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Categories Bizzell, Insights, Substance Use Disorder Tags Alcohol, Alcohol Use Disorder (AUD), Behavioral Health, CEO Insights, Health, 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

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.

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.

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.thebizzellgroup.com

Categories Insights, Substance Abuse and Mental Health Services Administration (SAMHSA), Substance Use Disorder Tags Behavioral Health, Center for Behavioral Health Statistics and Quality (CBHSQ), CEO Insights, Health, Opioid Use Disorder (OUD), Special Populations, Substance Abuse and Mental Health Services Administration (SAMHSA), Thought Leadership, Woman's Health, Women's Health

Integrated Strategies to Address Opioid Use Disorders in Women

By: Anton C. Bizzell, M.D.

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). 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).

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).

  • 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). 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) 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.

The Bizzell Group’s Experience Addressing OUDs Across the Female Population:

The Bizzell Group (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.thebizzellgroup.com or email us: info@thebizzellgroup.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.

Categories Bizzell, News, Substance Use Disorder Tags Awards & Recognition, Behavioral Health, CEO News, Communications & Outreach, Community Engagement, Corporate Updates, Health, U.S. Chamber of Commerce Foundation

Dr. Anton Bizzell Joins U.S. Chamber of Commerce Foundation to Combat Opioid Crisis

FOR IMMEDIATE RELEASE

The Bizzell Group Contact
Trevis Cage
Director of Communications
301-459-0100 ext. 130
www.thebizzellgroup.com

April 8, 2019 (Lanham, MD) – President and CEO of The Bizzell Group (Bizzell), Anton Bizzell, M.D., will partner with the U.S. Chamber of Commerce Foundation for the launch of Sharing Solutions – a campaign and online resource designed to help local businesses combat the opioid crisis.

“We have heard from many small and midsize business owners struggling to find a way to address prescription drug misuse among their employees and families, said Carolyn Cawley, president of the Chamber Foundation. “Employer specific resources are thin, and they’re scattered. Our campaign collects and curates credible resources to help employers get what they need more quickly.”

Dr. Bizzell, a U.S. Chamber Foundation Fellow, will serve as the substance abuse expert, advising The Chamber Foundation’s campaign, which will include a tour of ten hard-hit cities, where workshops and community education will be provided. Dr. Bizzell will lead and moderate panel discussions with other business leaders, sharing innovative solutions to help employers address the opioid crisis through changes in business processes, employee engagement, core competencies, and community outreach.

“Businesses at the core of our communities can help solve this public health crisis – starting with our families and people in the workplace,” said Dr. Bizzell. “As a business owner, I am honored to be a part of this movement, saving lives and making resources accessible to the people who need them most.”

Dr. Bizzell has more than 20 years of combined clinical, research, health services, policy and management experience with various private and public organizations and agencies within the U.S. Department of Health and Human Services (HHS), including Substance Abuse and Mental Health Services Administration (SAMHSA) and National Institutes of Health (NIH). Most of his career has been spent on public health issues related to access and quality of medical, substance abuse and behavioral health services. Dr. Bizzell founded Bizzell in order to continue to drive change and address public health issues.

About The Bizzell Group

Established in 2010, The Bizzell Group (Bizzell) is a U.S. Small Business Administration (SBA) 8(a) strategic management and consulting firm that specializes in Program & Project Management, Administrative Support, Communication & Outreach, Conference Management & Logistical Support, Health Services & Research, Technical Assistance, as well as Training & Development. Bizzell is a partner of choice for federal, state and local government agencies and private organizations. Bizzell’s expert staff and consultants work on health, scientific, education, environment, research, and information technology projects that meet national priorities.

Under the leadership and vision of founder, Dr. Anton C. Bizzell, 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 across the world.

About the U.S. Chamber of Commerce Foundation

The U.S. Chamber of Commerce Foundation is dedicated to strengthening America’s long-term competitiveness. We educate the public on the conditions necessary for business and communities to thrive, how business positively impacts communities, and emerging issues and creative solutions that will shape the future.

About the U.S. Chamber of Commerce

The U.S. Chamber of Commerce is the world’s largest business federation representing the interests of more than 3 million businesses of all sizes, sectors, and regions, as well as state and local chambers and industry associations.

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Download this press release here.

Categories Insights, Mental Health Tags Behavioral Health, Department of Labor (DoL), Department of Veteran Affairs (VA), Health, Mental Health, Military, Thought Leadership

PTSD Awareness Day

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

  1. 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.
  2. 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.
  3. 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.
  4. 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.

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