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Categories Insights Tags American Psychological Association, Behavioral Health, COVID-19, Mental Health, Thought Leadership

Strategies to Reduce Anxiety and Depression During COVID-19

Strategies to Reduce Anxiety and Depression During COVID-19

Written by: Randolph Edmead

The global COVID-19 pandemic has had profound social, economic, and health effects. A recent study found that 56% of U.S. adults reported that worry or stress related to the pandemic has caused them to experience at least one negative effect related to mental health and wellbeing.  Physical distancing to reduce spread of COVID-19 increases social isolation and creates new challenges for individuals experiencing symptoms of anxiety and depression.

Some of the most prevalent concerns people have reported about managing during the COVID-19 pandemic are uncertainty about the future, not having control over the virus and its effects, and the economic ramifications of the pandemic. With widespread job loss, and the potential for the virus to cause serious illness and death, these concerns are not unfounded. The pandemic is having a significant effect on those who have not previously struggled with mental health issues, and the effects are exacerbated for those who have. As with other traumatic events, it has taken an exceptional toll on frontline health care workers and first responders.

The American Psychological Association says that it is critical to maintain social support and connections during physical distancing, and that it is important to know the signs of anxiety and depression so that individuals who may be experiencing these challenges can get timely help.

Signs of anxiety include:

  • Persistent worry, feeling overwhelmed by emotions
  • Excessive worry about a number of concerns, general sense that something bad is going to happen
  • Restlessness, irritability
  • Difficulty concentrating, sleep problems, feeling on edge

Signs of depression include:

  • Lack of interest or pleasure in activities
  • Significant weight loss or gain
  • Lack of energy or difficulty concentrating
  • Insomnia or excessive sleeping
  • Feelings of worthlessness or excessive guilt
  • Recurrent thoughts of death or suicide

One unexpected consequence of the COVID-19 pandemic may be that the increased media attention on the mental health effects of the crisis is helping to reduce the stigma of talking about mental health issues. A new social media campaign through , “How are You, Really?”, aims to decrease the stigma of mental health issues by encouraging people to safely share their stories to show others that they are not alone.

Tips for Staying Mentally Healthy

The Director Dr. Joshua Gordon provides 5 tips for staying mentally healthy during the COVID-19 outbreak, which are timely for individuals struggling with anxiety or depression, as well as for those who are simply looking for positive strategies to cope with the challenges of the pandemic:

  • Avoid using alcohol or other drugs as coping mechanisms.
  • Maintain routines for meals, exercise, and sleep. Try to stay active.
  • Explore wellness programs, like meditation, yoga, muscle relaxation, or breathing exercises.
  • Stay connected. Talk by phone. Chat outside while maintaining recommended social distance. Join online gatherings.
  • Seek help right away if you have trouble coping or feel overwhelmed.

The Bizzell Group (Bizzell) was founded by President & CEO Anton C. Bizzell, M.D., a leading behavioral health expert and former Medical Officer for the U.S. Department of Health and Human Services (HHS). Bizzell’s recent work includes systematic, integrated approaches designed to effect lasting change in the field of behavioral health through work with the Substance Abuse and Mental Health Services Administration (SAMHSA), National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA), and the Centers for Disease Control and Prevention (CDC). Learn more about how we develop data-driven, research-informed, innovative solutions to advance mental health, behavioral health, and other complex-real-world challenges: https://BizzellUS.com/.

Categories News Tags Behavioral Health, Communications & Outreach, Health, National Institute on Drug Abuse (NIDA), Substance Use Disorder (SUD)

Bizzell Supports NIDA in the Launch of Innovative Learning Tools to Help Manage Opioid Treatment

Bizzell Supports NIDA in the Launch of Innovative Learning Tools to Help Manage Opioid Treatment

In conjunction with the National Institute on Drug Abuse-Clinical Trials Network (NIDA-CTN), Bizzell announces the availability of three educational videos for healthcare providers managing opioid use disorder (OUD). The first two videos are animations that discuss overdose prevention. The third video is an interactive tool used to educate healthcare providers on OUD in an emergency setting.

Video 1: Overdose Prevention Education for Clinicians Treating Patients with Opioids for Chronic Pain is an animated video that focuses on four key strategies: Reducing Risk for Development of OUD and Avoidance of Misuse, Identification of Risk Factors, Safety Planning, and Overdose Rescue Preparation.

Video 2: Overdose Prevention Education for Clinicians Treating Patients for an Opioid Use Disorder is an animated video that highlights three key strategies: Identifying Overdose Risk Factors, Developing a Safety Plan, and Overdose Rescue Preparation.

“These teachings are done in a simple, non-judgmental fashion offering the viewer clear and memorable points in assessing and managing opioid overdoses,” says Douglas L. Gourlay, M.D., MSc., FRCPC, FASAM, Former Director of the Pain and Chemical Dependency division of the Wasser Pain Management Centre at Mount Sinai Hospital in Toronto, a reviewer of the video.

Video 3:  Buprenorphine Initiation for Opioid Use Disorders in Emergency Departments: Interactive Case Vignettes is a branching video, which is an interactive educational tool. It allows participants to select a healthcare track which results in varying outcomes. The American College of Emergency Physicians (ACEP) is providing Continuing Medical Education (CME) credit and access to the tool will require the creation of a free ACEP account. Throughout the course, guidance is provided on the clinical management of OUD with a focus on screening, enlisting the patient’s input into their treatment, buprenorphine initiation, and referral to ongoing treatment.

After watching these videos, participants will be able to apply a patient-centered, shared decision-making approach while discussing the prevalence of overdose and the process of introducing buprenorphine in the ED for treatment of OUD. Participants will also be able to discuss chances for recovery as research suggests that patients are twice as likely to enter addiction treatment and remain in treatment at 30 days if medication is initiated in the ED.

The targeted audiences for the buprenorphine initiation video include: Emergency Physicians, Emergency Nurses, Nurse Practitioners, Residents, Medical Students, Physician Assistants, Emergency Department Medical Directors, Hospital Administrators, EMTs/Paramedics, and other healthcare providers engaged in the practice of emergency medicine.

“This branching video effectively and quickly walks users through the most high-yield information in the most engaging way possible. Providers around the country should see this video before their next shift caring for patients with opioid addiction,” says video reviewer, Alister Martin MD, MPP, Faculty – Center for Social Justice and Health Equity, Harvard Medical School, Massachusetts General Hospital Emergency Department.

All of the above mentioned videos were funded in part with federal funds from the National Institute on Drug Abuse, Center for the Clinical Trials Network Dissemination Initiative (contract # HHSN271201700059C). The content for the videos was developed by researchers and experts and does not necessarily reflect the official position of the National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services, nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government. These training resources should not be considered as a substitute for individualized patient care and treatment decisions.

  • This activity has been planned and implemented in accordance with the accreditation requirements and policies of The Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American College of Emergency Physicians, NIDA, The Bizzell Group, and Modern Epic. The American College of Emergency Physicians is accredited by the ACCME to provide continuing medical education for physicians.
  • The  American College of Emergency Physicians designates this enduring material activity for a maximum of 1 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate .with the extent of their participation in the activity.
  • Approved by the American College of Emergency Physicians for 1 hour of ACEP Category I credit.

ABOUT BIZZELL

Established in 2010, The Bizzell Group (Bizzell) is a U.S. Small Business Administration (SBA) 8(a) certified strategy, consulting, and technology firm that specializes in program management, administrative support, communications and outreach, conference management and logistical support, health services and research, technical assistance, and training and development. Bizzell’s expert staff and consultants work on health, scientific, education, environmental, research, and information technology projects that advance national priorities. Under the leadership and vision of founder, Anton C. Bizzell, MD, the company has grown from a staff of two in one small office, to a thriving firm with three offices in Lanham, MD, Rockville, MD, and Atlanta, GA, with ongoing projects around the world. Learn more about how we develop data- driven, research-informed, innovative solutions to complex-real-world challenges: www.BizzellUS.com.

ABOUT THE NATIONAL INSTITUTE ON DRUG ABUSE (NIDA)

The National Institute on Drug Abuse (NIDA) is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. Fact sheets on the health effects of drugs and information on   NIDA research and   other   activities   can be found at www.drugabuse.gov, which is now compatible with your smartphone, iPad or tablet. To order publications in English or Spanish, call NIDA’s DrugPubs research dissemination center at 1-877- NIDA-NIH or 240-645-0228 (TDD) or email requests to drugpubs@nida.nih.gov. Online ordering is available at drugpubs.drugabuse.gov. NIDA’s media guide can be found at www.drugabuse.gov/publications/media-guide/dear-journalist.

Categories Insights Tags Behavioral Health, CEO Insights, COVID-19, Health, Mental Health, Thought Leadership

Maintaining Recovery from Substance Use Disorders During the COVID-19 Pandemic

Maintaining Recovery from Substance Use Disorders During the COVID-19 Pandemic

Written by: Anton Bizzell, MD

The global COVID-19 pandemic has had a profound impact on health care delivery systems and on patterns of social support worldwide, creating an unprecedented set of challenges for individuals in recovery from substance use disorders (SUDs). In addition to managing the situational anxiety many people are facing with the unknowns of the pandemic, the social distancing that is vital to reduce the spread of the virus and protect vulnerable people, leaves individuals in recovery physically isolated from their health care providers and support system. Some people with SUDs may be at higher risk of relapsing with extended periods of time at home, uncertainty about work or finances, added stress on family relationships, or social isolation.

With this extraordinary situation, new resources and solutions are emerging to help people struggling with SUDs gain access to treatment in order to maintain their path to recovery.

New treatment access and guidelines during COVID-19. Health care and treatment of individuals with SUDs is evolving to meet the challenges of social isolation during the global pandemic:

  • Telehealth: Most insurance companies are now covering telehealth services at the same rate as traditional in-person visits with health care and behavioral health providers. Providers use secure virtual platforms to conduct a confidential video assessment, and to provide any necessary prescriptions or referrals to additional virtual or in-person treatment.
  • Take-home Medication-Assisted Treatment for Opioid Use Disorders: The Substance Abuse and Mental Health Services Administration (SAMHSA) has issued Opioid Treatment Program guidance for states to be granted an exception to administer 14 to 28 days of take-home medication to individuals in an Opioid Treatment Program. This new guidance improves access to evidence-based Medication-Assisted Treatment for individuals with opioid use disorders (OUDs).
  • Treatment for Alcohol Withdrawal: The American Society of Addiction Medicine (ASAM) has issued a Clinical Guideline on Alcohol Withdrawal Management. Some states have closed liquor stores as part of COVID-19 restrictions, resulting in limited access; at the same time, individuals experiencing alcohol withdrawal may also have limited access to treatment and withdrawal management programs. The ASAM Guideline advises clinicians in decision-making and treatment, improving care for these individuals struggling with alcohol use and alcohol withdrawal.

Virtual support during COVID-19. Many new resources are available to help individuals in recovery access support virtually:

  • SAMHSA Virtual Recovery Resources: SAMHSA notes that during the social distancing and isolation of COVID-19, it is still vital to continue social connections when recovering from SUDs and mental health conditions. This Tip Sheet describes resources for individuals in recovery and gives guidance for setting up a virtual recovery meeting.
  • National Alliance for Mental Illness (NAMI) COVID-19 Resource and Recovery Guide: Mental health support is a vital component of recovery. NAMI provides helpful tips for managing concerns about the virus, accessing virtual support, developing healthy daily routines, maintaining social support, and prioritizing self-care.
  • Alcoholics Anonymous Options for Meeting Online: During COVID-19, many Alcoholics Anonymous groups are exploring alternate ways to continue the community of support for recovery. This may involve phone calls, email, social media, and virtual meetings on digital platforms. Alcoholics Anonymous encourages groups to decide what will work best for them and provides information for groups making this change.
  • Virtual Narcotics Anonymous: This collaborative resource helps people find online and phone meetings of Narcotics Anonymous around the world. Narcotics Anonymous is for people who have any SUD and want support in their recovery.

Healthy habits to support recovery during COVID-19.  Some people in recovery have found it helpful to take this time of social distancing to focus on healthy habits that will support recovery. These can include:

  • Manage News Consumption
    • Check only established, reliable news sources. Set a timer to limit the amount of time you are reading the news. Avoid checking the news within one hour before bedtime, and instead focus on relaxing activities.
  • Get Ample Rest
    • Get at least 7-8 hours of sleep each night. Make sure that your sleeping area is used only for sleep. Use calming routines at night such as reading, taking a bath, or talking with a friend.
  • Develop and Maintain a Daily Routine
    • Keep a routine of getting up and getting dressed on a regular schedule each day. Set your alarm and start your day with a walk outside or your favorite breakfast. Take a shower, get dressed, and write out a plan for how you will spend your day.
  • Exercise Daily
    • Get daily exercise, even if it is just a gentle walk or simple stretches. If you usually go to a gym, look for online exercise programs such as yoga, dance, chair exercises, or even a boot camp routine. Start a virtual exercise routine with a friend so that you can encourage and support each other.
  • Schedule Time to Connect with Loved Ones
    • Schedule time for social connections each day, whether by phone, video, email, or text. Look for shared activities such as a book club, art activities, virtually movie night, or cooking that you can enjoy together remotely. Focus on connections with the people you can have honest conversations with about your feelings and struggles.
  • Other Mental Health Exercises
    • Choose activities that will support your mental health, including breathing exercises, journaling, or meditation. Look for online books and workbooks on Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Mindfulness, to help you manage your thoughts, worries, and behaviors during this challenging time. Notice what feels relaxing and restful for you, and intentionally choose those activities.

The COVID-19 pandemic has created new challenges for individuals in recovery; it has also fostered creative new approaches to treatment and support, many of which are reaching people in new ways that may continue beyond the end of social distancing. With continued integration of treatment, virtual support, and healthy habits, recovery can continue.

The Bizzell Group (Bizzell) was founded by President & CEO Anton C. Bizzell, M.D., a leading substance use disorders (SUDs) expert and former Medical Officer for the U.S. Department of Health and Human Services (HHS). Dr. Bizzell was selected as Maryland’s 2020 Small Businessperson of the Year by the U.S. Small Business Administration (SBA). Bizzell’s recent work includes systematic, integrated approaches designed to effect lasting change in the field of SUDs through work with the National Institute on Drug Abuse (NIDA), the National Cancer Institute (NCI), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and the United States Chamber of Commerce Foundation (USCCF). Learn more about how we develop data-driven, research-informed, innovative solutions to SUDs and other complex-real-world challenges: https://BizzellUS.com/

Categories Insights Tags Alcohol Use Disorder (AUD), Behavioral Health, CEO Insights, Mental Health, National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Thought Leadership

Alcohol Use Disorder: Hope for Recovery

Alcohol Use Disorder: Hope for Recovery

Written by: Anton Bizzell, MD

Alcohol use disorder (AUD) is often referred to as the hidden substance use disorder (SUD). With alcohol use legal and socially acceptable in many settings, the symptoms of AUD may initially go unnoticed. Yet individuals with AUD may experience significant difficulties in their relationships, work, and health.

In a newly released analysis, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) at the National Institutes of Health (NIH) found that over 70 percent of the adult population drank alcohol in 2017. Alcohol-related deaths more than doubled from 1999 to 2017. Overdoses of alcohol alone or in combination with other drugs accounted for 18 percent of the deaths in 2017; 31 percent of the deaths resulted from alcohol-related liver disease. Researchers note that the since this study examined only death certificate data, the actual number of lives lost may be significantly higher.

The death rates increased higher for women than for men, and gender differences persist in risks for alcohol-related cardiovascular disease, liver disease, and cancer. In addition, while prevalence of alcohol use and binge drinking remained stable for men, the prevalence of alcohol use increased by over 10 percent for women and binge drinking increased by over 23 percent among women.

The NIAAA screening tool for AUD includes questions a provider can use to diagnose whether an individual may have an AUD. Individuals who are struggling with their drinking, or families and friends concerned about their loved ones, can start by considering the following questions.

In the past year, have you:

  •  Tried to cut down or stop drinking more than once, but couldn’t?
  •  Found that drinking or being sick from drinking got in the way of you taking care of your home or your family, or caused problems at work or school?
  •  More than once gotten into situations while drinking that could be dangerous, such as driving, having unsafe sex, using machinery, walking in an unsafe neighborhood; or had a memory blackout?
  •  Kept drinking even though it was making you depressed or anxious, or adding to other health problems?
  •  Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating?

In addition to peer-led support models such as Alcoholics Anonymous, there are many options for professionally-led treatment. Treatment for AUD often involves a combination of talk therapy and medication. Therapy can be for individuals, groups, or families, under the direction of a licensed counselor trained in substance use disorders. Medication to help individuals stop drinking and avoid relapse can be administered under the care of a licensed primary care provider or a board-certified addiction medicine physician. In addition, different levels of care and care settings are available to meet the needs of each situation, including outpatient, partial hospitalization, residential, or intensive inpatient.

Although the consequences of AUD can be devastating, hope for recovery is possible with evidence-based, timely intervention.

About Bizzell

The Bizzell Group (Bizzell) was founded by CEO Anton Bizzell, M.D., a substance use disorders expert and former Medical Officer at NIAAA. Our recent work includes systematic, integrated approaches designed to effect lasting change in the field of substance use disorders through projects with the National Institute on Drug Abuse (NIDA), the National Cancer Institute (NCI), the Food and Drug Administration (FDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the United States Chamber of Commerce Foundation (USCCF). Learn more about how Bizzell advances data-driven, research-informed, innovative solutions to solve complex, real-world challenges. www.BizzellUS.com

Reference:

White, A. M., Castle, I. J. P., Hingson, R. W., & Powell, P. A. (2020). Using Death Certificates to Explore Changes in Alcohol‐Related Mortality in the United States, 1999 to 2017. Alcoholism: Clinical and Experimental Research.

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