STAT (6/27, Blau) reports that opioids could “kill nearly half a million people across America over the next decade as the crisis of addiction and overdose accelerates,” according to an expert panel assembled by STAT. According to the experts’ “worst-case scenario,” the death toll due to opioids “could spike to 250 deaths a day, if potent synthetic opioids like fentanyl and carfentanil continue to spread rapidly and the waits for treatment continue to stretch weeks in hard-hit states like West Virginia and New Hampshire.” The projections are based upon expert analysis and “a review of presentations from top Trump administration health officials, including Health and Human Services Secretary Tom Price, National Institutes of Health Director Francis Collins, and the acting chiefs of the Office of National Drug Control Policy, the Substance Abuse and Mental Health Services Administration, and the Centers for Disease Control and Prevention.”

Related Links:

— “STAT forecast: Opioids could kill nearly 500,000 Americans in the next decade,” MAX BLAU, STAT, June 27, 2017.

STAT (6/26, Caruso) reports that over half of all prescriptions for opioid pain medications in the US “are written for people with anxiety, depression, and other mood disorders,” according to a study [pdf] published in the Journal of the American Board of Family Medicine. According to the study, 19 percent “of the 38.6 million Americans with mood disorders use prescription opioids, compared to 5 percent of the general population — a difference that remained even when the researchers controlled for factors such as physical health, level of pain, age, sex and race.”

Kaiser Health News (6/26, Connor) reports that patients with mental health disorders are particularly vulnerable to developing addiction to opioid pain medications. One of the study’s authors “suggested that physicians consider using different criteria when prescribing opioids for people with mental illness.”

Related Links:

— “51 percent of opioid prescriptions go to people with depression and other mood disorders,” CATHERINE CARUSO, STAT, June 26, 2017.

TIME (6/26, MacMillan) reports a study published in the Journal of Alzheimer’s Disease found “people who did more moderate-intensity physical activity were more likely to have healthy patterns of glucose metabolism in their brains—a sign of healthy brain activity—than those who did less.” The authors found large doses of high-intensity exercise may be needed to offer the benefits of “a modest increase” in moderate activity, “suggesting that you don’t have to exercise to the extreme to get brain benefits.” Lead author Ozioma Okonkwo, assistant professor of medicine at the University of Washington School of Medicine and Public, says, in general, the evidence suggests that “light activity is insufficient, and vigorous activity might be unnecessary.”

Related Links:

— “How Exercise May Protect the Brain From Alzheimer’s Disease,” Amanda MacMillan, Time, June ,26 2017.

In “Well,” The New York Times (6/26, Brody, Subscription Publication) reports that symptoms of anxiety or depression can “masquerade as an as-yet undiagnosed physical disorder.” Psychiatric Times recently published a “partial listing” of 47 medical illnesses that may first present as anxiety and a “partial listing” of 30 categories of medications that could cause anxiety, including antidepressants like SSRIs. The lists were included in an article “meant to alert mental health practitioners to the possibility that some patients seeking treatment for anxiety or depression may have an underlying medical condition that must be addressed before any emotional symptoms are likely to resolve.”

Related Links:

— “When Anxiety or Depression Masks a Medical Problem,” JANE E. BRODY, New York Times, June 26, 2017.

HealthDay (6/23, Dotinga) reported that “a new federal report finds that fewer U.S. teens and young adults are indulging in frat-party style drinking because their levels of binge drinking have gone down over the past six years.” However, “fourteen percent of young people from 12 to 20 years old reported binge drinking at least once within the past four weeks.” Frances Harding, director of the Center for Substance Abuse Prevention at the U.S. Substance Abuse and Mental Health Service Administration, said, “We’ve made plenty of progress through prevention efforts, yet the work still needs to continue.”

Related Links:

— “Fewer U.S. Kids Binge Drinking,” Randy Dotinga, HealthDay, June 22, 2017.

Medscape (6/23, Davenport) reported that a meta-analysis indicates “deaths directly related to electroconvulsive therapy (ECT) are rare events and seem to be decreasing in incidence.” In “the pooled analysis of more than 750,000 ECT procedures performed since the mid-1970s,” investigators found “that the rate of deaths related to ECT itself was only around two per 100,000 treatments – less than that seen with general anesthesia for surgery.” The research was presented at the 13th World Congress of Biological Psychiatry and published in Acta Psychiatrica Scandinavica.

Related Links:

— Medscape (requires login and subscription)

The New York Times (6/22, Pear, Kaplan, Subscription Publication) reports that on Thursday, Senate Republicans “took a major step” towards their goal of repealing and replacing the Affordable Care Act by “unveiling a bill to cut Medicaid deeply and end the health law’s mandate that most Americans have health insurance.” The measure “would create a new system of federal tax credits to help people buy health insurance, while offering states the ability to drop many of the benefits required by the Affordable Care Act, like maternity care, emergency services and mental health treatment.” The article says that although GOP senators had promised their ACA repeal bill would significantly modify the American Health Care Act which the House passed last month, the proposal which was put forward maintains the AHCA’s “structure, with modest adjustments.”

USA Today (6/22, Kelly, Collins) reports the Senate’s bill differs from the AHCA in that “it does away with a controversial House provision – which critics dubbed an ‘age tax’ – that would greatly increase costs for older Americans who need subsidies to pay for medical coverage.” In addition, the Senate’s version “would tie subsidies to income rather than age,” but this would “make it harder for people to qualify for the subsidies by tightening the income requirements.” Republican leaders are saying this bill is the party’s best option to keep conservatives’ promise to repeal and replace the ACA.

The Wall Street Journal (6/22, A1, Armour, Peterson, Radnofsky, Subscription Publication) reports on its front page that the bill would unwind major provisions of the ACA, such as its expansion of Medicaid. The article says Republicans are hoping to move quickly to pass an ACA repeal bill before the July 4 recess. However, some GOP lawmakers in the Senate say they are worried about some of the changes included in the measure.

The Los Angeles Times (6/22, Levey, Mascaro) reports that the bill includes “a drastic reduction in federal healthcare spending that threatens to leave millions more Americans uninsured, drive up costs for poor consumers and further destabilize the nation’s health insurance markets.”

On its website, ABC News (6/22, Stracqualursi, Adam Kelsey, Rogin) says top medical groups criticized the bill. For instance, the American Psychiatric Association’s CEO and Medical Director Saul Levin, MD, said, “The Senate proposal represents a significant move in the wrong direction, resulting in fewer people having access to insurance, fewer patient protections, and less coverage for essential behavioral health care.”

The Huffington Post (6/22, Holmes) reports, “Mental health organizations have been expressing concern about how the Republican effort to repeal and replace” the Affordable Care Act “could affect people living with mental illness.” For example, “American Psychiatric Association officials noted that they were not consulted on the House version or the Senate’s draft legislation.”

Psychiatric News (6/22) quotes Dr. Levin, who also said, “We urge the Senate to reject this harmful legislation and start again on a health care bill that puts patients first.” Meanwhile, APA President-Elect Altha Stewart, MD, said in a June 21 press release, “Eliminating requirements for coverage of key benefits, including mental health and substance use disorders and other patient protections that are part of the Affordable Care Act, will have detrimental impacts for millions.” Dr. Stewart added, “Mental health is critical to overall health and needs to be equally accessible.”

Related Links:

— “Senate Health Care Bill Includes Deep Cuts to Medicaid,” ROBERT PEAR and THOMAS KAPLAN, New York Times, June 23, 2017.

The Wall Street Journal (6/22, King, Subscription Publication) reports that healthcare professionals say that patients who struggle with opioid addiction are increasingly turning to the black market due to a lack of access to treatment options, especially medication-based addiction treatment. Experts are increasingly recommending medication-based treatment, combined with counseling, to treat opioid addiction.

Related Links:

— “Lacking Treatment Options, Opioid Addicts Turn to Black Market,” Kate King, Wall Street Journal, June 22, 2017.

HealthDay (6/22, Preidt) reports, “More than one in five children with Tourette syndrome also tests positive for autism,” investigators found in a study including “535 children and adults with Tourette’s.” It is unlikely, however, that “so many children actually have both disorders.” What appears more likely is that “Tourette’s symptoms often mimic or seem quite similar to those of autism, the researchers noted.” The findings were published in the July issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

Related Links:

— “When is Tourette Syndrome Actually Autism?,” Robert Preidt, HealthDay, June 22, 2017.

The New York Times (6/20, A1, Pear, Steinhauer, Subscription Publication) reports on its front page that growing dissension “among Senate Republicans over federal spending on Medicaid and the opioid epidemic is imperiling legislation to repeal the Affordable Care Act that Senate leaders are trying to put to a vote by the end of next week.” The article says although President Trump urged senators to be more generous in their bill than the House was, on Tuesday, GOP leaders in the Senate “appeared to be drafting legislation that would do even more to slow the growth of Medicaid toward the end of the coming decade.” The piece adds that several lawmakers are warning the current measure would imperil consumers’ access to addiction treatment.

The AP (6/20, Alonso-Zaldivar) reports that the effort to repeal the ACA “is colliding with the opioid epidemic. Medicaid cutbacks would hit hard in states deeply affected by the addiction crisis and struggling to turn the corner, according to state data and concerned lawmakers in both parties.” Figures indicate “Medicaid expansion accounted for 61 percent of total Medicaid spending on substance abuse treatment in Kentucky, 47 percent in West Virginia, 56 percent in Michigan, 59 percent in Maryland, and 31 percent in Rhode Island.” The article adds that during a recent hearing, HHS Secretary Tom Price “defended the Trump administration and raised questions about how much difference Medicaid actually makes.” He explained that HHS’ “budget for the opioid crisis is more than three times greater than two years ago, $811 million versus $245 million,” which “reflects increases approved by Congress beyond what Medicaid spends.”

Related Links:

— “G.O.P. Rift Over Medicaid and Opioids Imperils Senate Health Bill,” ROBERT PEAR and JENNIFER STEINHAUER, New York Times, June 20, 2017.