health policy

Redefining Drug Overdose

Natalie Rich1 Comment

Everyone knows that only hardcore drug addicts overdose, right? Pills_Pic

Actually, this statement may be one of the most dangerous misconceptions driving the overdose epidemic in our country. In the United States, accidental overdose, which includes overdose due to alcohol, illegal drugs, and prescription drugs, has now overtaken motor vehicle crashes as the number one cause of injury death (i.e. non-disease-related death, like falling or homicide). Opioid pain relievers, like Oxycodone and Hydrocodone currently account for more overdose deaths than cocaine and heroin combined. Prescribed for acute or chronic pain, these drugs provide relief for thousands of people. But, as with any drug, they carry the potential for abuse and overdose. In order to fight the growing overdose epidemic, we must challenge misconceptions about overdose victims.

As a Health Educator at UNC Campus Health, I have worked with college students who have experienced accidental overdose due to a combination of alcohol and prescription drugs. Many are smart, studious high achievers. Often they are taking prescription medicines as prescribed, unaware of the toxic effects of mixing their drugs with alcohol. They wake up in the hospital shocked and confused: “How could I have been so near death from just one pill?” one student asked me after taking a prescribed opioid and drinking a few beers.

But accidental overdose is not limited to young people. In fact, the mean age of overdose victims is 39, suggesting that older adults are overdosing just as much as younger populations.  I experienced this firsthand when I worked on a research project investigating falls in older adults. I encountered seniors who had accidentally taken too much of their medicines and ended up in the hospital from an overdose. Many were reluctant to talk about their experience out of shame or embarrassment, not realizing that many drug overdoses happen in this way.

Another group at higher risk for overdose is veterans. Soldiers suffer disproportionately from chronic pain, PTSD, and mental illness, and the medicines prescribed for these illnesses place them at higher risk for an overdose. Opioid pain reliever prescriptions among soldiers have increased from 30,000 to 50,000 since the Iraq war began, so it is no wonder our troops suffer four times more overdose deaths than their civilian counterparts.

So what can be done? Opioid pain relievers contribute disproportionately to the problem. A drug called naloxone can reverse the effects of an opioid overdose, but because of naloxone’s prescription drug status, it must be administered by a doctor or self-administered. One option currently under discussion is expanding the law to allow overdose bystanders (i.e. friends and family) to administer the drug. Another way to reduce overdose deaths is through a 911 Good Samaritan Law, which would grant amnesty from any drug or alcohol related charges to a person calling 911 on behalf of an overdose victim. For the UNC students I work with, this could be a lifesaver, since so many of them avoid calling 911 for fear of getting in trouble.

These two efforts are part of an overdose prevention bill currently underway in the North Carolina General Assembly (NCGA). On February 5th, a policy summit will be held at the NCGA in Raleigh where these issues will be discussed more in depth. Drug overdose is not simply about addicts using illegal drugs (although this is an important population to consider). The prevalence of prescription drug use means that we must redefine what an overdose victim looks like: from the studious UNC student to the soldiers who risk their lives for our country.

It’s easy to feel powerless about these issues, especially from a policy standpoint. But, if you want to learn more about overdose or NC state politics, come to the FREE Policy Summit on February 5th in Raleigh. This is your chance to see politics in action and meet legislators and other folks who are working hard to prevent overdose in NC. The event is free, but you still need to register at http://www.nchrc.org/news-and-events/events/north-carolina-overdose-prevention-summit/.

Your Guide to Alcohol and the Law

Natalie RichLeave a comment

Getting an alcohol citation can be expensive, embarrassing, and very frustrating.   Many students can minimize their risk of getting a drinking ticket by becoming informed.   So, before you make any decisions about purchasing or drinking alcohol, make sure you know the law; know the consequences; and know your rights.

Know the Law:  

It is ILLEGAL to….

  • Purchase or attempt to purchase alcohol if you are under 21.  This includes attempting to order a drink at a bar or purchasing beer at a grocery store
  • Possess alcohol if you are under 21.  This includes alcohol found in your vehicle or in your hands as you walk down the street, even if it is unopened.   An underage person suspected to be under the influence of alcohol (smells like alcohol, holding an empty Solocup that smells like alcohol, visibly intoxicated, etc) can be charged with underage possession.
  • Use a Fake ID to purchase or attempt to purchase alcohol or to enter an over 21 drinking establishment.  Using a Fake ID to get into a bar can still result in a citation even if no alcoholic drinks are purchased or consumed.
  • Purchase alcohol for an underage friend.
  • Drink and Drive.  If you are 21 and over, this means having a blood alcohol content (BAC) of at least 0.08. It is also illegal to consume alcohol while driving or to have any alcohol in your system when there is an unsealed alcohol container in the passenger seat.   If you are under 21, you can get a DUI for having any alcohol in your system.
  • Possess an open container of alcohol in any publicly owned area, such as streets, sidewalks, municipal parking lots, public parks, playgrounds, recreational fields, tennis courts, athletic fields, and in any buildings owned by the town.  This law applies to people 21 and over.  If you are under 21, you will be charged with underage possession.  

Know the consequences

Typical consequences for the above offenses include a misdemeanor charge, fines, and court costs.  Additionally, many students are required to complete an 6-week alcohol education class as well as a 1-on-1 alcohol assessment.  A DUI results in a 1-year revocation of your Driver’s License for the first offense.  Depending on the situation, a student may also face imprisonment.   UNC Dean of Students has their own set of consequences for students that may include academic and/or housing probation.

Know your rights

If you are stopped by the police, here’s some helpful advice from UNC Legal Services…..

  1. You are not required to answer questions. You can choose to remain silent. Think “UNC”: “Uh, No Comment.”
  2. If police request to search your person or belongings, and you do not wish to be searched, you may say, “I do not consent to a search.”
  3. If the officer proceeds to search you or your belongings, such as your wallet, backpack, or car, do not resist.  If you do not consent to the search, simply say, “I do not consent to a search.” (If the search is unlawful, it can be suppressed in court.)
  4. If an officer asks for your identification, do not present a fake ID.  If you present proper identification and an officer asks to see your wallet to check if you have a fake ID, you can refuse.  After refusing, you may then ask, “Officer, am I free to go?”
  5. You are not required to submit to a breathalyzer unless you are driving a car.  If you are a passenger in a vehicle, you may refuse a breathalyzer without legal consequences unless you are underage and visibly intoxicated.  If you are approached on the street (e.g. walking home or outside a party), you may refuse a breathalyzer without legal consequences.  After refusing, you may then ask, “Officer, am I free to go?”
  6. NEVER physically resist a police officer.  Simply remain silent and remain calm.
  7. If you are arrested, state clearly for the officer, “I am going to remain silent.” Then remain silent.

Some additional things to keep in mind if you are stopped while driving….

  1. YOU MUST display your driver’s license upon an officer’s request.
  2. YOU MUST write your name (for the purpose of identification) upon an officer’s request and provide your name and address (and the name and address of the auto’s owner).
  3. If the officer pulls you over while driving, you must submit to a breathalyzer test or your license will be revoked. You do have the right to contact an attorney for advice.
  4. You may be asked to perform dexterity tests, but you are not required to do so.  There are no formal legal penalties for refusing to do so.

For more information:

UNC Legal Services http://www.unc.edu/student/orgs/sls/legal:alcohol

Alcohol Law Enforcement (ALE) https://www.nccrimecontrol.org/Index2.cfm?a=000003,000005,000272,000274

Are you pregnant or parenting at UNC?

lbrit459Leave a comment

What an impressive juggling act! Hats off to you. You’re doing important work!

Let me tell you about a few of the resources available for you locally:

• UNC Student Parent Association
• UNC Parenting Resource Guide is a great way to get oriented about services available to you through UNC and in the community at large.
• List of lactation spaces on UNC Campus
• La Leche League of Chapel Hill is a group where experienced mothers support women who are figuring breastfeeding out.

Personally, I didn’t really know much about breastfeeding until I trained as a doula (a doula stays with a laboring woman, not as part of the healthcare team, but as an attendant who provides emotional, physical & informational support). I was blown away when I learned about the emotional, nutritional, and health benefits for women & children that come through breastfeeding.
• The physical contact helps women and babies bond.
• The baby receives IgA antibodies through the mother’s breast milk that provide a natural passive immunity while the baby’s own immune system gets up & running.
• Babies instinctively drink the right quantity of breast milk, so they reduce their risk of over-nourishment.
• When babies latch on to the nipple, breast milk goes right down their throats without lingering in the mouth so the risk of dental cavities is reduced.
• Breastfeeding helps women lose weight after pregnancy and reduces risk of breast cancer and ovarian cancer.

Even if you aren’t thinking about having kids right now, it’s valuable for everyone to understand breastfeeding and benefits in order to be more supportive of nursing women. Breastfeeding can be challenging; many women have a difficult time with various parts of breastfeeding including latching, production, emotions, balance, and more. In other words, nursing women need all the support they can get!

FYI, in North Carolina it’s legal for a woman to breastfeeding in any public or private location without being in violation of indecent exposure laws. On top of that legal foundation, I hope we can have a culture on campus where all nursing Tarheels feel comfortable and respected breastfeeding their children.

Stay tuned for more! My next project is to examine a birth control method I’ve never understood: LAM, aka Lactational Amenorrhea Method, aka breastfeeding-as-contraception.
 

Free Birth Control?!

Molly McFatrichLeave a comment

Free birth control?! Well, sort of. Last August, the Department of Health and Human Services (DHHS) adopted the women’s health recommendations issued by the Institute of Medicine. By adopting these recommendations, DHHS is requiring new health insurance plans to offer a comprehensive list of women’s health services with no copay or deductible.

Some of these services include:

  • Screening for cervical cancer and HIV
  • Intimate partner violence screening and counseling
  • Prescription birth control coverage

This is great news and you might be wondering when you can take advantage of these benefits. Well, starting on August 1, 2012 most new health insurance plans will be required to cover these services without cost sharing. “New” is really the operative word here. If you are purchasing a new health insurance plan, this ruling applies to you!

“New” can mean many different things, though.  A health insurance plan doesn’t necessarily have to be new to an individual to be considered “new”. Any substantial change to a health insurance plan makes it a new plan under DHHS’ rules.  So, a person might have the same plan as before (say “Blue Cross Blue Shield PPO”) but if that plan made changes to its coverage or cost-sharing, it’s considered a “new” plan.  Once these changes are made to a plan, it loses its grandfathered status and has to obey the new regulations.

What about those of you without any type of new plan? If your plan existed before March 2010 and there haven’t been any big changes to the plan since then, it’s a “grandfathered plan.”  That means the plan doesn’t have to offer these benefits yet, so you probably won’t see a difference in cost. For now we will have to wait and see how insurance companies transition next August.  Health policy experts expect about half of all grandfathered plans to give up their status by 2013, so it’s likely that lots of plans will be offering this new coverage. So, it is possible that this ruling to could lead the way to lessening the cost burden for all women. Here’s to hoping!

If you want to learn more, check out this factsheet!

Also, if you have questions about your specific health insurance, you can always call your insurance company. Usually, there’s a phone number for customer service on the back of the insurance card.

Stop Dialing & Driving!

Brenda Buescher1 Comment
(Flickr, Creative Commons)

I admit it, I’m guilty of talking on my cell phone while driving.  I never thought twice about it.  That is, until last semester, when I studied distracted driving for a class project.  I learned that while I was chatting away on my iPhone, I was just as dangerous as a drunk driver with a blood alcohol content of 0.08.  Believe me, I am just as attached to my phone as every other student I know, and I am tempted to use it every time I get in the car, but now I keep it out of reach while I’m at the wheel.  Continue reading →

Health Policy: Way More Than Medicare

Brenda BuescherLeave a comment
CC Image courtesy of Amy the Nurse on Flickr

Did you know that having a social support network helps you live longer?  That living in a poor neighborhood makes you more likely to die young?  That discrimination is hazardous to your physical health, as well as your mental health?

We’re not exactly sure why these things are true, but they are.  The world you live in has a huge impact on your health.  Your house, your job, your friends, your gender, race, sexual orientation, income…they all matter.  That means that “health policy” goes way beyond Medicare and Medicaid.  It includes affordable housing policies, economic policy and labor laws, social welfare and civil rights.  In my graduate program, we call these things the social determinants of health.

Just how do health care reform, farm subsidies, and same-sex marriage affect our health?  Stay tuned to my blog updates!  In the meantime, get up-to-date on current events with my favorite sources.  Almost all of these have a Facebook page to like or a Twitter account to follow:

For extra credit, sign up for email updates from Kaiser Health News for smart, non-partisan, and in-depth coverage of health policy debates.

If that seems too much like homework, try Slate’s Weekly Gabfest.  Hosted by contributors to slate.com, it’s a lively podcast with snarky titles about the week’s political news.