Half of Americans Will Suffer Mental Health Woes, CDC Says

THURSDAY, Sept. 1 -- About half of Americans will experience some form of mental health problem at some point in their life, a new government report warns, and more must be done to help them.

Mental health issues run the gamut from depression to post-traumatic stress disorder to suicide, and many of those suffering presently do not get help, experts say.

The new report, from the U.S. Centers for Disease Control and Prevention, tallied the national burden of mental illness based on country-wide surveys.

There are "unacceptably high levels of mental illness in the United States," said Ileana Arias, principal deputy director of the CDC. "Essentially, about 25 percent of adult Americans reported having a mental illness in the previous year. In addition to the high level, we were surprised by the cost associated with that -- we estimated about $300 billion in 2002."

The high cost includes care for the illness and lost productivity, Arias said.

It isn't clear why so many Americans suffer from mental illness, Arias added. "This is an issue that needs to be addressed," she said, not only because of the illness itself, but because mental disorders are associated with other chronic illnesses such as heart disease and cancer.

And while having a psychiatric illness is tough enough, the stigma surrounding these diagnoses adds to the burden, experts said.

"Mental illness is frequently seen as a moral issue or an issue of weakness," Arias explained. "It is a condition no different from cancer or other chronic diseases. People need to accept the difficulties they are having and avail themselves of the resources that are available."

The report was published Sept. 2 as a supplement to the CDC's Morbidity and Mortality Weekly Report.

One survey done in 2009 by the Substance Abuse and Mental Health Services Administration found that 11 million people -- nearly five percent of the population -- experienced serious mental illness during the past year, defined as conditions that affected the ability to function.

In addition, some 8.4 million Americans had suicidal thoughts in the past year and 2.2 million made plans to kill themselves. One million attempted suicide, the report found.

Information from other sources confirmed these numbers, with slight variations, the report said.

Dr. John Newcomer, professor of psychiatry and behavioral sciences at the University of Miami Miller School of Medicine, believes the problem may be even bigger than the CDC report indicates.

For example, state Medicaid programs spend a great deal on drugs to treat mental illness, which the CDC didn't take into account, Newcomer said. "For several years the top three drugs were antipsychotic drugs," he noted.

Also, many people with mental illness hide the problem from others, Newcomer said. The CDC report looked at people already in the health-care system, "but there is a big problem with underdiagnosis and undertreatment," he said.

Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City, said healthy living -- getting enough sleep, eating right, exercising -- can help people avoid some mental illness.

"Understanding how to deal with psychological stresses is also important," he said. "How to deal with emotional reactivity and stress tolerances are also important skills to develop early in life."

Manevitz said people should always seek help for mental health troubles whenever "you are not functioning well in your life and isolating yourself."

More information

The U.S. National Institute of Mental Health has more about mental health.

Posted: September 2011

Excessive Heat Can Harm Medications

SATURDAY, Aug. 20 -- Medications can be harmed by high temperatures, say pharmacists.

Although just a handful of drugs have been tested at temperatures above 86F, all medications could be altered by extreme heat, they warn.

According to Dr. Amy Peak, clinical pharmacist and director of Drug Information Services at Butler University, several medications have been tested at high temperatures. She outlined some of the changes the researchers found:

• Albuterol inhalers: The container could burst at temperatures above 120F. Moreover, when stored at high temperatures, there may be a decrease in the amount of medication inhaled.
• Concentrated epinephrine: Cyclical heating could reduce 64 percent of the medication's potency.
• Diazepam: Concentration of this drug dropped 25 percent when stored at 98.6F.
• Formoterol (capsules that are placed in inhalers): Following four hours of exposure to 158F heat, the amount released from the capsules was less than half the normal amount.
• Lorazepam: When stored at 98F, concentration decreased 75 percent.
• Mometasone (formoterol inhalers): Temperatures above 120F may cause the container to burst.

Peak says several more medications may be susceptible to excessive heat, including:

• Insulin: Excessive heat could make the insulinless effective. It could also cause the insulin vials to explode.
• Thyroid hormones: Thyroid hormones could be altered by excessively high temperatures, resulting in inconsistent doses.
• Any medications in aerosolized canisters could burst when exposed to temperatures above 120F.

Although the United States Pharmacopeia Convention Inc. recommends that medications be protected from excessive heat, only a few drugs are actually tested at temperatures above 86F, Peak pointed out.

Nevertheless, she noted there are a number of steps people can take to ensure the quality of their medications during heat waves, including:

• Be aware that temperatures inside cars can top 160 F. When driving, be sure to keep medications out of the trunk and in the climate-controlled passenger compartment.
• Never leave medications in a parked car.
• During heat waves, have medications shipped overnight in special cooled containers.
• Request a one-time replacement from your insurance company or drug manufacturer for any medication that may have been affected by excessive heat.

More information

The National Institutes of Health provides more information on storing medicine safely.

Posted: August 2011

Safe Use Initiative: Preventing Harm from Medicines

Medicines are powerful. They can cure disease, relieve symptoms, and help you stay healthy. But they can also do a lot of damage if taken incorrectly, when not needed, or when prescribed inappropriately.

The Food and Drug Administration (FDA) believes that many medication-related risks can be prevented if everyone committed to the safe use of medicines works together. Acting on that belief, the agency launched the Safe Use Initiative in November 2009 to foster collaborations within the health care community that will help prevent medication errors, misuse, and abuse.

Studies estimate that up to 50 percent of harm from medication use could be prevented. According to the Institute of Medicine, this would translate into about 1.5 million preventable incidents each year.

The goal of the Safe Use Initiative is to

• identify specific, preventable harm related to medication use
• develop methods (interventions or strategies) to reduce harm
• identify ways to measure the success of these interventions

Tens of millions of people in the U.S. take prescription or over-the-counter (non-prescription) medicines each year, says Karen Weiss, M.D., director of the Safe Use Initiative. “If we can reduce injury that occurs because people are not prescribing or taking medications optimally, we can improve their individual health and the health of the public.”

Working Together

In its regulatory role, FDA has always tried to prevent medication errors, says Weiss. “A lot of what we do at FDA to reduce medication errors is because we have the authority from Congress to regulate drugs, drug labeling, and drug manufacturing standards.”

But the Safe Use Initiative is different, says Weiss, because it involves collaborations with other parts of the health care industry and professions—besides drug manufacturers and distributors—to reduce harm in ways that do not require regulation. Potential collaborators include

• physicians, nurses, and other health care professionals and their professional societies
• state and federal agencies
• pharmacies, hospitals, and other health care facilities
• health insurers
• patients, caregivers, consumers, and groups representing their interests

Opportunities

FDA continues to add opportunities for collaboration to its growing list of projects that could reduce preventable harm from medicines. Two such opportunities are

• to support and assist in the removal of abbreviations on prescription container labels
• to support efforts to educate patients about the misuse and abuse of prescription drugs

Although FDA regulates prescription drug labeling—the printed material that accompanies such drugs—individual states regulate the label that the pharmacist attaches to the pill bottle. FDA is working with pharmacies, medical standards organizations, and others to set standards for this bottle label, such as spelling out the full name of a prescription drug instead of using an abbreviation that consumers may not understand.

For example, the prescription form of acetaminophen is often abbreviated “APAP” on the label of the bottle the consumer is given at the pharmacy. If consumers don’t know that “APAP” and “acetaminophen” are the same and are already taking an over-the-counter acetaminophen product (such as Tylenol or another brand), they could be taking too much acetaminophen and accidentally overdose. Too much acetaminophen can cause liver damage.

The Safe Use Initiative team is also working to make consumers aware of the importance of checking drug labels in general because many have the same ingredient—like acetaminophen, which can be found in more than 600 medications.

Another Safe Use Initiative project addresses the taking of prescription drugs when not needed. “About 55 percent of people who misuse or abuse prescription drugs get them from friends and family,” says Dale Slavin, Ph.D., associate director of the Safe Use Initiative.

“We need to create opportunities for discussion between the patient and the doctor,” Slavin says. “We, through collaborative efforts, want to provide tools that the doctor can use to have frank conversations with patients, and tools that the patient can use to understand the benefits, risks, and limitations of their treatment.”

This is especially important for opioid drugs, says Slavin, “where the abuse potential is there, the dependence potential is there, and the potential for others to steal or misuse their drugs is there.”

FDA invites comments and suggestions on drug safety issues and how to prevent harm atcdersafeuseinitia@fda.hhs.gov.

This article appears on FDA's Consumer Updates page, which features the latest on all FDA-regulated products.

Posted June 29, 2011

For more about food, medicine, cosmetic safety and other topics for your health, visit FDA.gov/ForConsumers.