Drug And Alcohol Abuse Double Risk Of ICU Admission

While the personal health and safety risks of drug and alcohol abuse are well-documented, a new study by researchers at LDS Hospital and Brigham Young University suggests substance dependence increases medical costs by way of the intensive care unit.

Analysis of intensive care unit admissions at LDS Hospital in Salt Lake City shows drug and alcohol abuse make a patient twice as likely to be admitted to intensive care, according to the new study, published in the December issue of Intensive Care Medicine.

"Since these patients are admitted to an intensive care unit, which is geared to treat patients with a much higher acuity, medical costs are higher than for those admitted to a general ward in the hospital," reported Mary Suchyta, M.D., lead author and a physician at Intermountain Medical Center and LDS Hospital.

The researchers reviewed records for 742 patients admitted to LDS Hospital's intensive care unit over a one-year period. Nineteen percent of those patients had a history of drug and alcohol dependence prior to becoming critically ill. That's twice the rate of the population served by LDS Hospital.

"It appears that that patients with drug or alcohol dependence are at higher risk for intensive care unit admission compared to the general population, which would increase overall medical costs," said Ramona Hopkins, a psychology professor at BYU and researcher at Intermountain Medical Center and LDS Hospital.

Patients with drug or alcohol dependence were on average six years younger than the rest of ICU patients.

"What's alarming is that substance dependence meant that these individuals were critically ill and admitted to the ICU at a much younger age than the general population," Hopkins said. "If these individuals do not completely recover and return to work, that represents large potential societal costs."

The new study earned praise from the editors of Intensive Care Medicine, who noted that there are significant gaps in this type of knowledge in most ICU settings and while this article did not answer many of the questions posed by these gaps, it should stimulate further research and collaboration.

Both Drs. Suchyta and Hopkins agree that the detection of substance dependence earlier would allow doctors to address those issues and this may improve recovery.

"Dr. Hopkins and myself have thought for many years that patients with drug and alcohol dependence were over represented in the ICU populations that we have studied over the last 10-15 years and this study suggests that we were correct," noted Dr. Suchyta.

BYU undergrad Callie Beck is also a co-author on the new study. It's her second time publishing an academic paper alongside Hopkins. In 2006 she co-authored a study on brain imaging, a field she would like to pursue in graduate school. Beck is applying to nine graduate schools, including UCLA, Vanderbilt and the University of Maryland.

"Callie is an amazing student," Hopkins said. "She was involved in many aspects of the research, including data analysis and writing. That level of experience will make her stand out as she applies to graduate school."
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source: MediLexicon

The Recovery Cafe

"We are a community in which men and women traumatized by homelessness, addiction and mental health challenges can come to know ourselves as loved and as instruments of love in the lives of others with gifts to share."

Recovery Café's mission statement is no corporate, fluff marketing verse. It can't afford to be. The individuals who are currently abiding by this creed have fought through dogged pasts, creating a brighter future for themselves and others, all while exercising the very demons luring them back to the darkness of their former lives.

I walk past the Recovery Café most times I hop the free ride zone downtown. To be honest, I've been putting off writing / researching this blog because I was a little scared at what I might find, both inside the center and inside myself upon a visit.

But this was the week...I couldn't put it off any longer.

I walked the two blocks to Second and Bell, continually going over the questions that I had already scratched in my Roaring Springs Composition notebook, merely hoping to talk to someone who works there (calling ahead would be too professional), get my questions answered, shoot some photos, and be on my way - still emotionally unattached. David Coffee ("...like what you drink in the morning") the Café's director, made sure that didn't happen.

After bumbling into the café, I came across David hunched over a contract. David's around 5'9" with medium to short dark hair, prickling with grey. Hailing from DC, his Northface jacket now firmly marks him as a Seattlite. He would need some more time, but I was more than welcome to take some photographs, but not inside; the café houses a few women battling histories of domestic violence, and are hiding from their former "family" with their new family. At that moment, I knew this wasn't going to be an in and out operation.

Not long after, David joined me outside and needed no prodding to begin discussing the café, leaving me scrambling for scribble space in my notebook.

Four years ago, the café was started by a group of women who saw a hole in Seattle's otherwise stellar housing / work program agencies. The Recovery Café is rooted in the idea that former addicts and trauma victims need more than 28 days for a full recovery – they need a lifetime. Although former addicts and trauma victims were finding places to live and work, they still didn't have a support system, a clean support system, to keep them focused on their recovery. Their "deferment" of life regarding family and health needed assessment, answers, and healing .

"So that's where the café comes in," explains David, "it gives whoever wants it, as long as there clean and sober, the chance to make new friends, and through those friends to gain support and trust."

David introduced me, making me sound very important, to no less than ten people attending the days thirty minute meditation session, member introduction, and meal - each of them saying the same thing when asked what the best part of the café is:

"Being part of a community."

It's the simplest of comforts - feeling like a part of something. Each person I met also came with another, a partner of sorts. Phil had Karyn and Karyn had Phil. J. Garland had T. Rose, and they've known each other since Alcoholics Anonymous 20 years ago. In a weird way, I kind of had David, and this was not intentional, I believe it's just how things happen there. The openness, warmth, and camaraderie I felt in the time spent at the café was nothing short of authentic.

And that's why the café is successful. It breeds trust through it's many meetings, meditations, and meals. First, a member has to sign a contract, this can even be a daily contract (David told me of a gentlemen who on some days could not personally bring himself to sign the contract, knowing he might break it) that each person will act in accordance with the café's mission and goals. Once a member, you've earned access to the support needed for future growth, and even some of the special events like art focused activities, or Open Mic Night every third Saturday where members take their shot at amateur entertainment.

Even harder than trying to crack some jokes though, is completely prying open one's darkest self to a circle of focused eyes, but this is what Recovery Café excels at due to the high trust level. David Shull is Recovery Café's support services coordinator and facilitates the survivors group meetings. After naively explaining to David that my idea of a support meeting is only what I've seen on television, (thank you, Celebrity Rehab!) he makes me feel better confirming that my impressions aren't that far off.

"I only talk about 97% of the time, and if I'm talking more than that then something isn't right. I'm more of a facilitator than anything else."

Shull echoed the same secret that some of the members told me regarding what's needed to fully heal and move on:

"You have to go deep enough to bring it out..."

The David's make up a third of the full time staff, leaving duties to the over 240 volunteers that participate in the café's mission. Many of these volunteers are members themselves that help with various things around the café, but other volunteers come in a totally different form. By having "successful" individuals as volunteers, the café serves as a comfortable space for members to ask volunteers questions about their life and successes on their terms where as they might not feel comfortable doing the same on a bus or while shopping. Again, without trust within the café's walls, conversations and learning of this magnitude could never take place.

The café itself is struggling for the best of reasons, lack of space for it's growing community. Currently in a 1,700 sq. foot space, the tour didn't take long once meditation was finished. Aside from the comically large Starbucks donated espresso machine (I guess they do some good things while taking over the world) the smallish kitchen can't boast much more than some prep space and a microwave while the café's members are all congregated in one of three rooms, each of differing sizes specifically for intimacy demands, the smallest reserved for one or two person sessions. The plan now is a 4k sq. foot space with street access to keep the café notion central. Visibility and accessibility are top priority along with staying in Belltown. Spread the word.

Special thanks to the David's and everyone kind enough to answer my questions, letting me into a small space of trust that I don't believe I earned. The quizzical optimism I witnessed in a place that has heard so many sad stories, with more to come, was something I've only seen in a few others. After now being present in this odd sanguinity again, one that breads statements like, "it's just incredible the changes that happen here," amidst cases of failure, I realize it takes rare persons committed to service with realistic optimism. David Coffee is not in denial nor blind to the fact that some addicts or victims plunge back into their old ways. What he is however, along with Recovery Café's other employees, volunteers, and members, are people who have the chance to see a happy ending every day.

Now, I think I understand why they do it: The afterglow is quite something.
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source: http://blog.seattlepi.nwsource.com/thebelltownblocks