Adolescent Health and Recovery Treatment & Training supporters

Teens battling substance abuse get support, guidance from peers

For adolescents battling substance abuse, the hardest part of recovery can be finding someone who can relate to their experiences.

A unique University of Kentucky intervention program aims to provide just that by connecting adolescents recovering from substance abuse with someone who has been in their shoes. The program, called Youth Peer Support Specialists, is part of the the UK Division of Child and Adolescent Psychiatry’s Adolescent Health and Recovery Treatment and Training clinic, also known as AHARTT.

Peer support specialists connect with adolescents as they work through recovery, providing them with a person to talk to who has “lived experience.” Each supporter has firsthand experience with substance abuse and ongoing recovery, allowing patients to more closely identify with a member of their treatment team. This level of rapport is often unmatched by any other relationship they have encountered on their recovery journey.

In Kentucky, substance use by adolescents, rates of tobacco use, binge drinking and use of other drugs are higher than the national average. Use of these substances during the adolescent years can quickly lead to dependence and lay the foundation for lifelong use.

Once substance use begins, it changes the biology of the brain and affects life decisions. Specifically, more decisions revolve around the getting and using of alcohol, tobacco and other drugs. Sustained use makes biological and behavioral changes more entrenched. These changes often amplify feelings of hopelessness and alienation that teens may feel when they begin recovery treatment.

This is where the five Youth Peer Support Specialists working in the clinic aim to make a difference. The “supporters” ‒ James Riggs, Kelli Fullenlove, Josh Roehrig, Aaron Pope and Brittany Poe ‒ have all undergone rigorous training from the state of Kentucky and are certified to work with patients on a one-on-one basis. They receive careful supervision and are in close contact with the clinician caring for the adolescent. The supporters’ main objective is to “bridge the gap from the clinic to the community.”

“As peer supporters, we are able to show them, instead of tell them, exactly how to do this.” Pope said.

Riggs said the supporters’ role is to show adolescents that “people can be cool without using,” The stigma associated substance abuse can be a deterrent that keeps teens from seeking necessary treatment, but the supporters are in a unique position to help adolescents feel better about their recovery journey.

“We are an untapped resource for youth to enter the recovery community without having to deal with the associated stigma,” Roehrig said.


Next steps:

Appalachian Research Day shows community-based health care efforts

For many UK researchers who study health in Appalachia, the Center of Excellence in Rural Health (CERH) is an indispensable partner in conducting community-based research. The Center, located in Hazard, connects researchers with the local community and provides necessary infrastructure, from conference rooms to a team of community health workers, called Kentucky Homeplace, who engage participants and gather data.

This week, researchers shared the findings from these community-based studies at the second annual Appalachian Research Day.

“Today is an opportunity for people who do research with the Center to report back about their findings, and see what we can come up with together to better our lives here in Appalachia,” said Fran Feltner, director of the CERH.

Addressing Appalachian health issues

Rural Appalachian communities in Eastern Kentucky experience some of the nation’s most concerning health disparities, including elevated rates of obesity, diabetes, stroke, heart disease, depression, and cancer incidence and death. Residents of Appalachia might also face challenges in accessing health care, such as distance from providers, lack of insurance, or socioeconomic barriers.

Community-based research is essential in addressing disproportionate rates of poor health by collaboratively identifying problems and developing shared solutions that are a good fit for communities. For this type of research to succeed, it must begin at the local level, built upon the foundation of relationships with individuals, neighborhoods and groups who have common questions and concerns. In Eastern Kentucky, the CERH has enabled community-based studies since 1990, when it was founded to improve health through education, service, and research.

In 2015, the CERH launched Appalachian Research Day as an opportunity to share and discuss research findings with the communities that were involved in the studies. Feltner describes the day as an invitation for everyone involved in community health research to “come sit on the porch” of the Center and talk about their work and ongoing needs. More than 100 researchers, coordinators, community health workers, community advisory board members, students, and staff participated this year, with four podium presentations and 13 poster presentations.

“These research findings drive new and exciting health initiatives that are transforming lives across our rural Appalachian region,” Feltner said.

Researching change

The presen­tations focused on community research related to healthy lifestyles, depression, lung cancer screening, drug use and risk behaviors in Appalachia.

Mark Dignan, professor in the UK College of Medicine and director of the UK Prevention Research Center, discussed his work with faith-based communities to study energy balance, obesity and cancer in Appalachia.  According to the CDC, the national obesity rate in adults is about 29 percent, while in Appalachian states the rate is 31-35 percent. Dignan was particularly interested in how to help people re-engineer their lives to include more physical activity.

“When you do research in the community, hopefully you’ll make change that will be lasting,” he said.

Rates of depression are also higher in Appalachia than the rest of the country. For Appalachian women, the rate of depression is four times higher than the national rate. They are also less likely to receive adequate treatment, according to Claire Snell-Rood, PhD, who shared her research on adapting treatment options for rural settings where the traditional mental health system is both inappropriate and inadequate.

“This research focuses on how to adapt evidence-based programs to address not only limited treatment options in rural areas, but the substantial social and health challenges that impede Appalachian women from obtaining the care they need,” she said.

Snell-Rood worked with Kentucky Homeplace community health workers to conduct interviews with women, and she is currently adopting a collaborative, peer-based practice to support rural individuals in developing their own processes for wellbeing.

Roberto Cardarelli, DO, MPH, professor and chief of community medicine in the UK College of Medicine, also presented his research project, the Terminate Lung Cancer study, which aims to understand the knowledge and attitudes of lung cancer screening among high-risk rural populations. Kentucky’s lung cancer mortality rate dramatically exceeds the national lung cancer mortality rate, with 73.2 deaths per 100,000 in Kentucky versus 49.5 nationally. Cardarelli and his team conducted focus groups in order to develop an effective campaign to promote lung cancer screening in the region.

“We like to focus on research that’s important to communities, and we couldn’t find a more important topic than tobacco cessation and lung cancer screening,” he said.

The final presentation of the day addressed drug use and prescription opioid use in Eastern Kentucky. Michele Staton-Tindall, PhD, associate professor in the UK College of Social Work, conducted research in jails to learn about drug use and health-related risk behaviors among rural women in Appalachia. She said that rates of drug use are “alarmingly high” in this area of Appalachia, with many users injecting.

“Injection is the preferred route of administration, which is coupled with increased public health risks including HCV and HIV,” she said.

Solving problems together

The event was supported in part by the UK Center for Clinical and Translational Science, which aims to accelerate discoveries that improve human health, with particular focus on the Appalachian region.

For Feltner, a nurse who has worked in rural health for 35 years, Appalachian Research Day represents the best qualities of the place she calls home.

“What I love most about Appalachia is the fellowship we have together, as neighbors and friends, working together to solve problems.”

Understanding the signs and symptoms of Alzheimer's disease

Know the signs of dementia and Alzheimer’s disease

Forgetfulness is something many of us will experience as we get older. It’s a normal part of aging. But when memory loss starts to interfere with daily life, it can be a sign of a more serious issue such as Alzheimer’s disease.

Alzheimer’s disease is a form of dementia, a group of conditions that affect mental capability and can cause memory loss. While there is no cure for Alzheimer’s disease, one way to limit its effects is to identify it as early as possible.

Alzheimer’s usually affects people who are 65 or older, so if there’s a senior in your life, be aware of these signs and symptoms.

  • Forgetting important information: It’s normal for someone to forget a date or a name but suddenly remember it later. However, pay attention if they ask for the same information repeatedly or struggle to recall important dates (like their own birthdate).
  • Lack of problem-solving skills: Are they having trouble following a recipe? Problem-solving skills can deteriorate in someone with Alzheimer’s or dementia.
  • Difficulty completing familiar tasks: Do they get lost when driving to a familiar location? If they have difficulty completing familiar tasks, it might be a sign of Alzheimer’s.
  • Using incorrect words: Healthy people can occasionally a struggle to find the right word, but using the wrong word – particularly if they call something by the wrong name – merits further scrutiny.
  • Poor hygiene. Is the person suddenly displaying odd behavior related to clean clothes, bathing, oral health or shaving? It’s not uncommon for a person with Alzheimer’s to lose interest in personal hygiene.
  • Personality changes: Are they suddenly irrational, fearful or suspicious?

If a loved one in your life is experiencing any of these symptoms, make an appointment with a doctor.

And be sure to check out our infographic below for more information about Alzheimer’s disease in Kentucky.

Alzheimer's infographic


Next steps:

What you can do to prevent child abuse

Child abuse can happen in any family and in any neighborhood. Studies have shown that child abuse crosses all boundaries of income, race, ethnic heritage and religious faith. The incidence is higher, however, in families in which the parents are in their mid-20s; high school dropouts or lack a high school diploma; below the poverty level or financially stressed; stressed because of a loss of job or home; or have a history of intergenerational abuse, alcohol, or substance abuse problems, a history of depression, or spouse abuse.

Stopping abuse

Prevent Child Abuse America offers these tips for stopping child abuse:

  • Try to understand your children. Learn how kids behave and what they can do at different ages. Have realistic expectations and be reasonable if children fall short.
  • Keep your children healthy. Denying children food, sleep, or health care is abuse by neglect.
  • Get help with alcohol or drug problems. Keep children away from anyone who abuses those substances.
  • Watch your words. Angry or punishing language can leave emotional scars for a lifetime.
  • Get control of yourself before disciplining a child. Set clear rules so the child knows what to expect. Avoid physical punishment.
  • Take a time-out. Stop if you begin to act out frustration or other emotions physically. Find someone to talk with or watch your kids while you take a walk. Call a child abuse prevention hotline if you are worried you may hit your child.
  • Make your home a violence-free zone. Turn off violent TV shows and don’t let kids stay under the same roof with an abusive adult.
  • Take regular breaks from your children. This will give you a release from the stress of parenting full-time.

If you want to go the extra mile for supporting the safety of children, visit the Prevent Child Abuse Kentucky site and join us for the Commit to Prevent 5K Run/Walk on April 10. UK HealthCare is a proud sponsor of this event and we hope to see you there! Also, don’t forget to wear blue April 8 to promote child abuse awareness and stop by the Pavilion A Atrium Lobby at UK Albert B. Chandler Hospital at 1 p.m. for a group photo.


Next Steps:

From left: UK HealthCare Chief Administrative Officer Ann Smith; Dr. Henrietta Bada, vice chair of the UK HealthCare Department of Pediatrics; Francis Collins, director of the National Institutes of Health; Mark D. Birdwhistell, UK HealthCare vice president for external affairs; U.S. Rep. Hal Rogers; Dr. Lon Hays, UK HealthCare chair of psychiatry; and Dr. Catherine Martin, UK HealthCare director of child and adolescent psychiatry.

Leading the charge against drug abuse in Kentucky

Drug overdose deaths in Kentucky are a major public health crisis. In fact, in 2014, the Commonwealth had one of the highest drug overdose death rates in the country. But through research, public policy, community intervention and effective health care, the University of Kentucky and UK HealthCare are fighting back against this terrible problem. Last […]

Drinking tonight? Keep it safe.

Did you know St. Patrick’s Day is one of the biggest days of the year for alcohol consumption?

Drinking to excess is not only not good for your body, it tends to lead to bad decision-making, which can put you or those around you in danger.

Here are some tips to keep things safe and fun:

Know your limits

Drinking in moderation and knowing when you’ve had too much is key. If you are slurring your words or experiencing dizziness, it’s time to lay off the alcohol. Instead of guzzling your drink, sip it. One good rule of thumb is to have no more than one alcoholic drink per hour.

Don’t drink and drive

If you’re leaving home to drink, it’s essential to designate a driver or plan another way to get home. The designated driver does not drink AT ALL – you might take turns with your friends being the DD, and chip in to make sure the DD gets free snacks, etc.

Don’t want anyone in your group to have to abstain? Save a local taxi company’s number or download an app such as Uber. If worse comes to worse, stay where you are rather than risk being on the roads. Remember, even buzzed driving is drunken driving. If you feel buzzy, your reflexes are already impaired and you are not fit to drive.

Here are some other tips worth following:

  • Have a substantial meal before you start drinking, and snack through the evening. Food in your belly will help absorb alcohol and keep it from hitting your bloodstream all at once.
  • Beware of unfamiliar drinks that may contain more alcohol than you realize.
  • Stay with your friends. If you’re not thinking clearly, you don’t want to be on your own.

Happy St. Patrick’s Day and Go Big Blue!


Next steps:

Better rest may be the key to better health

Getting enough sleep may seem impossible with so few hours in a day, but it is more under your control than you might think. There are plenty of practices and habits that make for good sleep hygiene and will maximize the time you spend asleep.

danov-zoran

Dr. Zoran Danov

Most adults should be getting 7 to 8 hours of sleep a night, and when they don’t, it can lead to health problems like forgetfulness, difficulty fighting infections, mood swings and depression. Since sleep deprivation is becoming more common, it’s important to know how you can turn your bad sleep habits around and get good rest.

To celebrate National Sleep Awareness Week, we spoke with Dr. Zoran Danov, medical director of the Pediatric Sleep Program at Kentucky Children’s Hospital, to find out more about the positive effects that good sleep hygiene can have on day-to-day activities and improving overall health and happiness.

Does it help to fall asleep and wake up on a regular schedule?

Danov: Having a regular sleep schedule is very important for maintaining a sleep cycle and getting enough uninterrupted sleep. We should try whenever we can to wake up at the same time consistently regardless of whether it’s a weekend or a work/school day.

Why is it so important to get good sleep?

Danov: Sleep really is a necessary and important part of our daily lives. If you don’t get enough, it’s been shown to lead to changes in a person’s mood causing irritability, lack of motivation, anxiety and depression. Insufficient sleep can also directly influence your actions. For example, waking up without the right rest can be seriously dangerous. Drowsy driving can lead to an injury and possibly even death.

All the shortcomings of a lack of sleep are serious and can be improved only by regular and adequate sleep both in duration and quality.

What tips do you recommend for getting better sleep?

Danov: You’re going to want to have a regular schedule for bedtime, wake time and the meals throughout your days. Staying physically active is also important, but you won’t want to do any strenuous activity right before your desired bedtime. As for those habits right before bedtime, you should cut out the electronics an hour before trying to fall asleep, and caffeinated drinks five to six hours before. The bedroom should be kept dark and quiet, at a comfortable temperature.

How does napping factor into a good sleep routine?

Danov: Napping is a normal human behavior. Naps temporarily improve alertness and they can take the edge off sleepiness, but they do not replace sleep. It’s natural to want to nap usually between 2 and 5 p.m., when we often feel the sleepiest during the day. However, napping too long or too close to your desired sleep time may hurt the night’s sleep. You may not be getting enough sleep during the night if you need to take more than two naps per week.

How do eating habits affect sleep?

Danov: Regular and scheduled meals contribute to regular and quality sleep. Your sleep and diet are interconnected. Insufficient sleep has been associated with obesity and craving comfort foods. We should avoid going to bed hungry, but I wouldn’t recommend any heavy meals within three hours of going to sleep.

What habits may be contributing to poor-quality sleep?

Danov: Using electronics before going to bed and during the night is by far the most common habit that interferes with sleep. People feel the need to stay connected to the outside world and their friends even during sleep. Electronics break up our sleep by emitting light that disrupts our circadian rhythm directly, which is only going to keep you up longer. Interruptions like text messages and phone calls only contribute to sleep fragmentation and not getting quality sleep. Other bad sleep habits that are common are consuming caffeinated drinks close to bedtime and over-scheduling.


Next steps:

Celebrate International Women's Day with UK HealthCare's health tips.

Women, take charge of your health

In our society, women often care for everyone else – parents, spouses, children – first and neglect themselves. Looking after yourself isn’t selfish – it’s the best way to keep on doing what you do for those around you.

In honor of International Women’s Day today, check out our list of tips that will help you be your healthiest:

  • Understand recommended cancer screenings for your age. Breast, skin, lung and gynecologic cancers are some of most common types affecting women, and regular screening can help catch the disease when it’s most treatable. Check out the American Cancer Society’s guidelines for early cancer screening.
  • Get the HPV vaccine. If you’re 26 or younger, ask your doctor about getting an HPV vaccine, which protects against the types of human papilloma virus that most typically cause cervical cancer.
  • Don’t smoke and avoid second-hand smoke. Smoking is a major risk factor for cancer and heart disease, the No. 1 killer of women in America.
  • Listen to your heart. Women’s hearts are different from men’s in certain ways, which can affect the way women develop heart disease and experience heart attacks. Check out the top 10 things to know about women’s heart health from Dr. Gretchen Wells, director of the UK Gill Heart Institute Women’s Heart Health Program.
  • Protect your skin by using sunscreen and avoiding indoor tanning. Exposure to ultraviolet rays from the sun and tanning beds can cause melanoma, the deadliest type of skin cancer.
  • Stay active. Regular exercise, along with a healthy diet, can lower your risk for several types of cancer and reduce your risk for heart disease. Being overweight can increase your risk of a heart attack and other heart complications.
  • Think about your mental health, too. Some mental illnesses are more common in women or affect women in different ways than men. Conditions such as anxiety, eating disorders and postpartum depression can significantly impact your life. The National Institute of Mental Health has more information specifically for women, but simple things like staying in touch with family and friends, exercising, and getting good sleep can boost your mental health. If you’re unable to shake your symptoms or they keep coming back, talk with your doctor.
  • Be a role model for health. Make sure you’re setting good examples for the girls and young women in your life. Practice healthy eating habits at home and encourage exercise. Encourage the teenage girls in your life to get the HPV vaccination. And for teenage girls especially, emotional support is important. Be available to talk with young women in your life who may be experiencing increased anxiety or depression as they undergo a time of physical and personal growth.

Next steps:

Forgetfulness or dementia? How to tell the difference in elderly loved ones

If you’re spending time with elderly friends and family members this holiday season, be aware of noticeable changes in their memory and behavior, as these can be early warning signs of dementia.

“If you haven’t seen your elderly loved one in a while, you might be more likely to notice changes in their memory and behavior that worries you,” said Dr. Gregory Jicha of the University of Kentucky Sanders-Brown Center on Aging.

Here are some early warning signs of dementia that you might notice in an older friend or family member:

  • It’s normal for someone to forget a date or a name but suddenly remember it later. However, pay attention if they ask for the same information repeatedly, or struggle to recall important dates (like their own birthdate).
  • Are they having trouble following a recipe? Problem-solving skills can deteriorate in someone with Alzheimer’s.
  • Do they get lost when driving to a familiar location? If they have difficulty completing familiar tasks, it might be a sign of AD.
  • Healthy people occasionally struggle to find the right word, but using the wrong word  ̶  particularly if they call something by the wrong name  ̶  merits further scrutiny.
  • Poor judgment: are they giving lots of money to telemarketers or charities?
  • Poor hygiene.
  • Personality changes: are they suddenly irrational, fearful or suspicious?

Memory infographic

If you see any behavior that worries you, talk to your doctor. To make an appointment with a UK HealthCare doctor, visit our Appointment page or call 800-333-8874 today.

More information:

The Memory Disorders Clinic at the Kentucky Neuroscience Institute

 

Learn more about binge-eating disorder

When most people hear the term “eating disorder,” they usually think of anorexia or bulimia nervosa. While anorexia and bulimia are more commonly recognized, doctors are concerned about a different kind of eating disorder that is on the rise.

Binge-eating disorder, or BED, is a disorder characterized by excessive overeating. Though it is common to overindulge occasionally, especially around the holidays, those with BED are plagued with insatiable cravings that lead to recurrent episodes of intense overconsumption. Unlike the binge and purge aspect of bulimia, those with BED do not try to compensate for the caloric intake by excessive exercise or induced vomiting.

Symptoms of binge eating disorder include:

  • Eating unusually large amounts of food in short periods of time
  • Feeling like your eating behavior is out of control
  • Eating when full or not hungry
  • Frequently eating alone or in secret
  • Feeling guilty about binge episodes

BED is quickly becoming the most commonly diagnosed eating disorder in the United States, affecting one in 35 people. More than six million people have been diagnosed with BED since the American Psychological Association first recognized it as a disorder in 2013. BED is what doctors call an ‘equal opportunity’ disease. Unlike anorexia and bulimia, which more commonly affects women, or body dysmorphic disorder, which is seen more in men, binge eating disorder tends to occur equally among the sexes.

Causes

Though doctors and psychologists are unsure of what triggers binge eating disorder, they have noticed increased prevalence in those with a history of depression or dieting and weight fluctuation, and/or a family history of eating disorders. Young adults are also more likely to suffer from eating disorders.

Treatment

Since binge eating disorder is treated as a mental illness, other psychiatric disorders are often linked with BED. The most common are depression and anxiety. Obesity is also frequently associated with BED and can cause other medical conditions such as heart disease, hypertension, sleep apnea, type 2 diabetes and gastroesophageal reflux disease (GERD).

If you or someone you know shows signs of binge eating disorder, encourage them to talk to a physician or psychologist. BED is very treatable through medication, lifestyle changes, and/or psychotherapy.

Lori Molenaar

Lori Molenaar

 

Lori Molenaar, APRN, is a member of the Eating Disorder Treatment Team at the University of Kentucky’s University Health Service.