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Physicians realize the limits of their training in substance abuse and mental health. Clearly, there should be a requirement that Primary Care Centers have a staff psychologist: See-

Health care reform law helps 1.3 million minority young adults obtain health insurance

New data released today by Health and Human Services shows that the Affordable Care Act has extended health insurance to a substantial number of racial and ethnic minorities nationwide. The health care reform law allows young adults to stay on their parents' insurance plans through age 26.

The data, based on combined estimates from the National Health Interview Survey and the Current Population Survey, indicate that approximately 736,000 Latinos, 410, 000 Blacks, 97,000 Asian Americans, and 29,000 American Indian/Alaska Natives have gained coverage because of the law.

Highlighted in an HHS issue brief, the data coincides with a research letter also published today in the Journal of the American Medical Association (JAMA).

“As a result of the Affordable Care Act, we are making strides in giving every American regardless of race or ethnicity a fair shot at quality, affordable health coverage,” said HHS Secretary Kathleen Sebelius. “Because of the law, more and more young adults can breathe a little easier knowing they have health coverage.”

The studies released today provide the first estimates of the law’s effects on young adults in minority groups.

“These results show that the Affordable Care Act has already made a real difference in the lives of young adults, and that the benefits have occurred for Americans across racial and ethnic lines,” said Richard Kronick, Ph.D., HHS deputy assistant secretary for planning and evaluation, and one of the study’s authors. “The Affordable Care Act has helped give millions of young adults – white and black, Latino and Asian – the security of health insurance as they begin to build their careers and their families.”

For more information about this topic, please see the HHS Issue Brief at

For more information about the JAMA research article released today, please visit

AHRQ News and Numbers

Only 10 percent of the U.S. population accounted for nearly two-thirds of all health care costs in 2008. The average annual cost for each of these individuals totaled almost $24,000, which includes costs covered by insurance and paid out of pocket. Approximately 45 percent of these individuals remained in this 10 percent of the population in 2009, based on their health expenses that year. [Source: Agency for Healthcare Research and Quality, MEPS, Statistical Brief #354: The Concentration and Persistence in the Level of Health Expenditures over Time: Estimates for the U.S. Population, 2008-2009.]

Mediator: Slimming Drug a Killer

Mediator, a drug licensed for use by diabetics that became widely prescribed in France … Mediator, a drug licensed for use by diabetics that became widely prescribed in France as a slimming aid, "probably" caused at least 1,300 deaths before it was withdrawn, a study published on Thursday said. Mahmoud Zureik of the National Institute of Health and Medical Research (Inserm), who co-led the probe, told AFP that around 3,100 people had required hospitalisation during the 33 years during which the drug was sold.

However, these figures could well be an "underestimate," he said. The study, appearing in the specialised journal Pharmacoepidemiology & Drug Safety, finetunes an estimate by Zureik in 2010 that the death toll from the scandal was between 1,000 and 2,000.
Mediator, known by its lab name as benfluorex, was initially licensed to reduce levels of fatty proteins called lipids, with the claim that it
helped diabetics control their level of blood sugar. But it also suppressed appetite, which meant it gained a secondary official
use to help obese diabetics lose weight. In fact, it was widely sold on prescription for non-diabetics wanting to slim.
In 2009, Mediator was pulled from the European market amid evidence that it damaged heart valves and caused pulmonary hypertension.
Its French manufacturer, Servier, is being probed on suspicion of dishonest practices and deception.

The new study is an extrapolation based on figures for deaths from faulty heart valves, although not from hypertension, among major users of the drug. The main data comes from France's national health insurance system, which said that 303,000 patients used Mediator in 2006.

According to Mediator, 145 million packets of Mediator were sold on the French market before the drug was pulled.
The Mediator case came to light after a scandal involving a similar type of anti-obesity drug, fenfluramine, in the late 1990s.

Ritalin Gone Wrong

An enlightening opinion article in today's NY Times by Dr. L. Alan Sroufe who is a professor emeritus of psychology at the University of

Minnesota’s Institute of Child Development.

See:

Here are some excerpts:

THREE million children in this country take drugs for problems in focusing. Toward the end of last year, many of their parents were

deeply alarmed because there was a shortage of drugs like Ritalin and Adderall that they considered absolutely essential to their children’s

functioning.

In 30 years there has been a twentyfold increase in the consumption of drugs for attention-deficit disorder.

But are these drugs really helping children? Should we really keep expanding the number of prescriptions filled?

As a psychologist who has been studying the development of troubled children for more than 40 years, I believe we should be asking why we rely so heavily on these drugs.

In 1973, I reviewed the literature on drug treatment of children for The New England Journal of Medicine. Dozens of well-controlled studies

showed that these drugs immediately improved children’s performance on repetitive tasks requiring concentration and diligence. I had

conducted one of these studies myself. Teachers and parents also reported improved behavior in almost every short-term study. This

spurred an increase in drug treatment and led many to conclude that the “brain deficit” hypothesis had been confirmed.

But questions continued to be raised, especially concerning the drugs’ mechanism of action and the durability of effects. Ritalin and

Adderall, a combination of dextroamphetamine and amphetamine, are stimulants. So why do they appear to calm children down? Some experts argued that because the brains of children with attention problems were different, the drugs had a mysterious paradoxical effect on them.

However, there really was no paradox.

TO date, no study has found any long-term benefit of attention-deficit medication on academic performance, peer relationships or behavior problems, the very things we would most want to improve. Until recently, most studies of these drugs had not been properly

randomized, and some of them had other methodological flaws.

But in 2009, findings were published from a well-controlled study that had been going on for more than a decade, and the results were very

clear. The study randomly assigned almost 600 children with attention problems to four treatment conditions. Some received medication alone, some cognitive-behavior therapy alone, some medication plus therapy, and some were in a community-care control group that received no systematic treatment. At first this study suggested that medication, or medication plus therapy, produced the best results. However, after three years, these effects had faded, and by eight years there was no evidence that medication produced any academic or behavioral benefits.

However brain functioning is measured, these studies tell us nothing about whether the observed anomalies were present at birth or whether they resulted from trauma, chronic stress or other early-childhood experiences. One of the most profound findings in behavioral

neuroscience in recent years has been the clear evidence that the developing brain is shaped by experience.

Other large-scale epidemiological studies confirm such trends in the general population of disadvantaged children. Among all children,

including all socioeconomic groups, the incidence of A.D.D. is estimated at 8 percent. What we found was that the environment of the

child predicted development of A.D.D. problems. In stark contrast, measures of neurological anomalies at birth, I.Q. and infant

temperament — including infant activity level — did not predict A.D.D.

Putting children on drugs does nothing to change the conditions that derail their development in the first place. Yet those conditions are receiving scant attention.

.....the large-scale medication of children feeds into a societal view

that all of life’s problems can be solved with a pill and gives

millions of children the impression that there is something inherently

defective in them.

Editor's Note: Dr. Sroufe's article and summary review of the science on amphetamines to treat the serious mood disorder (ADHD-a diagnostic lable that smacks of an "education disorder", which, in reality, describes a severe mood disorder that often turns into adult Bipolar Disorder, or a serious character disorder, and which runs in families that are most frequently severely dysfunctional with clear and pervasive multigenerational mental illness that is being cross generationally projected) makes the same conclusion about "medication only" approaches to treat mental disorder that the National Psychology Practitioner Association (www.nappp.org), the Academy of Medical Psychology (www.amphome.org), The World Health Organization, the NICE Study and the Royal Medical Society in Britan, and even a letter from the director of the FDA have made in national campaigns and conclusions. Recently, even the come lately oriented American Psychological Association (APA) has become engaged (at leaste at the Division level) and has jumped on this band wagon that started four years ago by other professional associations. Yet, the pharmaceutical houses, the medical establishment, and even the reimbursement patterns and rules of the Medicaid, and Medicare systems (usually used by Insurance and Managed Care organizations) has no rules requiring accurate diagnoses prior to prescription of a treatment plan, no comprehensive treatment plans (no "medication only approaches"), and requiring that the nation's Primary Care System staffs adequately with psychologists to do this important diagnostic and treatment work. Treating ADHD, and indeed all childhood mental disorders, with medication only approaches (and even individual psychotherapy alone) is more a "convience for the doctor" rather than adequate treatment. ADHD and severely mentally ill families are characteristically dysfunctional and provide negative and problematic learning and brain development environments. We need rules that require that the child and family (and parents) be individually and collectively diagnostically evaluated and that a comprehensive treatment plan be developed. We need rules that Primary Care Centers and Community Hosptials are required to have adequate staffing of psychologists to maintain their licensure and certification in federal reimbursement programs. We need to implement the NAPPP and AMP supported standards for proper diagnostic evaluation and comprehensive treatment of patients with mental disorder and placing the adjunctive medication techniques in their proper second or third line or "component" place in the treatment plan.

ADHD AHQR Scientific Findings:

see:

See lovely Science Web site at:

Alcohol and Drugs:

Alcohol and drug abuse are devastating American society, are a major source of healthcare costs, loss of industrial and workforce productivity, move countless families from the middle class into poverty, is over crowding jails, and makes up a large portion of emergency room and nursing home visits and placements. Societies are being attacked by criminals, cartels, and manufacturers of drugs and alcohol and social structure is being undermined. Large numbers of ill people (the addicted) have their illness ignored and untreated and go to waiting lists, jails without proper staffing and treatment for their illness, and are mislabeled "career criminals" instead of crime complicated addict lifestyles as a component of a serious illness. Below are basic learning materials to begin your process of understanding addiction in the brain, patient, family, and society:

A Very Extensive Benzodiazepine Review For Advanced Professionals:

Some Valuable Information about Anxiety Disorders:

Below is a film that has some valuable pathophysiology and pharmacokenetics related to anxiety and its control. This film has the typical Medical Model mistakes and faulty conceptualization. First, that medications such as anxyolitics and antidepressants "control most of the symptoms of an anxiety or depressive disorder". In fact, these classes of medications actually work with less than half of the people they are given to, and they only control a few of the many symptoms of these diseases and no medication has ever been found to rise to the level of cure or even stand alone treatment for a depressive or anxiety disorder (see: TruthInDrugs-www.nappp.org). Clearly, psychotherapies that effectively treat the entire syndromes of the anxiety disorders and depressive disorders are available and scientifically proven effective. Any real treatment plan for these diseases should include them, and should view medication approaches as short-term and palliative or minority symptom "control" techniques rather than a "treatment, or treatment plan". Clearly, anxiety and depression in their normal state are helpful emotions and cues that are needed by the higher cortical centers for decision making and valuing of expereince and needs. Our goal is to train our brain, or learn to interpret and appropriately apply these signals/affects without alcohol or drugs or maladaptive acting out these feelings. We simply can't be healthy by subscribing to a path of chemically controling these emotions and pretending that that is improving our self-management or achieving health. Medications are helpful, but not a solution, and those who pretend they are are short-sighted, lack expertise and training, or are inappropriately enamered with their chemistry set. Enjoy the film:

Differentiating medical from psychological disorders: How do medically and nonmedically trained clinicians compare?

Abstract 1991-24344-001 Publication Date Accepted: Nov 5, 1990 Revised: Nov 2, 1990 First Submitted: Feb 26, 1990

Existing research has demonstrated that many medical disorders manifest with behavioral symptomology. A relatively conservative estimate of so-called "medical masquerades" is around 10%. This study compared 3 types of health care clinicians, 30 in each group, (psychiatrists, nonpsychiatric physicians, and nonmedically trained mental health psychotherapists) with regard to their accuracy in diagnosing 3 types of clinical vignettes (psychiatric, somatoform, and medical masquerades). There were few differences in the accuracy of diagnosis of the clinical vignettes as judged by the 3 groups of professionals. The nonmedically trained mental health psychotherapists were as accurate in judging the vignettes as were the 2 medically trained groups. The results do not support the contention that in the diagnosis of these disorders nomedically trained psychotherapists are less accurate than those medically trained. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

Overview of Behavioral Health's Future Configuration

For more information go to the Academy of Medical Psychology web site and click on Health Reform Guidelines (http://www.amphome.org/index.html).

Palentological Diet: Redoes all our previous concepts about nutrition based on top and emerging science:

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