As the United States and other industrialized countries begin to adapt healthcare systems to accommodate the increasing impact of chronic health conditions and contributing problems like prescription opioid addiction, cigarette smoking and obesity, science is turning to personal behavioral change for solutions.
To share the latest research in effectively managing these problems, Stephen Higgins, Ph.D., University of Vermont professor of psychiatry and director of the Vermont Center on Behavior and Health, collaborated with experts from UVM and across the country on a special issue of the journal Preventive Medicine, titled “Behavior change, health, and health disparities.”
“In this special issue, we devote considerable space to the current U.S. prescription opioid addiction epidemic,” Higgins says of his second collaboration with the journal. “We also have continued to address the two largest contributors to preventable disease and premature death: cigarette smoking and physical inactivity/obesity.”
Across each of these topics, Higgins worked with accomplished policy makers and scientists to publish recent accomplishments as well as remaining knowledge gaps and challenges to effectively managing these pressing chronic health problems.
The special issue outlines the scope of the U.S. opioid abuse epidemic, as well as state and national efforts to increase treatment capacity; and, calls for better physician education and evidence-informed prescribing guidelines. More user-friendly Naloxone rescue devices and wider use are strongly recommended, as is the use of rescue kits for chronic pain patients.
Contributors on the subject of opioid addiction include:
- Wilson M. Compton, M.D., M.P.E., deputy director of the National Institute of Health’s National Institute on Drug Abuse, who is involved in many of the federal efforts to curtail prescription opioid addiction, addresses “Prescription opioid abuse: Problems and Responses.”
- Alexander Y. Walley, M.D., M.Sc., of Boston University, who addresses “HIV prevention and treatment strategies can help address the overdose crisis.” One of eight strategies, the naloxone rescue kit, is gaining considerable recognition.
- Sharon L, Walsh, Ph.D., associate professor of Behavioral Science, Psychiatry, and Director of the Center on Drug and Alcohol Research at the University of Kentucky, who argues for “Distribution of naloxone for overdose prevention to chronic pain patients.”
- Stacey Sigmon, Ph.D., UVM associate professor of psychiatry and psychology, Vermont Center on Behavior and Health, provided “Interim treatment: Bridging delays to opioid treatment access.”
- Marjorie Meyer, M.D., UVM associate professor, obstetrician and maternal fetal medicine physician, contributed “Caring for pregnant opioid abusers in Vermont: A potential model for non-urban areas.”
Regarding physical inactivity and obesity, an epidemic overrepresented among socioeconomically disadvantaged children and adults, commentary in the special issue calls into question the lack of lifestyle programs to support behavior change. Also concerning is the fact that health care insurance companies generally do not provide coverage for behavioral weight loss programs to prevent or treat type 2 diabetes. Contributors on the subject include:
- Harry Chen, M.D., Vermont Commissioner of Health, who discusses “The scope and impact of obesity in Vermont — Strategies for change”
- VCBH Associate Director Philip Ades, M.D., a UVM cardiologist and cardiac rehabilitation specialist, who authored an article on “A lifestyle program of exercise and weight loss is effective in preventing and treating type 2 diabetes mellitus: Why are programs not more available?”
Higgins also contributed a paper to the issue, titled “Borrowing from Tobacco Control to Curtail the Overweight and Obesity Epidemic: Leveraging the U.S. Surgeon General’s Report.” His report strongly recommends leveraging the power of the U.S. Surgeon General’s Office to help curtail the obesity epidemic in a manner comparable to what has been done for tobacco.
Other VCBH expert contributors include:
- UVM Associate Professor of Psychiatry Sarah Heil, Ph.D., co-authored “Contraceptive use and method choice among women with opioid and other substance use disorders: A systematic review.”
- UVM Assistant Professor of Psychiatry Diann Gaalema, Ph.D., worked with Higgins and Ades on “Smoking and cardiac rehabilitation participation: Associations with referral, attendance and adherence.”