Vermont first state to propose bill to screen for ACEs in health care

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Dr. George Till, Vermont state legislator and physician

When Vermont State Legislator and physician Dr. George Till heard Dr. Vincent Felitti present the findings of the CDC’s Adverse Childhood Experiences Study at a conference in Vermont last October, he had an epiphany that resulted in a seismic shift in how he saw the world. The result: H. 762, The Adverse Childhood Experience Questionnaire, the first bill in any state in the nation that calls for integrating screening for adverse childhood experiences in health services, and for integrating the science of adverse childhood experiences into medical and health school curricula and continuing education.

That Vermont would be the first in the nation to address adverse childhood experiences so specifically in health care at a legislative level isn’t unusual. More than most states, Vermont is a “laboratory of change” for health care. It has embraced universal health care coverage for all Vermonters, and it passed the nation’s first comprehensive mental health and substance abuse parity law. (Washington State passed a law in 2011 to identify and promote innovate strategies, and develop a public-private partnership to support effective strategies, but it was not funded as anticipated. The Washington State ACEs Public-Private Initiative is currently evaluating five communities’ ACE activities.)

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Arresting our way out of drug crisis is yesterday’s theory, says VT Gov. Shumlin; urges public health approach

AshumlinState of the state addresses—like the State of the Union—tend to cover a wide range of topics from the economy to health care to education.  Vermont Governor Peter Shumlin broke the mold when he devoted his entire 2014 State of the State address to the state’s drug addiction crisis.  The rising tide of drug addiction and drug-related crime spreading across Vermont is “more complicated, controversial, and difficult to talk about” than any other crisis the state confronts, he said.

“We have lost the war on drugs,” he said. ” The notion that we can arrest our way out of this problem is yesterday’s theory.”  Even though Vermont is the second smallest state in the union (pop. 626,600), more than $2 million of heroin and other opiates are being trafficked into the state every week. Shumlin expressed alarm over the increase in the deaths from heroin overdose that doubled in 2013 from the year before and the 770 percent increase in treatment for opiates.

Shumlin told emotional stories of young Vermonters becoming addicted to prescription opiates and heroin — one recovered, one died from an overdose. While stories of young and promising individuals dying from heroin overdoses may grab headlines, data from the Centers for Disease Control and Prevention (CDC) show that deaths from prescription opioid pain relievers — such as codeine, methadone, and oxycodone — between 1999-2008 now exceed deaths involving heroin and cocaine combined.

CDC reports that in 2008, 36,450 deaths were attributed to drug overdoses in the U.S.  Opioid pain relievers were involved in 14,800 deaths (73.8%) of the 20,044 prescription overdose deaths.  The drug overdose death rate of 11.9 per 100,000 (Vermont’s rate was 10.9 per 100,000) was roughly three times the rate in 1991. Prescription drugs accounted for most the increase.  An April 12, 2012 statement from the Office of National Drug Control Policy reported that death from unintentional drug overdoses is greater than car accidents, the leading cause of injury in the U.S.

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Survey shows 1 in 5 Iowans have 3 or more adverse childhood experiences

iowaacesIowa’s 2012 ACE survey found that 55 percent of Iowans have at least one adverse childhood experience, while one in five of the state’s residents have an ACE score of 3 or higher.

In the Iowa study, there was more emotional abuse than physical and sexual abuse, while adult substance abuse was higher than other household dysfunctions.iowaprevalence

This survey echoed the original CDC ACE Study in that as the number of types of adverse childhood experiences increase, the risk of chronic health problems — such as diabetes, depression, heart disease and cancer — increases. So does violence, becoming a victim of violence, and missing work days.

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Foster human flourishing, and improved economic production will follow

lifelinesIn a recent New York Times opinion piece, “Lifelines for Poor Children“, James J. Heckman, Nobel Laureate and professor of economics at the University of Chicago, makes a compelling case for quality early childhood programs for disadvantaged children that “more than pay for themselves in better education, health and economic outcomes.” But making these high-yield investments in children from birth to age five will require us, according to Heckman, “to rethink long-held notions of how we develop productive people and promote shared prosperity.”

Heckman points to two long-term research studies that have demonstrated high rates of return on investment: the Ypsilanti, Michigan Perry Preschool project and the Carolina Abecedarian Project, aka “ABC.” Both programs included cognitive stimulation as well as non-cognitive skill development such as training in self-control and social skills, and parenting practices. The Perry Preschool project showed that while the experience did not make lasting changes in children’s IQs as was expected, it did improve their overall, lifetime success in education, earnings and stability overall. The “ABC” project did show lasting effects on IQ as well as on parenting practices and

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Terrifying children into a life of asthma

Credit: Cellular Image/Flickr

Credit: Cellular Image/Flickr

Sometimes the clearest indicator of a family’s dysfunction is, unfortunately, illness in its children. Like the proverbial canaries in the coal mine, it’s the children who are most susceptible to the toxicity of family addiction and dysfunction. Hurt people hurt people, and literally scare the life out of little kids.

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Video: End It Now — Understanding and Preventing Child Abuse

Last month, Loma Linda University Children’s Hospital released an outstanding, optimistic, and solution-oriented video about child abuse, which they define as physical, sexual, verbal abuse and domestic violence.

What makes the video so strong are the stories told by three very brave people:

  • Amanda Marsh, who was sexually abused by her stepfather from the time she was 13 to 17 years old. She and her sister eventually reported him, and he is now in prison.
  • Crystal Risely, physically and sexually abused by her physician father from infancy until she was 22 years old, molested by a teacher when she was 12, and molested by a principal when she was 16.
  • One man who was physically abused by his father from infancy until he was 16 years old. It ended when he left home. In the video, he prefers to remain anonymous.

Dr. Clare Sheridan-Matney, director of the division of

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Trauma is VERY common, manageable, and treatable

In the U.S., 70% of adults have experienced some type of traumatic event at least once in their lives. That’s 223.4 million people. Check out this great infographic from the National Council for Community Behavioral Healthcare for more information on addictions and treatment.

Below are a couple of screen grabs from the very long info graphic. Other parts include symptoms, coping strategies and effective treatments.

 

Are there really Democrat v. Republican parenting styles?

With the Republican and Democratic conventions upon us, and the U.S. presidential campaign in full swing, DailyInfographic.com dug into the archives for this amazing visualization of “right” and “left” that British data journalist David McCandless and information artist Stefanie Posavec put together in 2009 for his book The Visual Miscellaneum. The “Right” and “Left” refer to U.S., British and French politics, as you can see in the top strip of “Parties”.   

In 2009, McCandless made this observation in his explanation of the visual:

Researching this showed me that, despite my inevitable journalistic lean to the ‘left’, I am actually a bit more ‘right’ than I suspected.

The pieces that intrigued me most are the parenting styles, enlarged here.

Instilling fear in a child as a method of parenting, if interpreted negatively by a child, is considered one aspect of emotional abuse, which is one of the more damaging types of child maltreatment, according to the CDC’s Adverse Childhood Experiences Study (ACE Study). According to marriage and family therapist Felice Block on GoodTherapy.org: “Children who experience emotional abuse feel that they are responsible for the behavior of their parents and that if only they were more polite, better students or better children, than their parents would be more loving.”

But is there really a difference between left and right parenting styles? Is fear as an element of parenting exclusive to a particular political point of view?

That hasn’t been my experience. I’ve met quite a few people grew up in households filled with chronic intimidation and fear, and whose parents were registered Democrats.

Hitting, pushing kids increases risk of mental illness; WOOF pairs SF homeless, puppies needing friends; “disorder” diagnosis for kids disputed

Researchers looked at people who were pushed, grabbed, shoved, slapped and hit as children — a step milder than “punching, burning, physical neglect or sexual abuse,” according to this post by Time.com reporter Bonnie Rochman. The results were grim: depression and anxiety were 1.4 times greater than those who did not experience the “mild” abuse; alcoholism increased 1.6 times and abuse of other drugs 1.5 times.

What qualifies as appropriate punishment is a hot-button topic among parents. The American Academy of Pediatrics opposes corporal

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Indiana child services in hot water; OK wants to stop child abuse deaths; Washington, DC, homeless families risk CPS probe; CA man charged after video shows he hit son with belt

Youth Opportunity Center juveniles walk through the hallways to their different classes. The Muncie facility was one of those to be closed in plan to “right-size” network.

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It’s abandoned a plan to “right-size” the state’s network of youth treatment centers, but the Indiana Department of Child Services is still facing criticism, according to this detailed story by Keith Roysdon and Douglas Walker on Starpress.com.  Many people say that centralizing parts of its operation — including a centralized call system for reporting child abuse and long-distance oversight of local cases — is just not working.

This story aptly demonstrates how a policy of dealing with problems downstream instead of instituting

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