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NATIONAL INSTITUTES OF HEALTH

National Institute on Drug Abuse

FOR IMMEDIATE RELEASE
Wednesday, October 18, 1998

CONTACT: Jan Lipkin Sheryl Massaro (301) 443-6245

EVERY MIDDLE SCHOOL NATIONWIDE TO RECEIVE AWARD-WINNING, SCIENCE-BASED DRUG EDUCATION MATERIALS

A new science education initiative for middle school students, teachers, and counselors will be launched by the National Institute on Drug Abuse (NIDA), National Institutes of Health, at the November 21 National Leadership Forum of the Community Anti-Drug Coalitions of America. "NIDA GOES TO SCHOOL" is designed to bring to the Nation's educators the latest scientific information about how drugs of abuse affect the brain and to give them effective, accurate tools to use in teaching their students.

WHAT: Launch of National Science Education Initiative, "NIDA GOES TO SCHOOL"

WHO: Dr. Alan I. Leshner, Director National Institute on Drug Abuse, NIH

WHEN: November 21, 8:30 a.m.

WHERE: National Leadership Forum Community Anti-Drug Coalitions of America Omni Shoreham Hotel Washington, D.C.

"Science-based education about drug abuse should be a prominent part of the curriculum for all students," said Dr. Alan I. Leshner, Director of NIDA. "This new initiative provides teachers easily usable, student-oriented materials to help achieve that goal."

The initial mailing, to every middle school in the country, will feature NIDA's award-winning "MIND OVER MATTER" materials. This innovative magazine series consists of seven full-color glossy magazines that unfold into posters, and a teachers's guide to help in using the materials. The series was developed to teach middle school students about how drugs of abuse, including marijuana, opiates, stimulants, hallucinogens, inhalants, steroids, and nicotine, act in the brain. "MIND OVER MATTER" also provides additional information on the brain and the effects of drugs. Other science-based education materials will be included in the initial "NIDA GOES TO SCHOOL" mailing.

NIDA has also created a "NIDA GOES TO SCHOOL" website featuring information specially geared to students and teachers. Beginning November 21, the site can be accessed from NIDA's home page at http://www.nida.nih.gov. As new science education materials are developed, they will be added to this website.

NIDA supports more than 85 percent of the world's research on the health aspects of drug abuse and addiction. The Institute also carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice.

Fact sheets on health effects of drugs of abuse and other topics can be ordered free of charge in English and Spanish, by calling NIDA Infofax at 1-888-NIH-NIDA (-644- 6432) or 1-888-TTY-NIDA(-889-6432) for the deaf. These fact sheets and further information on NIDA research and other activities can be found on the NIDA home page at http://www.nida.nih.gov.

Study Focuses on Antidepressants

CHICAGO (AP) -- Patients who recovered from depression with drug treatment were much more likely to avoid recurrences if they took the drug for two years instead of tapering off after a few months, researchers say.

The findings confirm what psychiatrists have assumed -- that long-term drug treatment can keep some patients from new bouts of the disabling illness, according to a study published today in the Journal of the American Medical Association.

Subjects of the study had previously suffered from either chronic depression, defined as lasting two years or more, or ``double depression,'' a milder form of depression called dysthymia followed by at least one two-week episode of full-blown depression.

After seven months on the drug Zoloft, 161 subjects were randomly assigned to continue the medicine for 1 1/2 years or be tapered off to a placebo, without knowing which.

Only five of 77 patients (6 percent) of the drug group suffered new bouts of depression, compared with 19 of 84 (23 percent) of those who took the placebo.

The study was led by Dr. Martin Keller of Brown University and conducted at 10 medical centers and two research clinics.

The study involved Zoloft, but the findings should extend to other drugs in the same class -- Prozac, Paxil, Effexor, Serzone and Celexa, according to Dr. Jerrold Rosenbaum, an expert not involved in the work.

He said doctors already prescribe antidepressants for years at a time because previous studies have suggested they would be safe and effective.

But the new findings provide needed data to back the practice, said Rosenbaum, associate chief for clinical research in psychiatry at Massachusetts General Hospital.

Plan Will Meld Medical, Mental Care

©The Associated Press

By LISA CORNWELL

CINCINNATI (AP) -- Eleven-year-old Erica Robinson hasn't started any fires in three years, a victory her family attributes to an innovative treatment program.

It's so simple it sounds obvious: Erica gets her mental-health care at her medical clinic instead of having to go to a separate, specialized center where people don't know her as well.

Erica has bipolar disorder, characterized by angry and often violent outbursts, and had been hospitalized several times before she started going to the West End Health Center.

"Between the mood swings, temper tantrums and fire-starting, we had reached the point where we didn't know what to do,'' said Erica's mother, Tashua Robinson, 32. "After three years at the center, she still has ups and downs and sometimes throws things, but she is dealing with her anger much better and we are too.''

Erica said she feels better than she used to.

"Now I talk about it when I get angry, or I draw pictures and color and that helps. I also take some medicine that helps,'' she said.

The program at West End and three other public health clinics in Cincinnati is unlike any other offered on a citywide basis, said Dr. Tom Curtin of the National Association of Community Health Centers, based in Washington, D.C.

"Before medicine became so specialized, most parents took their children to the family doctor for answers to medical and behavioral problems,'' Curtin said. "But in the last 20 or 30 years, families have had to find that treatment at separate locations.''

The Pediatric Integrated Care Project is expected to eventually expand to all 16 low-income children's clinics in Hamilton County.

The 3-year-old program has a variety of funding sources, including a $460,000 grant from the Robert Wood Johnson Foundation.

The system has impressed Dr. Hugh Pettigrew, a psychiatrist serving as a consultant at the health centers.

"It's wonderful to me to have such easy access to pediatricians and laboratory tests,'' said Pettigrew. "And families don't have to worry about getting to a separate facility for tests or treatment or working their way through insurance and paperwork barriers.''

Love Mills-Byrd, a behavioral health specialist at West End, said the program makes it much easier for patients and families to trust people giving them care.

In addition, she said, not having to go to a separate facility for mental health treatment "removes the stigma that many people associate with such treatment.''

Suicide Prevention Plan Unveiled

21 October 1998

.c The Associated Press

By PATRICIA J. MAYS

ATLANTA (AP) -- A new national suicide prevention strategy would require Americans to be more aware of mental illness and more immediate help for those most at risk of taking their own lives.

The initiative was unveiled Tuesday by Surgeon General David Satcher, who called suicide -- the nation's eighth-leading cause of death -- an overlooked area of health care.

"Many suicides are already preventable. Even more suicides could be prevented if this country better focused its resources and its attention on this problem,'' Satcher said. "A pure medical approach will not do the job.''

Among the strategy's 81 recommendations are increasing research, reducing barriers to treatment, expanding insurance coverage of mental health and substance abuse treatment, and improving depression screening.

Nearly 31,000 people take their lives each year and another 775,000 attempt suicide. In 1995, the number of suicides -- 31,284 -- exceeded homicides (22,552) in the United States.

Since 1980, suicide has become an acute problem among black teen-age males, Satcher said. Between 1980 and 1995, the suicide rate among this group increased 146 percent.

The Centers for Disease Control and Prevention suggested this year that young black males may be more affected by drugs, the breakdown of the family and stress associated with assimilation into the middle-class.

Prevention efforts should also focus on other groups that have a high suicide rate, including American Indians, gays and lesbians, the elderly and the mentally and physically ill, Satcher said.

Last month, the CDC announced a $1.5 million grant to establish the Suicide Prevention Research Center at the University of Nevada School of Medicine to investigate why nine of the top 10 suicide states in the country are in the West.

Preparing health care providers to diagnose potential victims is also key to combating the problem, Satcher said. More than 70 percent of people who commit suicide had seen a primary care physician within 30 days of their deaths.

"Too many physicians and other health providers are coming into contact with people who are at risk for suicide and yet not asking about it, not asking the right questions,'' he said.

AP-NY-10-21-98 0437EDT

Copyright 1998 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without prior written authority of The Associated Press.

NATIONAL INSTITUTES OF HEALTH

Office of the Director

FOR IMMEDIATE RELEASE
Wednesday, November 18, 1998

CONTACT: Bill Hall or John Ferguson NIH Office of Medical Applications of Research (http://odp.od.nih.gov/omar) (301) 496-5641

Marilyn Weeks National Institute of Mental Health (http://www.nimh.nih.gov) (301) 443-4536

NIH CONSENSUS PANEL STATEMENT CITES INCONSISTENCIES IN CARE FOR CHILDREN WITH ADHD

Children with attention deficit hyperactivity disorder (ADHD) often receive an inconsistent level of care from a fragmented system that consumes a large share of health care dollars, according to a consensus panel convened by the National Institutes of Health (NIH).

"There is no consistency in treatment, diagnosis or followup for children with ADHD. It is a major public health problem," said panel chair Dr. David J. Kupfer, Thomas Detre Professor and Chair, Department of Psychiatry, University of Pittsburgh.

"These children are subjected to a fragmented treatment system that reaches beyond health care into a wide range of social and educational support services. Its impact on individuals, families, schools, and society is profound, and it demands our immediate attention," Dr. Kupfer said.

The problem is compounded by the fact that an accurate diagnosis for ADHD remains elusive and controversial yet continues to be a commonly diagnosed behavioral disorder of childhood. One of the most important, immediate research needs is to develop standardized diagnostic criteria based on age and gender, the panel said.

While the panelists concluded that the absence of a simple, consistent diagnostic test for ADHD continues to pose validity problems for the disorder, they agreed that the 3 to 5 percent of school age children grappling with ADHD experience an inability to sit still and pay attention in class, peer rejection, and disruptive behaviors, which can lead to academic and social difficulties. Other long-term consequences include higher rates of accidents as well as alcohol and drug abuse and criminal behaviors when ADHD is accompanied by conduct problems.

Diagnosis and treatment inconsistencies often begin with the practitioner. Studies show that most children with ADHD are diagnosed by family practitioners; pediatricians diagnose fewer patients but typically spend a longer amount of time with each patient. Family practitioners also prescribe medications more frequently than pediatricians or psychiatrists; comorbid symptoms of ADHD also are less frequently diagnosed by primary care physicians, according to the panel.

Studies show that there is inadequate communication between the physician diagnosing the child and the educators who must play a key role in implementing and monitoring the prescribed treatments. The panel emphasized the importance of cooperation between practitioners and educators in diagnosing and treating children with ADHD. The group called for more training to help teachers recognize and understand behavioral problems frequently associated with ADHD and to develop the skills to interact with the children in the classroom.

Although experts disagree on the best approaches to treating ADHD-medication, behavioral therapy or a combination-many children face any number of barriers to treatment. Common barriers to mental health treatment include high out-of-pocket costs, little or no mental health insurance benefits, and few choices for lower income patients. Additional barriers to treatment access arise depending on gender, race, and geographical location, the panel said. In most school systems less than half of children with ADHD qualify for special education programs.

Treatment of ADHD with medication or certain types of behavioral therapy improves the behavior of children with ADHD, but there is no evidence that treatment improves academic achievement or long-term outcomes and research is needed in these areas.

Careful therapeutic use of stimulants is effective in treating the core symptoms of ADHD as long as a child is taking the medication. However, the panel identified the need to study the benefits and risks of long-term use of such medications. Although behavioral treatments produce positive short-term results, it remains unclear what combination of these strategies are most effective.

The panel issued their consensus statement at the conclusion of a 3-day NIH Consensus Development Conference on Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder, during which they heard presentations by experts in the field and public testimony from interested organizations and individuals.

The full NIH Consensus Statement on Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder is available by calling 1-888-NIH-CONSENSUS (1-888-644-2667) or by visiting the NIH Consensus Development Program Web site at http://consensus.nih.gov.

The NIH Consensus Development Program was established in 1977 as a form of "science court" to resolve in an unbiased manner controversial topics in medicine. To date, NIH has conducted 110 such conferences addressing a wide range of controversial medical issues important to health care providers, patients, and the general public. An average of six consensus conferences are held each year.

This conference was sponsored by the NIH Office of Medical Applications of Research, the National Institute of Mental Health, and the National Institute on Drug Abuse. The conference was cosponsored by the National Institute of Environmental Health Sciences, the National Institute of Child Health and Human Development, the U.S. Food and Drug Administration, and the Office of Special Education Programs, U.S. Department of Education.

NOTE TO RADIO EDITORS: An audio report of the conference results are available November 18-25, 1998 from the NIH Radio News Service by calling 1-800-MED-DIAL (1-800-633- 3425) or by visiting http://www.radiospace.com/nihhome.htm on the Web.

Addictions in the Elderly

RESEDA, Calif., Nov. 16 /PRNewswire/ -- In a society where there is a twelve-step program for every addiction from nicotine to narcotics, substance abuse problems in the elderly are largely ignored. While their younger counterparts are likely to be diagnosed and treated, elderly people go undiagnosed and untreated, leaving them to suffer needlessly from substance abuse problems.

Addictions in the elderly is one of the topics being addressed at the "Innovative Strategies for the Challenges of Senior Care" symposium at the Los Angeles Jewish Home for the Aging, Tuesday, Nov. 17 from 9:00 a.m. to 4:00 p.m. Other topics include Pain Control, Communicating with Alzheimer’s Patients, Depression in the Elderly, End of Life Issues, and Ethical Dilemmas in the Care of Older People.

Learn how twenty minutes of relaxation therapy a day can help ease the pain of arthritis. Therapist Michael Aharoni uses many different techniques to help people cope with pain. "Through hypnosis," he says, "I can teach people to literally block pain."

If you are caring for aging parents, ethical dilemmas can be tough to face. As the ability of an individual to make basic life diminishes, the role of others to make these decisions increases. Torn between protecting an individual’s rights and protecting the individual, the question looms before us, "Who will make these decisions?"

For the first time ever we are facing a large aging population. At the turn of the century the average life expectancy was 47 years. Now it is 76 years. Half of all the people who have ever lived past 65 are alive today. What new issues this large aging population creates and how we handle them is the subject of this symposium.

Speakers are available for interviews the day of the symposium. Additional experts, as well as the names of elderly people who have experienced the issues, can be provided. Call Valica Boudry at 818-757-4422 if you have any questions.

DIRECTIONS: The Jewish Home for the Aging is in western San Fernando Valley at 18855 Victory Boulevard, Reseda, CA. Take the Ventura Freeway (101) to the Reseda Boulevard exit. Turn north and go about two miles to Victory Boulevard, turn left and the Jewish Home for the Aging is down a block-and-a-half on the right side of the street. On-site parking is available.

Surgeon General addresses suicide

18 October 1998

SPARKS, Nev. (AP) -- Surgeon General David Satcher announced plans today to unveil the first national strategy for suicide prevention, saying the "silent killer'' is a serious public health problem that no longer can be ignored. In a closing address to the first U.S. conference on suicide prevention, Satcher said he would announce details at a news conference Tuesday in Atlanta. Satcher said nearly 31,000 people take their lives each year, making suicide the nation's eighth-leading cause of death.

Daylight Savings Triggers Winter Blues; New Studies Support Effectiveness of Bright Light Treatment for Seasonal Depression

21 October 1998

GAITHERSBURG, Md., Oct. 21 /PRNewswire/ -- Daylight Savings Time ends this weekend, and although we gain an extra hour of sleep on Saturday night when we set our clocks back, for many people, this change signals the beginning of a dreadful season of short days and long dark nights.

A lack of exposure to daylight has been linked to symptoms of overeating, oversleeping, fatigue, and low mood which characterize the medical disorder Seasonal Affective Disorder ("SAD"). Phototherapy, or exposure to bright artificial light, has been used for over a decade to treat the problem, but some health professionals continue to be skeptical about its usefulness. Three new studies published in last week's Archives of General Psychiatry, however, convincingly document phototherapy's efficacy in treating winter depression.

One study by Charmane Eastman, a researcher at Rush-Presbyterian St. Luke's Medical Center in Chicago, who has long been a bright-light skeptic, shows a high efficacy rate for both morning and evening light treatment. Results for these groups were significantly higher than for those using the placebo treatment. This study is noteworthy because instead of using a dim light for the placebo, a deactivated negative ion generator was used. Patients believed they were receiving negative ions, a treatment which has been shown in earlier studies to be effective.

Two other studies on light therapy appear in the same journal. Michael Terman, a psychologist at Columbia University in New York, reports that in a comparison of three different treatment options, patients receiving either bright light therapy or high density ions improved significantly, while the placebo group receiving low density ions did not. Dr. Alfred Lewy, of Portland's Oregon Health Sciences University, compared the efficacy of bright light administered at different times of day, and found better improvement among those using morning light than in those using evening light.

Neal Owens, a SAD sufferer, has relied on light therapy to get him through the winters for 16 years. "For years, people laughed at me for using my SunBox to get me up and keep my winter blues away. This exciting new research showing bright light to be beneficial may widen the door for this treatment's acceptance by the medical community and by the health insurance industry. There's the potential to help millions of people who feel down in the wintertime."

Free SAD information is available by calling: Winter Blues Information Network, 1-888-SAD-AWAY (723-2929). For information about light therapy devices, contact: The SunBox Company, 19217 Orbit Drive, Gaithersburg, MD 20879-4149, 1-800-LITE-YOU (548-3968), www.sunboxco.com, e-mail: sunbox@aol.com.