According to the AP (2/17, Witte), on Feb. 17, “a bipartisan group of Maryland lawmakers…gathered to express their support for a package of legislation to modernize and improve access to mental health services in the state.” The proposals are aimed at “getting people help earlier, preferably in community and primary care settings, before they experience a mental health crisis requiring costly trips to the emergency room or in-patient care.” The measures include funding for a 988 suicide and crisis prevention hotline, reimbursement for collaborative care, expansion of “intensive in-home, and case management behavioral services for youths,” as well as extension of telehealth coverage, a plan for community health clinics, and a new behavioral health commission.

Related Links:

— “Maryland lawmakers want to modernize mental health services “Brian Witte, AP, February 17, 2023

The New York Times (2/20, Hamby) reports on the effects of ketamine as a treatment for mental health conditions. Although “many patients have benefited, the rapid growth of remote prescribing and at-home use of” ketamine “has outpaced the evidence that doing so is safe and effective.” Many patients are now taking ketamine “more frequently and for longer periods of time – multiple times a week, even daily in some cases, and for months or years – despite scant research on safety.” The Times interviewed “more than 40 patients who said their access to the drug was expanded through telehealth, spoke with two dozen doctors and other medical professionals, and reviewed scientific studies, case reports and data from researchers, government agencies and private analytics firms.”

Related Links:

— “Ketamine can be mind-altering, and getting it has become much easier “Chris Hamby, The New York Times, February 20, 2023

According to MedPage Today (2/17), “Older patients prescribed an atypical antipsychotic for hospitalization-related delirium more often stayed on it past the recommended duration than if prescribed a typical antipsychotic, researchers reported.” They found that “among nearly 6,000 patients 65 and older without prior psychiatric disorders, 13.5% were newly prescribed haloperidol and 86.5% initiated an atypical antipsychotic to treat delirium around an infection-related hospitalization.” The findings were published in JAMA Network Open.

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— MedPage Today (requires login and subscription)

MedPage Today (2/16, George) reports, “Cognitive functioning improved 12 months after cochlear implantation for older adults with severe hearing loss and poor cognition, datafrom a single-center study showed.” Among the “21 cochlear implant candidates whose preoperative scores indicated mild cognitive impairment, overall cognitive scores improved 12 months after cochlear implant activation from a median percentile of 5 to 12…reported” researchers in JAMA Otolaryngology-Head & Neck Surgery. The article adds, “Speech recognition in noise improved, which was tied to a rise in cognitive abilities.”

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— MedPage Today (requires login and subscription)

Psychiatric News (2/16) reports, “In their most recent guideline on the use of opioids to manage chronic pain, the U.S. departments of Veterans Affairs (VA) and Defense (DoD) recommend against using full agonist opioids…for patients who require daily pain management.” Instead, “the guideline, which was approved in May 2022, recommends using buprenorphine for patients who require long-term opioid therapy.” A reportpublished online Feb. 14 in the Annals of Internal Medicine summarized that guideline.

Related Links:

— “VA, DoD Recommend Buprenorphine Over Full Agonist Opioids for Chronic Pain, Psychiatric News, February 16, 2023

Healio (2/16, VanDewater) reports, “Among patients with COVID-19 who visited” emergency departments (EDs), “those with both psychiatric and substance use disorders had greater odds of hospitalization compared with those with one or neither type of disorder,” researchers concluded in a study that “analyzed discharge data for adults with COVID-19 at 873 hospitals with EDs and inpatient facilities in 48 states from April 2020 to August 2021,” then “also assessed incidence of substance use and psychiatric disorders using records from previous hospital visits or the first visit for COVID-19.” The findings were published online Feb. 15 in JAMA Psychiatry.

Related Links:

— “Comorbid psychiatric, substance use disorders increase odds of COVID-19 hospitalization “Kalie VanDewater, Healio, February 16, 2023

HealthDay (2/15, Murez) reports that for a study published in The Journal of Neuroscience, researchers “used brain scans and challenging work to assess how kids and adults might work through…tough problems and whether or not their problem-solving processes were the same.” The team “found that while the multiple demand network is not fully developed in kids, it operates similarly to the way it does in adults, said” the senior study author who explained, “We found that the multiple demand network was a distinct network even in young children, and was separate from the language network, just as it is in adults.”

Related Links:

— “Young Kids, Adults Use Same Brain Areas to Solve Tough Problems “Cara Murez, HealthDay, February 15, 2023

The New York Times (2/15, Hoffman) reports two FDA “panels of addiction experts on Wednesday unanimously recommended that” naloxone (Narcan), “the overdose-reversing nasal spray, be made widely available without a prescription, a significant step in the effort to stem skyrocketing drug fatalities.”

The AP (2/15, Perrone) reports the “experts voted unanimously in favor of the switch after a full day of presentations and discussions centered on whether untrained users would be able to safely and effectively use the nasal spray in emergency situations.” The agency “will make a final decision on the drug in coming weeks.”

CNN (2/15, Christensen) reports the agency “has advised the industry to change the label to add simple directions for use and possibly instructions to call 911 after administering the drug.”

Bloomberg Law (2/15, Meghjani, Baumann, Subscription Publication) and NBC News (2/15, Lovelace) also report.

Related Links:

— “Panel backs moving opioid antidote Narcan over the counter “Matthew Perrone, AP, February 15, 2023

Healio (2/15, Rhoades) reports, “Despite ‘significant stressors’ that emerged from the COVID-19 pandemic, substance use decreased among adolescents and young adults in 2020 compared with pre-pandemic years,” investigators concluded. In fact, “results from the NIDA-supported Monitoring the Future” survey revealed that “the percentage of 8th-, 10th- and 12th-graders reporting drug use decreased significantly as the pandemic endured, consistent with…findings” that show “marked reduction in substance use among youth aged 13 to 20 years in 2020.” The study authors concluded that “the ‘massive shifts to social functioning’ early in the pandemic led to abrupt discontinuations of data collection on national substance use,” according to the findings published online Jan. 31 in JAMA Network Open.

Related Links:

— “Substance use decreased among youth, young adults during COVID-19 pandemic “Andrew Rhoades, Healio, February 15, 2023

Psychiatric News (2/15) reports, “As many as 7% of U.S. veterans were found to have a positive screen for prolonged grief disorder,” investigators concluded in a study that “analyzed data from the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 2,441 U.S. veterans.” After adjusting for confounding factors, the study team found that “veterans with prolonged grief disorder were five to nine times more likely to screen positive for PTSD, major depressive disorder, and generalized anxiety disorder,” and “after additional adjustment for current psychiatric and substance use disorders, veterans were two to three times more likely to endorse suicidal thoughts and behaviors.” The findings were published online Feb. 13 ahead of print in the American Journal Of Geriatric Psychiatry.

Related Links:

— “Prolonged Grief Disorder Among Veterans Linked to Risk of Other Psychiatric Disorders, Suicide, Psychiatric News, February 15, 2023