The community health center crisis
Federally qualified health centers, most of which are in a category called community health centers, are vital health care infrastructure. They are non-profit community based organizations that receive federal support to provide primary care services in medically underserved areas, and to serve the uninsured and underinsured. Most of their income is from Medicaid and Medicare, and they charge on a sliding scale (going to zero) for people who are uninsured. They typically provide pre-natal care, may have dentistry and other specialty care, and substance abuse and mental health treatment. Right now they are in crisis. The physicians who wrote the linked article work at Upham's Corner Community Health Center, which I am very familiar with from my time in Boston. It's in the " United Nations " community in Dorchester. Like all CHCs, Upham's Corner has been financially devastated by the Covid-19 pandemic. They were already in financially perilous circumstances. Congress cut off their subsidy funding for many months in 2017, and it is now scheduled to expire again in November. With the precipitous decline in visits during the pandemic, they have lost much of their revenue from health insurance and many have been forced to close. As Doctors Kishay and Hayden tell us:Congress should adequately fund CHCs. We cannot rely on our private health system to care for Americans in crisis. Though the $1.3 billion provided by the Coronavirus Aid, Relief, and Economic Security (CA...
Here are a few I came across last week. Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment. ----- https://mhealthintelligence.com/news/amid-rising-substance-abuse-rates-treatment-centers-turn-to-telehealth Amid Rising Substance Abuse Rates, Treatment Centers Turn to Telehealth Amid a surge in substance abuse issues caused by the coronavirus pandemic, the Desert Hope Treatment Center is using a telehealth platform to screen patients and expand access ...
Historically, federal and state policies have narrowly defined treatment models that have resulted in limited access to and engagement in counseling for individuals receiving medications for opioid use disorder (MOUD; e.g., methadone and buprenorphine). In response to the coronavirus pandemic, outpatient MOUD treatment providers rapidly transitioned from traditional, in-person care delivery models to revised COVID-19 protocols that prioritized telehealth counseling to protect the health of patients and staff and ensure continuity in MOUD care.
The coronavirus 2019 disease (COVID-19) pandemic emerged at a time of substantial investment in the United States substance use service infrastructure. A key component of this fiscal investment was funding for training and technical assistance (TA) from the Substance Abuse and Mental Health Services Administration (SAMHSA) to newly configured Technology Transfer Centers (TTCs), including the Addiction TTCs (ATTC Network), Prevention TTCs (PTTC Network), and the Mental Health TTCs (MHTTC Network).
Coronavirus disease 2019 (COVID-19) will have a lasting impact on public health. In addition to the direct effects of COVID-19 infection, physical distancing and quarantine interventions have indirect effects on health. While necessary, physical distancing interventions to control the spread of COVID-19 could have multiple impacts on people living with opioid use disorder, including impacts on mental health that lead to greater substance use, the availability of drug supply, the ways that people use drugs, treatment-seeking behaviors, and retention in care.
By HAYWARD ZWERLING I walked into my exam room to see a patient I first met two decades ago. On presentation, his co-morbidities included poorly controlled DM-1, hypertension, hyperlipidemia, and a substance abuse disorder. Over the years our healthcare system has served him well as he has remained free of diabetic complications and now leads a productive life. Watching this transformation has been both professionally rewarding, personally enjoyable, and I look forward to our periodic interactions. At this visit, he was sporting a MAGA hat. I was confused. How can my patient, who has so clearly benefited from America...
Mental health flows from the ceramic jug psychotherapist Lori Gottlieb keeps on her desk. There’s nothing special about the jug—a minor accessory in an office designed with the sort of tidy impersonality common to her field. And there’s no special elixir in it—just water. But all the same, the jug provides a certain kind of healing. When patients are struggling, crying, overcome in some way, Gottlieb, a Los Angeles based practitioner and author of the book Maybe You Should Talk to someone, will offer up a cup of water, pour it for them and hand it across. In that small gesture is a whole constellati...
A new C.D.C. survey indicates that young people, as well as Blacks and Latinos of all ages, are showing signs of deteriorating mental health and some are resorting to substance abuse.
In response to the novel coronavirus 2019 (Covid-19) pandemic, many people experiencing homelessness and substance use disorders entered respite and recuperation facilities for care and to isolate and prevent subsequent SARS-CoV-2 transmission. However, because drug use was officially prohibited in these facilities, we observed people who use substances leaving isolation temporarily or prematurely. The initial Covid-19 surge magnified the need for harm reduction access for those who use substances to ensure their safety and well-being and that of their local communities.
The current coronavirus disease (COVID-19) pandemic has rapidly spread across the world. Individuals with stimulant use disorder are a vulnerable population, who are particularly at risk of negative outcomes during this pandemic due to several risk factors, including mental and physical comorbidities, weakened immune responses, high-risk behaviors, and barriers to healthcare access. Engaging patients with stimulant use disorder in regular treatment has become even more difficult during this pandemic, which has resulted in many cuts to addiction treatment programs.
Clinical trials represent an essential component of improving treatment for substance use disorders (SUD). The SARS coronavirus-2 pandemic disrupted our ongoing clinical trial of smoking cessation and forced us to rapidly implement changes to assure participants access to ongoing counseling and monitoring via telephone calls and/or video chat sessions. Our experiences suggest that this pandemic will lead to changes for both future clinical trial participants and project staff. While challenges remain, it will be important to assessing the impact of these changes with regard to participant experiences and treatment outcomes.
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