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