Anxiety Disorders: Scope and Clinical Considerations

Journal of Managed Care Medicine | Vol. 21, No. 3 |; By: Omar S. Manejwala, MD, DFAPA, FASAM

Anxiety disorders are the most common psychiatric condition in the United States. Our understanding of causative factors has evolved, as have some treatment options. The conditions are generally treatment responsive, but refractory illness persists. The majority of people with these conditions remain untreated and for those who are treated, adherence to evidence-based care remains poor. Innovations in care delivery that focus on engagement will be key to driving superior outcomes.

Office Visit: Identifying behavioral health issues

The Journal Record; Opinion | Guest Column; By: Joseph R. Cunningham, MD; July 24, 2018

In recent months, mental health has been a prevalent topic of conversation. From anxiety to depression, behavioral health issues have been in the spotlight, oftentimes bringing awareness to their symptoms.

US Adults with Mental Health Disorders Receive More Prescription Opioids

Davis MA, Lin LA, Liu H, Sites BD. Prescription opioid use among adults with mental health disorders. J Am Board Fam Med. 2017;30(4):507–517.

As we continue taking steps to reduce opioid abuse in the US, it’s important to understand who is being prescribed these medications. View this Catasys-created infographic to see the uneven opioid distribution in America as it relates to people with co-existing mental health disorders.

Health Plan Members with Chronic Pain and Coexisting Behavioral Health Conditions Experience 45% Decline in Medical Claims Costs with Catasys OnTrak Program

Catasys Chronic Pain Study

Chronic pain affects millions of Americans and many suffer from coexisting behavioral health conditions. Concomitant behavioral and medical conditions lead to significantly higher per person healthcare spending for millions of Americans. The OnTrak™ Program, developed by Catasys®, Inc., was designed to address such increased costs by improving the health of its members in several ways including improving pain, reducing dependence on opioids, and reducing the impact of behavioral health conditions on medical comorbidities. The program identifies, engages, and treats the subset of health plan members with behavioral and coexisting medical conditions who avoid behavioral health treatment. Based on a cohort of 985 individuals experiencing chronic pain, the OnTrak Program substantially reduced per-member-per-month (PMPM) health plan spending.

For the participants who completed the OnTrak Program, there was a 45% gross reduction in PMPM spending, from $2,737 in the base period to $1,505 during the post-enrollment period.

How behavioral conditions worsen chronic pain

By: Omar Manejwala, MD, MBA — Senior VP and Chief Medical Officer of Catasys

The opioid overdose epidemic is worsening at alarming rates, and current and near-term proposed strategies are not likely to turn the tide over the next few years. One nearly universally adopted strategy to curb overdoses has been to reduce the dose and quantity of prescribed opioids. In 2016, the Centers for Disease Control released guidelines for prescribing opioids, which were not intended to force reductions in opioid prescribing but rather to prioritize non-opioid pharmacotherapy, carefully consider the risks of prescribing, limit new prescriptions and monitor for the development of opioid use disorders. Despite the CDC’s emphasis on collaborative, multidisciplinary approaches rather than involuntary tapers, many providers and policy makers have interpreted the guidelines as a mandate to restrict opioid prescribing in a blanket fashion.

The Opioid Crisis is a Wicked Problem

American Academy of Addiction Psychiatry | Fall 2017 | Volume 33, Number 3; By: Jonathan C. Lee, MD

Wicked problems are endemic complex systems with components that interact in complicated, poorly understood and unpredictable ways.1 Interventions into the system produce downstream consequences that cannot be known in advance and cannot be undone. It is impossible to establish a single locus for a wicked problem because changing one element of the system changes the dynamics of the entire system. The wicked problem definition changes depending on both the focal point of interventions and the responses that any proposed solution generates.2

Featured: Omar Manejwala, MD, MBA, Senior VP and Chief Medical Officer of Catasys

I looked for a state that’s taken the opioid epidemic seriously. I found Vermont.

Vermont declared an emergency over the opioid crisis — and actually did something about it.

Vox; October 31, 2017; By: German Lopez

BURLINGTON, Vermont — A group of more than a dozen addiction care providers gathered at a community health center one morning in September for their monthly meeting, where they chatted about their latest thorny problem.

One of their patients had vanished. Again.

The missing man, a 28-year-old whom I’ll call Tyler, was never an easy patient. On and off, he had used two to eight bags of heroin each day for the past seven years. He was strongly resistant to medication-assisted treatment (MAT), in which patients use medications such as methadone or buprenorphine to stave off withdrawals and reduce cravings — widely considered the gold standard for opioid addiction care.

Featured: Omar Manejwala, MD, MBA, Senior VP and Chief Medical Officer of Catasys

How I Reached Clarity In My Confusing Relationship With Antidepressants

My world, my words

Nylon; October 02, 2017; By: Hayden Manders

I was depressed for a little over a decade before I sought treatment. It took a broken heart—a real broken heart—to lose my desire to do pretty much anything other than go through the motions after I’d pulled myself out of bed. I was a junior in college.

Up until my breaking point, I had grown accustomed to sadness, anger, and worry. The heaviness I felt and the overall sense of being “over it,” often before anything began, was my norm. I knew it wasn’t normal, per se, but I was doing really well and excelling. I appeared fine—fabulous, even—but I knew that at any moment, something or someone could send me reeling.

Featured: Omar Manejwala, MD, MBA, Senior VP and Chief Medical Officer of Catasys