).

Researchers from the Center used the scientific policy surveillance process in collaboration with experts from TFAH to provide states with detailed information about the current state of US laws that could be used to improve community health through cost-saving policy changes.

“You must first measure a policy to understand its impact on health and cost. These maps give policymakers, advocates, practitioners and other stakeholders a comprehensive look into what these laws say and how the nuanced characteristics differ across the US,” said Lindsay Cloud, JD, Director of the Policy Surveillance Program at CPHLR. “The policy surveillance process we use is the gold standard for legal research because it creates objective, detailed legal data that can be used for evaluation and provides a clear visual to identifying gaps and areas for policy improvement.”

The project will include 13 datasets on a variety of public health topics through the end of 2020, ranging from universal pre-kindergarten and school nutrition standards, to housing and economic policies like the Earned Income Tax Credit and paid sick and family leave laws. The laws displayed were in effect as of August 1, 2019.

The two datasets released today, on syringe service programs and tobacco pricing strategies, represent two of the harm reduction-focused datasets in the series.


Syringe Service Programs

Syringe service program (SSP) policies authorize the legal sale and exchange of sterile syringes, and are one of the most effective and scientifically-based methods for reducing the spread of HIV and Hepatitis. This legal map identifies where SSPs have been explicitly authorized by the law, legal exemptions for individuals who access SSPs if they’re in possession of paraphernalia if stopped by law enforcement, and additional services an SSP must provide directly or through referrals.

Some key findings from this dataset include:

  • 31 states have passed laws that explicitly authorize SSPs. This number has nearly doubled since 2014 (18 states as of August 1, 2014).
  • In four of the 31 states – Delaware, Florida, Hawaii, and Maine – the law requires a one-for-one exchange of syringes.
  • In three states – Colorado, Georgia and Ohio – SSPs are also required to provide HIV and Hepatitis screenings.


Tobacco Pricing Strategies

Tobacco use and exposure to second-hand smoke are leading causes of preventable death in the US. One strategy to decrease tobacco use and promote quitting is to increase the price of tobacco products. This legal map details US laws that apply taxes or set pricing limits for tobacco products, like traditional cigarettes, e-cigarettes, and others.

Some key findings from this dataset include:

  • All 50 states and the District of Columbia tax cigarettes.
  • All 50 states and the District of Columbia have taxes on non-cigarette tobacco products.
  • 14 states and the District of Columbia also tax e-cigarettes, either by taxing the device, the liquid, or both.
  • 31 states and the District of Columbia prohibit selling cigarettes, non-cigarette tobacco products, or both below cost.
  • 32 states preempt local taxation of tobacco, either through explicit prohibitions on local tobacco taxation or through general limitations on the power of local governments to impose their own excise taxes.

Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. Learn more at www.tfah.org

The Center for Public Health Law Research at the Temple University Beasley School of Law supports the widespread adoption of scientific tools and methods for mapping and evaluating the impact of law on health. Learn more at http://phlr.org

 

 

Adolescent Suicide Up 87 Percent Over Last Decade; LGBT and American Indian/Alaskan Native Teens at Highest Risk

Vaping among teens also increasing at an alarming rate.

(Washington, DC and Oakland, CA – October 29, 2019) – Adolescent suicides have spiked over the last decade and substance misuse including vaping is exacting a heavy toll on teens according to a report released today by Trust for America’s Health (TFAH) and Well Being Trust (WBT).

The report, Addressing a Crisis: Cross-Sector Strategies to Prevent Adolescent Substance Misuse and Suicide finds that, while progress has been made in reducing some risky behaviors, adolescent suicide and substance misuse rates remain high and in some cases are climbing. The report calls for the expansion of evidence-based and cross-sector strategies in order to save lives.

Suicide rates among 12- to 19-year-olds have increased 87 percent between 2007 and 2017 (when the most recent data is available) – making suicide the second leading cause of death among adolescents. In 2017, 7.4 percent of high schoolers nationwide attempted suicide within the preceding 12 months – a 17 percent increase from the previous year. Nearly 3,000 12- to 19-year-olds died by suicide in 2017.

“We know strategies that are proven to work and can improve mental health and well-being among our young people,” said Benjamin F. Miller, PsyD, chief strategy officer, WBT. “From Zero Suicide to Youth Mental Health First Aid to LifeSkills Training programs and dozens of other initiatives, there are solutions out there – why this is not the first question of every Presidential debate, prioritized in Congress, and in every state legislature is beyond me. Our country has failed to devote the time, energy, and resources to our youth.”

An additional area of concern threatening youth well-being is vaping—with rates of use among adolescents climbing dramatically. In just one year, 2017 to 2018, e-cigarette use by high school students increased by 78 percent and by 48 percent among middle school students. More teens are also reporting vaping marijuana.

While there is some good news – rates of illicit or injection and prescription drug use among adolescents have declined or held steady among 12- to 17-year-olds since 2002 – but those rates are still too high and cause serious harm and disruption to young lives. In 2017, 5,455 young people between the ages of 15 to 24 died due to a drug overdose.

Alcohol use among adolescents has also declined. Past month alcohol use among 12- to 17-year-olds declined from 18 percent in 2002 to 10 percent in 2017 and lifetime alcohol use among high school students has declined from 82 percent in 1991 to 60 percent in 2017.

Substance misuse and suicide disproportionately affect adolescents from certain population groups

Of additional concern are large disparities in substance misuse rates and suicide based on teens’ race, ethnicity, socioeconomic status, sexual orientation/gender identification or where they live.  Most striking is the high risk for substance misuse and suicide-related behaviors among gay, lesbian and bisexual adolescents.  Forty-eight percent of gay, lesbian and bisexual adolescents report considering or attempting suicide as compared to 13 percent of their heterosexual peers.  These high rates of suicide risk for sexual minority teens are likely due to stressors they experience including discrimination, bullying, violence and family rejection, according to the report.

American Indian/Alaskan Native teens experience the highest rates of suicide among any race and ethnicity in the United States: 16 suicides per 100,000 15- to 19-years-olds in 2016 – a rate 60 percent higher than the national average for all teens.  The high rates of substance misuse and suicide among American Indian/Alaskan Native teens are likely associated with the historical and intergenerational trauma experienced by their community as well as the lack of education and economic opportunities typically available to them.

Solutions do exist and need implementation

Adolescence is a critical juncture in teens’ lives. This report highlights the many opportunities to set youth on healthy pathways be increasing the life circumstances that protect them from harm.

The report highlights dozens of evidence-based programs in place in communities across the country that help reduce risk and build protective factors in teens’ lives  by strengthening families, providing counseling and mentorship, teaching social and emotional skills, fostering connectedness, particularly in schools, and working across sectors. Most importantly, addressing the factors that create or reduce risk for substance misuse or mental health issues will not only reduce negative impact on teens’ health, it will also improve outcomes in other sectors such as high school graduation rates or involvement with the juvenile justice system.

“Adolescence is a challenging time when the impact of poverty, discrimination, bullying and isolation can be intense,” said John Auerbach, President and CEO of Trust for America’s Health. ” Fortunately, there are policies and programs that can reduce some of these circumstances and the risks associated with them by strengthening teens’ coping and emotional skills – skills that can improve their health and lead to their succeeding in school.”

Recommendations for programs and policy actions

The report includes recommendations for policy actions at the federal, state and local level.

Among the specific recommendations are:

  • The federal government and state legislatures should create and/or scale up policies that support families including increases to federal and state earned income tax credits and programs that provide access to health insurance and affordable housing.
  • Congress should increase funding for substance misuse and suicide prevention including Project AWARE and the Garrett Lee Smith State/Tribal Youth Suicide Prevention and Early Intervention Grant program.
  • States should expand Medicaid services in schools using flexible models such as school-employed providers, school-based health centers and telehealth.
  • Congress should increase investments in the Centers for Disease Control and Prevention’s Division of Adolescent and School Health.
  • All youth-serving systems should adopt trauma-informed and culturally competent policies and practices and should engage youth leaders in program development.
  • Federal, state and local efforts to improve school safety should include strategies to prevent school violence by investing in safe and supportive school environments and mental health services.
  • Public and private funders should incentivize strategies that address common risk/protective factors across all adolescent serving sectors.

The report is part of the TFAH/WBT Pain in the Nation publication series, launched in 2017 and examining substance misuse and suicide trends and evidence-based policies and programs in an effort to promote a comprehensive approach to solving the nation’s deaths of despair crisis. The report series is designed to focus attention on the need for national resilience strategy.

 

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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. Twitter: @healthyamerica1

Well Being Trust is a national foundation dedicated to advancing the mental, social, and spiritual health of the nation. Created to include participation from organizations across sectors and perspectives, Well Being Trust is committed to innovating and addressing the most critical mental health challenges facing America, and to transforming individual and community well-being. www.wellbeingtrust.org. Twitter: @WellBeingTrust.

 

 

 

Minority Mental Health Awareness Month

Health is a combination of physical and mental wellness. According to the National Alliance on Mental Illness, one in five U.S. adults will experience a mental illness this year.  Dealing with stereotypes, bias, discrimination, and racism creates unique stressors in the lives of people of color and other marginalized groups including immigrants and members of the LGBTQ community – stressors that can have negative impacts on mental, emotional and physical health.  Additionally, poverty and lack of health insurance – two realities in many minority communities – create substantial barriers to care when people need help with a mental health or substance misuse issue. While overall rates of mental disorders for most communities of color are largely similar to those for Whites, numerous studies have found that racial and ethnic minorities are less likely than Whites to seek mental health treatment, often due to factors such as lack of health insurance and sometimes due to stigma. People of color are also more likely to face barriers such as lack of available mental health services, poorer quality of care, and lack of culturally and linguistically appropriate care within treatment settings.

There is overwhelming evidence that inequitable social, economic and environmental factors— such as, poverty, discrimination, and lack of access to educational opportunities, jobs and affordable housing —contribute to disparities in health including mental health.

For Minority Mental Health Awareness Month, Trust for America’s Health (TFAH) is sharing the following information on what communities can do to support the mental and emotional health of all residents and to reverse the inequities that often lead to poorer health outcomes in communities of color.

Pain in the Nation Update: While Deaths from Alcohol, Drugs, and Suicide Slowed Slightly in 2017, Rates Are Still at Historic Highs:  More than 150,000 Americans died from alcohol- and drug-induced causes and suicide in 2017—more than twice as many as in 1999—according to analysis by TFAH and Well Being Trust of mortality data from the U.S. Centers for Disease Control and Prevention. In 2017, synthetic-opioid deaths were highest among males, Blacks, Whites, adults ages 18–54, and those living in urban areas. Between 2007 and 2017, drug deaths among Blacks increased by 101 percent and alcohol deaths were up 49 percent.  For Latinos during the same period, drug deaths were up 78 percent and alcohol deaths were up 48 percent. Over the past decade (2008–2017), suicide increased in nearly every state. However, there were substantial variations by demographics —with larger proportional increases among younger people and racial and ethnic minorities.

Pain in the Nation Issue Brief – Alcohol and Drug Misuse and Suicide and the Millennial Generation – a Devastating Impact: The impact of the national epidemics of alcohol, drug and suicide deaths has been especially pronounced amongst Millennials.  Millennials, people born between 1981 and 1996, faced and continue to face a mix of challenges unique to their generation including the opioid crisis, the skyrocketing costs of education and housing, and entering the job market during the great recession. Between 1999 and 2017, opioid overdose death rates among 18- to 34-year-olds increased by more than 500 percent. During the same period, the increase in synthetic opioid death rates among young adults increased by a staggering 6,000 percent.

The millennial generation is a more diverse generation than are baby boomers, therefore the need for culturally and linguistically appropriate mental and substance misuse treatment services for today’s young adults has grown significantly. This report includes policy recommendations on ways to prevent substance misuse and suicide among Millennials.

Racial Healing and Achieving Health Equity in the United States: Health equity is the   opportunity for everyone to have a fair chance of achieving optimal health. This 2018 issue brief highlights and acknowledges health inequities, the factors that influences them and highlights policy recommendations that can help the nation achieve health equity.

Advancing Health Equity: What We Have Learned from Community-based Health Equity Initiatives: On March 1, 2018, TFAH, with support from The California Endowment, held a convening Advancing Health Equity: What We Have Learned from Community-based Health Equity Initiatives in to identify and examine promising practices from existing initiatives. The resulting convening summary outlines core strategies of successful community-based health equity initiatives and recommendations for next steps in creating and advancing a policy agenda to promote community-based health equity.

Taking Action to Promote Health Equity – Using the Lessons from Cutting-Edge Practices to Improve Health and Well Being: TFAH’s Fall 2018 4-part health equity webinar series features public health practitioners and community leaders sharing their experiences shaping and implementing programs to advance health equity in their communities.  The webinar series informed a broad, national audience about compelling and replicable health equity initiatives and how to address the grass roots issues that will impact their success.

 

More Millennials Are Dying ‘Deaths of Despair,’ as Overdose and Suicide Rate Climb

Time
by Jamie Ducharme
June 13, 2019

There’s been a marked uptick in so-called deaths of despair—those involving drugs, alcohol or suicide—among millennials over the last decade, according to a new report released by public-health groups Trust for America’s Health and Well Being Trust.

Drug, alcohol and suicide deaths have risen in nearly every age group over the last decade, but the increase has been especially pronounced for younger Americans. Between 2007 and 2017, drug-related deaths increased by 108% among adults ages 18 to 34, while alcohol-related deaths increased by 69% and suicides increased by 35%, according to the report, which drew on Centers for Disease Control and Prevention data. All together, about 36,000 millennials died “deaths of despair” in 2017, with fatal drug overdoses being the biggest driver.

Read the full article.

 

 

Millennial Generation Deaths Due to Drug Misuse up 400 percent since 1999; Deaths from Drugs and Suicide at All-time Highs

New issue brief provides solutions for stopping deaths of despair among Millennials

(Washington, DC and Oakland, California June 13, 2019 ) – Young adult deaths due to alcohol and drug misuse and suicide have increased precipitously among 18- to 34-year-olds during the last two decades, including a 400 percent increase in drug-related deaths, fueled in large part by the opioid crisis, according to a new issue brief released today by Trust for America’s Health and Well Being Trust.

The report, which analyzed CDC data, found that between 1999 and 2017, opioid overdose death rates among Millennials increased by more than 500 percent. During the same period, synthetic opioid death rates increased by a staggering 6,000 percent.  The age group’s overall increase in drug deaths between 1999 and 2017 was 400 percent.

During the past decade (2007 – 2017), among people 18-34, alcohol-induced deaths increased by 69 percent, drug induced deaths increased by 108 percent and suicide deaths increased by 35 percent.

And, from 2016-2017, for 18- to 34-year-olds, drug-induced deaths increased 10 percent and suicide deaths were up 7 percent.  Alcohol-induced deaths for the year were down by 4 percent but as noted above are up sharply for the decade.

“The huge increases in the numbers of Millennials being lost to substance misuse and suicide is a national tragedy,” said John Auerbach, President and CEO of Trust for America’s Health. “As a nation, we need to pay particular attention to the lived experience of the Millennial generation.  They are young parents, many have burdensome levels of educational debt, they are more than one-third of today’s workforce and comprise the largest proportion of Americans serving in the military. Unfortunately, they also comprise the largest portion of people in prison.  They are grappling with economic, health and social challenges unique to their generation.  There is a critical need for targeted programs that address Millennials’ health, well-being and economic opportunity.”

The issue brief focuses on five issues areas that must be considered in any efforts to stem the tide of deaths of despair among young adults, they are the need to: 1) prioritize childhood risk and protective factors and emphasize prevention in the developmental years in order to put today’s children on a pathway that will allow them to become thriving adults, 2) ensure access to mental health and substance misuse treatment services, 3) address health inequities, 4) recognize the multigenerational impact of alcohol and drug misuse and suicide and 5) improve substance use disorders treatment within the criminal justice system.

The Millennial generation, typically defined as people born between 1981 and 1996 are today 23 to 38 years of age.  Millennials continue to face a mix of challenges unique to their generation including the exploding costs of education and housing and beginning and growing their careers during the great recession and the opioid crisis.  Another critical element of the issue brief’s focus on Millennials is the fact that many are parents of young children and their alcohol or drug misuse or poor mental health often has serious impacts on multiple generations of their family.

“There’s not a segment of the population that isn’t experiencing loneliness and despair,” said Benjamin F. Miller, PsyD, chief strategy officer, Well Being Trust. “We must address issues that matter– tackling the obstacles that prevent people from having a healthy and fulfilling life and upholding our responsibility to improve the health and well-being of our communities. No place is this more apparent than with Millennials—those who have and are about to have families of their own. If we fail Millennials, we’re failing the next generation and we’ll not break this cycle of despair.”

According to the issue brief, new and specific interventions aimed at reducing these deaths of despair amongst young adults are critically needed, notably including these 10:

  1. Ensuring behavioral healthcare, including screenings, are a routine part of primary care and that everyone has access to such care. Care must be culturally competent.
  2. Barriers to treatment like the lack of providers in rural areas or the need for more residential treatment programs for pregnant and postpartum women should be addressed by growing the Federal Behavioral Workforce Education Program, greater use of telemedicine and increasing student loan repayment programs for practitioners working in underserved areas.
  3. Behavioral health screening and referral services should be readily available at all colleges, universities, technical training facilities and reproductive health clinics.
  4. Health insurance and Medicaid coverage for medication-based treatments for substance misuse disorders should be increased.
  5. Wider implementation of suicide prevention programs, such as the Zero Suicide Initiative, is needed throughout the healthcare system. All hospitals should ensure that any patient in crisis is connected with behavioral health services in a timely manner.
  6. States and localities should use pricing strategies to limit the consumption of alcohol by adolescents and young adults.
  7. Federal and state governments should prioritize the implementation of the Family First Prevention Services Act to support prevention services for families in crisis and to reduce foster care placements.
  8. Hospitals and birthing centers should screen new mothers for substance misuse disorders at delivery.
  9. Drug and mental health courts should be created in all states and federal districts. When appropriate, people with substance misuse disorders should receive mandatory treatment as part of their incarceration and be connected to in-community treatment services upon their release.
  10. Transition programs to assist veterans returning to civilian life should be readily available.

The Trust for America’s Health/Well Being Trust Pain in the Nation publication series was launched in 2017 and examines substance misuse and suicide trends and evidence-based policies and programs in an effort to promote a comprehensive approach to solving the nation’s deaths of despair crisis.  The issue brief series is designed to focus attention on the need for a national resilience strategy.

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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. Twitter: @healthyamerica1

Well Being Trust is a national foundation dedicated to advancing the mental, social, and spiritual health of the nation. Created to include participation from organizations across sectors and perspectives, Well Being Trust is committed to innovating and addressing the most critical mental health challenges facing America, and to transforming individual and community well-being. www.wellbeingtrust.org. Twitter: @WellBeingTrust

 

 

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