NIMH Budget Woes
The National Institute of Mental Health's budget took a severe hit in fiscal year fiscal 2008 and is slated for another in fiscal 2009. In FY07, the agency received a total of about $1.4 billion. For the following year, which began in October 2007, Congress appropriated about $25 million more, but a required across-the-board cut brought the total budget to $1.405 billion–a hair above the previous year's budget. In late January, the White House proposed to essentially keep funding level, at $1.406 billion. This amount is “far below the increase needed to keep pace with medical research inflation,” the National Alliance on Mental Illness noted in a statement.
Mo. Psychologists Eye Prescribing
Legislators in the Missouri House and Senate have introduced bills (H.B. 1739 and S.B. 917) that would create a special designation allowing psychologists to prescribe medication, including Schedule II stimulants and Schedule IV drugs such as benzodiazepines and mood stabilizers, according to the American Psychiatric Association. Psychologists seeking a “prescribing license” would have to complete 400 hours of didactic instruction, complete a 1-year fellowship, and pass the American Psychological Association's national exam. The American Psychiatric Association and three Missouri psychiatric societies have written to every Missouri Senate member stating their opposition to the proposals.
Heart-Brain Link Overlooked
African Americans are not likely to be aware that good cardiac health is linked to good brain health, according to a survey conducted by the Alzheimer's Association and the American Heart Association. Sixty-one percent of survey respondents reported that they were concerned about developing heart disease and 40% said they were concerned about Alzheimer's, but only 6% knew there was a link between cardiovascular disease and dementia. African Americans are at greater risk for diabetes, high blood pressure, and vascular dementia than are other races. Although half of those surveyed knew of their increased cardiovascular risk, only 8% were aware that they were also at increased risk for dementias including Alzheimer's disease. Fewer than 1 in 10 were aware that heart disease, hypertension, diabetes, and hypercholesterolemia were all linked to Alzheimer's. The survey was conducted online in January 2008 with a random sample of 1,210 African Americans and 1,004 adults of other races. The sampling error was plus or minus 3.5%.
Ecstasy Use Continues to Rise
Use of 3,4-methylenedioxymethamphetamine (ecstasy) rose from 2005 to 2006 and would likely continue to increase in 2007, according to the National Survey on Drug Use and Health, conducted by the Substance Abuse and Mental Health Services Administration. About 12 million Americans aged 12 years or older admitted to at least once-in-a-lifetime use of ecstasy in 2005, and 2 million admitted to use in the past year. Twenty-three million had used LSD once, and 6.6 million had used phencyclidine hydrochloride (PCP) once during their lifetime. Use of hallucinogens tended to split along age lines. People aged 18–25 years were more likely to have used LSD, PCP, and ecstasy in the past year than were those aged 26 years or older, or those aged 12–17 years. New hallucinogens such as Salvia divinorum also are emerging, according to SAMHSA. Salvia is a member of the sage family. It grows in Oaxaca, Mexico, but is sold over the Internet. The survey found that 1.8 million people had used Salvia in their lifetime–750,000 in the past year.
Medication Errors Hit 1 in 10
A review of 4,200 charts at six community hospitals in Massachusetts found that 1 in 10 patients admitted to the facilities had suffered a preventable medication injury. Dr. David Bates of Brigham and Women's Hospital, Boston, reviewed the charts and PricewaterhouseCoopers conducted the financial analysis. The study was conducted for the Massachusetts Technology Collaborative and the New England Healthcare Institute, both of which advocate for adoption of computerized physician order entry systems at hospitals. The review found a variety of medication-related errors, including inappropriate use of expensive drugs. About 9% of patients with compromised kidney function received drugs they should not have. The organizations said that by using computer entry, the six hospitals could have saved an average of $154,000 by reducing inappropriate use of expensive drugs, and $47,000 if the system prompted use of oral medications instead of more expensive intravenous formulations. A system costs $2 million to purchase and $435,000 annually to operate, but the investment could be recouped in 26 months, said the organizations.
Top 10 Cost Half a Trillion
The nation's 10 most expensive medical conditions cost about $500 billion to treat in 2005, according to the Agency for Healthcare Research and Quality. Heart disease topped the list at $76 billion, with trauma second at $72 billion, and cancer third at $70 billion. Mental illness, including depression, cost $56 billion, and asthma and chronic obstructive pulmonary disease cost $54 billion. Hypertension cost $42 billion to treat, type 2 diabetes cost $34 billion, and osteoarthritis/joint diseases also cost $34 billion. Back problems and normal childbirth rounded out the list at $32 billion each. The agency counted money spent on office visits, clinic and emergency department use, hospital stays, home health care, and prescription medicines.