Dr. David Sleet Co-Authors Report on Reducing Homelessness at Canadian Emergency Departments

Dr. David Sleet Co-Authors Report on Reducing Homelessness at Canadian Emergency Departments

A novel Canadian program (The Bridge Healing program) aims to break the cycle of homelessness and prevent unsustainable, repeated “social admits” of homeless individuals to emergency departments (EDs).

Dr. David Sleet, Bizzell Senior Associate, Injury Prevention, co-authored “Bridge Healing: A Pilot Project of a New Model to Prevent Repeat “Social Admit” Visits to the Emergency Department and Help Break the Cycle of Homelessness in Canada,” published in the International Journal of Environmental Research and Public Health. The article describes the program designed to provide healthcare services that act as transitional housing for homeless individuals who would not normally receive any other housing assistance.

Dr. Sleet stated that, “the project design facilitates reintegrating residents into the community, preventing poor health outcomes and unnecessary costs to the healthcare system. Multiple stakeholders have endorsed the model and grassroots community-level organizations have financially supported it.”

Significant successes included the establishment of relationships with government agencies to facilitate the acquisition of permanent housing. The study found that collaborating with income support services that cover basic needs allowed staff to focus on acquiring permanent housing, thus minimizing reliance on EDs.

“We hope that our research eases the burden on local emergency departments and increases the resources so desperately needed by individuals working to exit the cycle of homelessness and housing insecurity,” added Dr. Sleet.

About Bizzell

Bizzell is a strategy, consulting, and technology firm with a mission to improve lives and accelerate change. We develop innovative solutions to some of the most critical issues of our time such as health care services equity, global health, workforce innovation, and other urgent needs facing the world. Learn more about how we develop data-driven, research-informed, innovative solutions to complex, real-world challenges.

Learn more at www.BizzellUS.com.

About BHARC

The Behavioral Health Advancement Resource Center (BHARC) is an authoritative source for behavioral health information, insights, technical assistance, training, and innovative tools. BHARC is a mechanism to share evidence-based behavioral health interventions and best practices. The BHARC Advisory Council consists of experts in substance use, mental health, clinical trials, pharmaceuticals, and healthcare standards and quality. Learn more about the Behavioral Health Advancement Resource Center at BHARC.org.

Honoring the Journey: Celebrating PTSD Awareness Month

Honoring the Journey:

Celebrating PTSD Awareness Month

By Bizzell Editorial Staff

 “Unlike other forms of psychological disorders, the core issue in trauma is reality.” 

Bessel A. van der Kolk, “Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society” 

What is trauma? Trauma is an emotional response to an extremely stressful event(s) like an accident, physical abuse, intimate partner violence, sexual assault, combat, natural disasters, and even global pandemics. While not everyone who experiences trauma will develop post-traumatic stress disorder (PTSD), it is still important to understand the effects of trauma. 

Trauma biologically changes a person’s brain. When experiencing a traumatic event, the body treats it as a threat, the “fight, flight, or freeze” part of the brain is activated, and the body switches into survival mode. Usually, when the threat has passed, the body will return to a more restful state. However, when the brain doesn’t leave that reactive survival space, PTSD can develop [1]Bizzell, A. C., (2021, June 9). What You Need to Know About PTSD. Psychology Today. https://www.psychologytoday.com/us/blog/mind-your-health/202106/what-you-need-know-about-ptsd.

June is observed as PTSD Awareness Month, with June 27 highlighted as PTSD Screening Day. Within the civilian population, anywhere from 2.3% to 9.1% of Americans will experience an episode of PTSD within a given year. Within the military population, the rates are significantly higher, with 6.7% to 50.2% of American service members experiencing an episode during a year. Regardless of military status, women are more likely to develop PTSD than men [2]Schein, J., Houle, A., Cloutier, M., Patterson-Lomba, O., Wang, Y., King, S., Levinson, W., Guérin, A., Lefebvre, P., & Davis, L. L. (2021). Prevalence of post-traumatic stress disorder in the United States: a systematic literature review. Current Medical Research and Opinion, 37(12), 2151 – 2161. https://doi.org/10.1080/03007995.2021.1978417. In addition, it is very common for individuals with PTSD to have at least one comorbid condition, such as depression or anxiety. 

By encouraging people to become more informed about PTSD and what the symptoms may look like, we can lessen the stigma around this condition. Physical symptoms can vary, but may include: 

  • Flashbacks or re-experiencing the event
  • Insomnia
  • Panic attacks
  • Anxiety
  • Chronic fatigue
  • Migraines
  • Mood instability
  • Depression

Other ways PTSD can manifest itself is through the coping behaviors people employ to manage their symptoms. For example, individuals may avoid certain places, activities, people, or dates to avoid triggering an episode. Other people have intense dreams or repetitive flashbacks that intrude on their normal thought processes. Alterations in both cognition and reactivity are also common responses to PTSD; examples include compulsive negative thoughts, engaging in self-destructive activities, or having a distorted self-perception that reinforces feelings of shame or guilt. 

Self-treatments such as learning mindfulness techniques, practicing deep breathing, and progressively tensing and relaxing muscles can help a person healthfully cope with the overwhelming stimuli during an episode. Other successful treatments include therapy, medication, or a mix of all the above.  

PTSD can be effectively managed through compassionate understanding and appropriate care. The majority of individuals who undergo PTSD ultimately find a path to recovery. Collaborating with a primary care physician to monitor and address symptoms is crucial for achieving recovery or effective management. It is essential to recognize that individuals with PTSD have the capacity to adapt, coexist with their symptoms, and lead meaningful, productive lives. 

Learn more about PTSD from the U.S. Department of Veteran Affairs’ National Center for PTSD.

 

References 

[1] Bizzell, A. C., (2021, June 9). What You Need to Know About PTSD. Psychology Today. https://www.psychologytoday.com/us/blog/mind-your-health/202106/what-you-need-know-about-ptsd 

[2] Schein, J., Houle, A., Cloutier, M., Patterson-Lomba, O., Wang, Y., King, S., Levinson, W., Guérin, A., Lefebvre, P., & Davis, L. L. (2021). Prevalence of post-traumatic stress disorder in the United States: a systematic literature review. Current Medical Research and Opinion, 37(12), 2151 – 2161. https://doi.org/10.1080/03007995.2021.1978417 

Supporting Drug Prevention Week

Supporting Drug Prevention Week

By Todd W. Mandel, MD, Bizzell US

National Prevention Week is a Substance Abuse and Mental Health Services Administration (SAMHSA) led national public education campaign highlighting the work of communities and organizations dedicated to raising awareness about substance misuse prevention and positive mental health. Observed May 7–13, this week-long endeavor encourages preventative initiatives and tactics designed to increase positive mental health outcomes.

This collaborative effort helps to strengthen prevention efforts and create a culture of health and wellness, bringing together individuals, organizations, and communities across the country. Please visit the Prevention Week homepage to register and join SAMHSA in honoring of the work of their partners in prevention and celebrating stories of success.

There are numerous dangers of substance use disorders (SUDs) that can affect both an individual’s physical and mental health. SUDs can cause changes in brain chemistry that can facilitate the development of mood disorders, anxiety, and depression. SUDs contribute to potentially fatal overdoses, and other issues such as heart disease, liver and kidney damage, and respiratory issues. Additionally, SUDs can disrupt personal relationships, cause financial problems, and even lead to legal issues.

According to the CDC figures cited by the Drug Enforcement Agency (DEA), 107,375 people in the United States died of drug overdoses and drug poisonings in the 12-month period ending in January 2022 [1]United States Drug Enforcement Administration. (2022, April 29). Fentanyl Awareness. Retrieved May 9, 2023, from https://www.dea.gov/fentanylawareness. A staggering 67 percent of those deaths involved synthetic opioids, like fentanyl, with some of these deaths attributed to fentanyl mixed with other illicit drugs like cocaine, methamphetamine, and heroin. This illicit mixture leaves many users unaware they were taking fentanyl, further contributing to overdoses. Only two milligrams of fentanyl can be a potentially lethal dose, particularly for someone who does not have an opioid tolerance. Recent data from the DEA indicates that Fentanyl is involved in more deaths of Americans under 50 than any cause of death, including heart disease, cancer, homicide, suicide, and accident-related deaths [1]United States Drug Enforcement Administration. (2022, April 29). Fentanyl Awareness. Retrieved May 9, 2023, from https://www.dea.gov/fentanylawareness.

While the focus of National Prevention Week is providing an educational forum to encourage people to not start using substances, for those who are already facing challenges with SUDs, effective treatments are available. There are also other strategies and resources for overdose prevention. Bizzell US, through its work with The National Institute on Drug Abuse Clinical Trials Network, produced online educational resources on topics for screening, fentanyl overdose prevention, and treatment for methamphetamine use disorder:

Prevention efforts such as education and awareness campaigns, early intervention programs, and easy access to treatment and support are essential to reduce drug use and its harmful consequences. By working together as a community to prioritize drug use prevention, we can help individuals and families avoid the devastating effects of drug addiction, promoting a safer and healthier future for everyone.

 

References

[1] United States Drug Enforcement Administration. (2022, April 29). Fentanyl Awareness. Retrieved May 9, 2023, from https://www.dea.gov/fentanylawareness.

 

5 ounces of table wine is 12% alcohol which equals 12 ounces of regular beer at 5% alcohol which equals 1.5 ounces of liquor at 24% alcohol.

Alcohol Awareness Month: A Time for Reflection and Action

Alcohol Awareness Month:

A Time for Reflection and Action

By David A. Sleet, PhD, Senior Associate, Bizzell US

April is Alcohol Awareness Month, an opportunity to raise awareness about alcohol harms and take action to prevent them, both at home and in the community.

Data from the World Health Organization found the harmful use of alcohol is a causal factor in more than 200 disease and injury conditions. Worldwide, 3 million deaths every year result from harmful use of alcohol. Overall, 5.1 percent of the global burden of disease and injury is attributable to alcohol, as measured in disability-adjusted life years (DALYs).

According to the Centers for Disease Control and Prevention, excessive alcohol use was responsible for more than 140,000 deaths each year in the United States during 2015–2019, or more than 380 deaths per day. There is clear evidence that heavy drinking, even on a small number of days increases risks to health.

Excessive drinking is also costly, reaching $249 billion in 2010, or about $2.05 per drink. Most (77 percent) of these costs were due to binge drinking, defined as drinking four or more alcoholic beverages per occasion for women or five per occasion for men. Further, two of every five dollars were paid by federal, state, and local governments, demonstrating that we are all paying for excessive alcohol use.

It is well known that alcohol is strongly associated with death from motor vehicle crashes, drowning, falls, workplace injuries, fires, burns, suicide, and violence[1]Chikritzhs, T., & Livingston, M. (2021). Alcohol and Risk of Injury. Nutrients, 13(8), 1-15. https://doi.org/10.3390/nu13082777. Alcohol also has what is regarded as “secondhand harms,” defined as harms to individuals as a result of someone else’s drinking — estimated to affect one in five adults annually[2]Nayak, M., Patterson D., Wilsnack, S., Karriker-Jaffe K., and Greenfield, T. (2019). Alcohol’s Secondhand Harms in the United States: New Data on Prevalence and Risk Factors. Journal of Studies on Alcohol and Drugs, 80(3), 273-281. https://doi.org/10.15288%2Fjsad.2019.80.273.

A recent analysis from the Institute for Health Metrics and Evaluation even suggests that for young adults aged 15-39, there are no health benefits to drinking alcohol, only harms. The harms they are most likely to experience involve injuries. Both males and females under age 40 risked health losses from alcohol use, even when consuming small amounts. For those over age 40, consuming small amounts of alcohol (e.g.,1-2 glasses of wine daily) may provide some health benefits but only among selected groups[3]GBD 2020 Alcohol Collaborators. (2022). Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis from the Global Burden of Disease Study 2020. Lancet, 400(10347), 185–235. https://doi.org/10.1016/S0140-6736(22)00847-9.

We need stronger interventions tailored towards younger individuals to reduce the substantial global health loss attributable to alcohol use. To improve population health, the public should demand greater accountability from those who manufacture, advertise, market, distribute, and sell alcohol.

Actions you can take:

  • Encourage friends and family to make small changes, such as keeping track of how much they drink – daily, weekly, or monthly – and setting safe drinking limits.
  • Find effective ways to talk to your children about the risks of alcohol use and the dangers of underage and binge drinking.
  • Support health care efforts to curb alcohol-related illness and disease by screening patients for alcohol problems, obtaining routine blood alcohol concentrations (BAC) for injured patients, and by strengthening laws that limit the availability of alcohol to underage youth. 
  • Avoid driving after drinking and support state government initiatives to enact per se laws for alcohol impaired driving to 0.05 percent BAC, from current laws at 0.08 percent. 
  • Limit alcohol intake to two drinks or less a day (if you are a man) and one drink or less a day (if you are a woman), on days when alcohol is consumed. 

 

References

[1] Chikritzhs, T., & Livingston, M. (2021). Alcohol and Risk of Injury. Nutrients, 13(8), 1-15. https://doi.org/10.3390/nu13082777

[2] Nayak, M., Patterson D., Wilsnack, S., Karriker-Jaffe K., and Greenfield, T. (2019). Alcohol’s Secondhand Harms in the United States: New Data on Prevalence and Risk Factors. Journal of Studies on Alcohol and Drugs, 80(3), 273-281. https://doi.org/10.15288%2Fjsad.2019.80.273

[3] GBD 2020 Alcohol Collaborators. (2022). Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis from the Global Burden of Disease Study 2020. Lancet, 400(10347), 185–235. https://doi.org/10.1016/S0140-6736(22)00847-9