Thought Leadership – Page 5

17Oct2019

Integrated Strategies to Address Opioid Use Disorders in Women

The opioid crisis has a complex set of contributing factors in women and requires integrated strategies and solutions. The Center for Behavioral Health Statistics and Quality (CBHSQ) of the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that 19.5 million females (15.4 percent) age 18 years or older used illegal drugs in the past year, and 8.4 million females misused prescription drugs in the past year (CBHSQ, 2017)Center for Behavioral Health Statistics and Quality. (2017). Results from the 2016 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf. Opioid use and misuse may have a different progression in women as compared to men, due to differences in sex and gender. The National Institute on Drug Abuse (NIDA) at the National Institutes of Health (NIH) defines differences by sex as pertaining to biological differences, and differences by gender as referring to culturally defined roles for women. Research has shown effects on women who use drugs from hormones, pregnancy, menstrual cycle, and menopause. Women have described reasons for using drugs, such as caregiving, depression and anxiety, fatigue, and coping with pain. Women are also affected by adverse childhood experiences, trauma, post-traumatic stress disorder (PTSD), partner stress, and domestic violence (NIDA, 2019)National Institute on Drug Abuse. (2019). Substance Abuse in Women. Retrieved September 19, 2019, from https://www.drugabuse.gov/publications/drugfacts/substance-use-in-women..

In the past, women were not included in research studies at the same rate as men, or the data was not reported separately by sex. The NIH and other federal agencies have made significant efforts to include women, and to research the biological differences in women that are important to understanding how substance use disorders develop and how to treat them effectively.

Researchers know that there are some differences in how substance use disorders develop in women versus men, and continued research will seek to better understand these differences (NIDA, 2019)National Institute on Drug Abuse. (2019). Substance Abuse in Women. Retrieved September 19, 2019, from https://www.drugabuse.gov/publications/drugfacts/substance-use-in-women.

Dependence: Women sometimes become dependent after using smaller amounts of drugs for a shorter time period, as compared to men.
Relapse: In addition to developing dependence more quickly, women may experience more cravings and be more likely to relapse following treatment.
Biological factors: Science has also shown differences in brain changes, effects on the heart and blood vessels, and increased sensitivity to drugs due to sex hormones. Women may have a higher likelihood of going to the emergency room or dying from an overdose from some substances, as compared to men.
Psychosocial factors: Psychosocial stressors can be a significant factor in opioid misuse and opioid use disorders (OUDs). Women who experience changes in relationships due to divorce or loss of child custody, as well as those who are victims of domestic violence, are at increased risk of developing an OUD. Other stressors such as unemployment, housing instability, caregiving, and untreated mental health conditions can play a role as well.

Substance misuse and OUDs affect millions of women, many of whom are of childbearing age. Most drugs, including opioids, can have serious and harmful effects to a pregnant woman and to an unborn baby. Some substances can increase the risk of miscarriage and stillbirth, in addition to causing health complications to the mother such as high blood pressure and seizures, according to the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) at NIH (2013)Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2013). Tobacco, drug use in pregnancy can double risk of stillbirth. Retrieved from https://www.nichd.nih.gov/news/releases/Pages/121113-stillbirth-drug-use.aspx. Women who are using may be afraid to get help while pregnant, due to fears that they will lose custody of their children, or due to barriers such as stigma, lack of access to treatment programs, or lack of child care. Babies born to women who misuse drugs, especially opioids, can go through withdrawal after birth, a health condition referred to as Neonatal Abstinence Syndrome (NAS). The Office on Women’s Health (OWH) issued Final Report: Opioid Use, Misuse, and Overdose in Women (2017)Office on Women’s Health. (2017). Final Report: Opioid Use, Misuse, and Overdose in Women. Office on Women’s Health. Retrieved from https://www.womenshealth.gov/files/documents/final-report-opioid-508.pdf detailing how the epidemic affects women, and the key prevention, treatment, and recovery issues for women who misuse opioids and who have OUDs. Stakeholders must collaborate to continue to develop relevant research, effective outreach, and evidence-based intervention targeted to the unique needs of women at risk of and affected by opioid use disorders.

Integrated Strategies to Address OUDs Among Women

Integrated strategies are vital to address the complex causes and effects of OUDs in women. The following is list of suggestions for improving health outcomes for women experiencing an OUD:

Research: More research and data are needed on women who have substance use disorders, and the treatment strategies that are most effective for women.

Education: Education should focus on prevention, as well as on early identification and treatment of substance use disorders. Partnerships between organizations such as schools, employers, and community centers are essential to reach women of all ages.

Integration of services: Substance use disorder screening should be integrated into health care, mental health services, and social services. Screen to identify women who are at risk and who need help, and partner with treatment providers to coordinate care across settings.

Whole person care: Coordinated assessment is needed of all aspects of women’s lives that may be contributing to a substance use disorder and may be a barrier to care. Treat the underlying contributors to substance use disorder and the barriers to recovery, including chronic pain conditions, pressures of caring for elderly parents plus young children, emotional distress and mental health conditions, relationship stress, domestic violence, under- or unemployment, and housing instability. Partner with social services to provide child care while a woman is undergoing treatment, and to address other social stressors in addition to opioid misuse and addiction.

Bizzell US’s Experience Addressing OUDs Across the Female Population:

Bizzell US (Bizzell) has advanced national and regional efforts over the past decade to improve prevention, identification, and treatment of opioid use disorders in women. The most recent Bizzell projects include:

Bizzell partnered with OWH in 2019 to support the meeting Combating Opioid Misuse Among Women and Girls: Prevention Strategies at Work, where 18 grantees and 75 participants discussed projects in 12 states focused on prevention strategies aimed at girls age 10 to 17, women of reproductive age, and older women. Topics included community engagement, pregnant and postpartum women and infants, youth and education, training and capacity building for the clinical workforce, pain management, and health IT and innovation to improve health care delivery.
Bizzell partnered with SAMHSA in a multi-year contract to provide technical assistance for approximately 1600 opioid treatment programs nationwide, integrating specific strategies to improve outcomes of women with opioid use disorders.
Bizzell partnered with SAMHSA in a multi-year contract to develop and deliver training to over 1500 clinical staff in 16 states through workshops and web-based interactive education, including modules on effective use of medication assisted treatment for pregnant and breastfeeding women.

Are you interested in learning more about Bizzell’s work to improve health outcomes for those affected by the opioid epidemic, including targeted interventions for women and other special populations? At Bizzell, we provide Management Consultation, Technical Assistance, Training, and Subject Matter Expertise in Opioid and other Substance Use Disorders, addressing complex real-world problems with modern, integrated strategies. Visit www.BizzellUS.com or email us: info@bizzellus.com.

References

Center for Behavioral Health Statistics and Quality. (2017). Results from the 2016 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf.

Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2013). Tobacco, drug use in pregnancy can double risk of stillbirth. Retrieved from https://www.nichd.nih.gov/news/releases/Pages/121113-stillbirth-drug-use.aspx.

National Institute on Drug Abuse. (2019). Substance Abuse in Women. Retrieved September 19, 2019, from https://www.drugabuse.gov/publications/drugfacts/substance-use-in-women.

Office on Women’s Health. (2017). Final Report: Opioid Use, Misuse, and Overdose in Women. Office on Women’s Health. Retrieved from https://www.womenshealth.gov/files/documents/final-report-opioid-508.pdf.

30Nov2018

World AIDS Day

Lisa Black – November 30, 2018

December 1, 2018 is World AIDS Day. This year’s federal theme is “Saving Lives through Leadership and Partnership.” HIV, the virus that causes AIDS, is a serious public health crisis. According to (UNAIDS) the Joint United Nations Program on HIV/AIDS, there were approximately 36.9 million people worldwide living with HIV/AIDS in 2017; 1.8 million are children who are under the age of 15. In 2017, an estimated 1.8 million individuals worldwide became newly infected with HIV—nearly 5000 new infections per day. This includes 180,000 children, most of whom live in sub-Saharan Africa and were infected by their HIV-positive mothers during pregnancy (mother-to-child transmission) or during breastfeeding.

According to the Centers for Disease Control, pregnant women and their babies are at risk because:

Pregnant women with HIV may not know they are infected, and women may not know that their partner has HIV.
Preconception care and family planning services are often not provided in HIV care settings.
Women living with HIV may not know they are pregnant, how to prevent or safely plan a pregnancy, or what they can do to reduce the risk of transmitting HIV to their baby.
The risk of transmitting HIV to the baby is much higher if the mother does not stay on HIV treatment throughout pregnancy, labor, or delivery, or if HIV medicine is not provided to her baby. The risk is also higher if the mother acquires HIV during pregnancy.
Social and economic factors, especially poverty, may make it harder for some women living with HIV to access health care.

In recognition of World AIDS Day, we are dedicated to, “Saving Lives through Leadership and Partnerships.”

The Bizzell Group (Bizzell) is committed to improving global health and we recognize that economic growth of nations. It is our mission to provide quality research, education, training, and technical assistance related to this worldwide public health crisis. We are a leader in partnering to set global standards for HIV prevention, the care and treatment of pregnant women, prevention of mother-to-child HIV transmission; and the development of evidence-based strategies and global health initiatives.

Bizzell offers full-scale global and social impact assessments. Our team members and subject matter experts have vast experience in addressing global health disparities, with an emphasis on improving worldwide health conditions by using data-driven strategies. We offer expert support in the monitoring, evaluation, and learning framework; program and knowledge management; technology solutions; logistics; environmental scans; baseline studies; needs assessments; program development and implementation; and compliance and program auditing.

Bizzell has supported programs across the globe. We are committed to improving global health conditions by offering our expertise and cadre of subject matter experts to identify and address health disparities. Our goal is to find sustainable solutions to intractable international problems by supporting agencies, organizations, or other governing bodies who are equally committed to making a positive global impact. Bizzell staff has previously managed programs in Africa including Nigeria, Kenya, South Africa, Tanzania, and worked in Asia, including Thailand, has supported programs in Europe, and provided expert support in Haiti and the Pacific Islands. Under the President’s Emergency Plan for AIDS Relief (PEPFAR), Bizzell staff worked to improve global health and reduce the impact of HIV/AIDS. Bizzell staff has also provided proposal development, and programmatic and administrative support for the Military Malaria Research Program, which supports the development of a vaccine and drugs to treat malaria.

The Bizzell team oversaw the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) Global AIDS Program that established technical and financial infrastructure systems for the Global AIDS Program’s (GAP). Bizzell supported the GAP missions in Ethiopia and Malawi by developing protocols for establishing and sustaining relationships between U.S. entities and local organizations, such as the Ministry of Health (MoH), military, local schools, and hospitals. This included developing, designing, and implementing administrative systems within the Office of the Chief of Party, including procurement, budget, and personnel systems. The Bizzell team also established and implemented monitoring and evaluation systems, including evidence- based trainings to support effective public health programs for HIV/AIDS, TB and STI in Ethiopia, and facilitated linkages to other in-country programs and organizations for sharing of monitoring and evaluation data.

Bizzell; “Saving Lives through Leadership and Partnerships.”

27Jun2018

PTSD Awareness Day

The National Center for PTSD promotes awareness of PTSD and effective treatments throughout the year. Starting in 2010, Congress named June 27^th PTSD Awareness Day.

Post-Traumatic Stress Disorder (PTSD) is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. PTSD can happen to anyone at any age and includes war veterans, children, and people who have been through physical or sexual assault, abuse, accident, disaster, or other serious events. According to the National Center for PTSD, about 7 or 8 out of every 100 people will experience PTSD at some point in their lives. Women are more likely to develop PTSD than men, and genes may make some people more likely to develop PTSD than others. PTSD happens after traumatic events that cause people to have painful memories. For many people, the effects of the traumatic fade over time, but others are unable to make the thoughts and feelings go away even months or years after the event has occurred.

PTSD symptoms usually start immediately after the traumatic event:

The U.S. Department of Veteran Affairs has a list of symptoms for PTSD:

Reliving the event (also called re-experiencing symptoms). You may have bad memories or nightmares. You even may feel like you’re going through the event again. This is called a flashback.
Avoiding situations that remind you of the event. You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.
Having more negative beliefs and feelings. The way you think about yourself and others may change because of the trauma. You may feel guilt or shame. Or, you may not be interested in activities you used to enjoy. You may feel that the world is dangerous and you can’t trust anyone. You might be numb, or find it hard to feel happy.
Feeling keyed up (also called hyperarousal). You may be jittery or always alert and on the lookout for danger. Or, you may have trouble concentrating or sleeping. You might suddenly get angry or irritable, startle easily, or act in unhealthy ways (like smoking, using drugs and alcohol, or driving recklessly.

Below is a list of PTSD screens, that is, brief questionnaires that may identify people who are more likely to have PTSD.

For each measure, a brief description, sample items, versions, and references are provided. Information on how to obtain the measure is also provided.

A closeup phot of a wooden table with a cigarette with the words, "the last one" written on the side.

31May2018

World No Tobacco Day

Every year on May 31st, The World Health Organization (WHO) and partners mark World No Tobacco Day (WNTD). World No Tobacco Day (WNTD) highlights the health and other risks associated with tobacco use and advocate for effective policies to reduce tobacco consumption. WNTD focuses on the impact tobacco use has on the cardiovascular health and how tobacco use is an important risk factor for the development of coronary heart disease, stroke, and peripheral vascular disease.

Although Tobacco is considered a legal drug, the effects and complications related to tobacco use kill many of its users when used as intended by manufacturers. WHO has estimated that the use of tobacco is responsible for the death of about six million people across the world yearly. WHO’s new Global Report on Trends in Prevalence of Tobacco Smoking 2000-2025 report shows that 27% of people worldwide smoked in 2000, compared to 20% in 2016.

For tobacco users that are interested in quitting and living a healthier lifestyle, there are many resources available to help develop a solid “quit plan” that provides ways to stay focused, confident, and motivated throughout the journey. Smokefree.gov has 5 steps that can help smokers handle quit day, which is a smoker’s first day without cigarettes.

1. Make a Quit Plan

Having a quit plan can make quitting much easier. You can build your plan or find a program that works for you. Visit Create My Quit Plan for assistance.

2. Stay Busy

Staying busy is a great way to stay smoke-free. Being busy will help keep your mind off smoking and distract you from cravings. Here is a list of activity ideas that could help distract you:

Exercise
Chew gum or hard candy
Drink lots of water
Go to a movie
Spend time with non-smoking friends and family
Go to dinner with non-smoking friends and family

3. Avoid Smoking Triggers

Triggers are people, places, things, and situations that set off your urge to smoke. Here are some ways to avoid common smoking triggers:

Throw away your cigarettes, lighters, and ashtrays
Avoid caffeine and replace with water instead
Change your routine to avoid the things you might associate with smoking

4. Stay Positive

Try not to put too much pressure on yourself about quitting. Take things one day at a time and reward yourself for small milestones.

5. Ask for Help

You don’t have to do this alone. Ask for support from your family, friends, or a professional. They can help you get through the rough spots.

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