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Anyone know who is on this Task Force?


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I downloaded the document linked to in that news article.

 

Here is the link:  https://www.uspreventiveservicestaskforce.org/uspstf/public-comments-and-nominations/opportunity-for-public-comment

 

The first document: Draft Evidence Review.  Title: Screening for Depression, Anxiety, and Suicide Risk in Adults: A Systematic Evidence Review for the U.S. Preventive Services Task Force

 

The names and organizations on the document:

 

Prepared for:

Agency for Healthcare Research and Quality

U.S. Department of Health and Human Services

5600 Fishers Lane

Rockville, MD 20857

www.ahrq.gov

 

Prepared by:

Kaiser Permanente Evidence-based Practice Center

Kaiser Permanente Center for Health Research

Portland, OR

 

Investigators:

Elizabeth O’Connor, PhD

Michelle Henninger, PhD

Leslie A. Perdue, MPH

Erin L. Coppola, MPH

Rachel Thomas, MPH

Bradley N. Gaynes, MD, MPH

 

Kaiser Permanente is usually on board for any big government shovel money at big pharma/big insurance deal. So that also concerns me.

 

The investigator names are there. I'll try to look into them tomorrow. Must try to sleep now.

 

Unless the guidelines for prescribing benzodiazepines are radically changed, I think screening a good chunk of the population for anxiety will invariably result in more people being handed scripts for benzos and other psych drugs. It surely must.

 

 

 

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These names may also be of interest:

 

The authors gratefully acknowledge the following individuals for their contributions to this project: Iris Mabry-Hernandez, MD, MPH, and Tina Fan, MD, MPH, at AHRQ; current and former members of the U.S. Preventive Services Task Force who contributed to topic deliberations; Ramin Mojtabai, MD, PhD, MPH, Pim Cuijpers, PhD, Tiffany A. Moore Simas, MD, MPH, FACOG; Raquel Halfond, PhD, Bobbi Jo Yarborough, PsyD, who provided expert review of the draft report; Rebecca DelCarmen-Wiggins, PhD, Regine Douthard, MD, MPH, Shilpa H. Amin, MD, MJ, CAQ, FAAFP, Damiya E. Whitaker, PsyD, MA, and Elena Gorodetsky, MD, PhD, with the National Institutes of Health Office of Research on Women's Health, Jackie Wallace MD, MPH, with the National Institute of Child Health and Human Development, Erin M. Abramsohn, DrPH, MPH, with the Centers for Disease Control and Prevention for providing federal partner review of the draft report; Melinda Davies, MAIS, and Jill Pope, BA, at the Kaiser Permanente Center for Health Research for technical and editorial assistance.

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Thank you for posting the link for US Preventive Services comments. 

I wrote:

 

"Screening for anxiety would do more harm than good, as it would likely result in increased, unnecessary prescribing of benzodiazepines.  There are few tools the medical community have to treat anxiety.  Talk therapy is not available to many patients through their insurance coverage.  The quick, easy and often only other option covered by insurance is psychopharmaceuticals, of which benzodiazepines predominate.  Benzos are rarely sufficient or effective in the short run of "safe" usage, should not be taken on an "as needed" basis and can cause great anguish if used regularly longterm.  Both doctors and the public are largely unaware of the risks.  Do not open this Pandora's Box, creating more misery for more people."

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Seeing this in the NYTimes today, I came here to post the same concerns:

 

https://www.nytimes.com/2022/09/20/health/anxiety-screening-recommendation.html

 

Would this result in an increase in benzo prescriptions?

 

I would hope not, but it seems likely.

 

clearbluesky

 

Of course it will. If you screen people randomly you will pick up cases of anxiety that were previously undetected. Some percentage of those will invariably end up with benzodiazepine prescriptions. Others will end up with prescriptions for SSRIs, SNRIs, antipsychotics, etc. etc.

 

Given that:

 

1.) Benzos are not a long term solution for anxiety.

2.) Recent evidence shows that SSRIs, SNRIs very likely do not work and they have their own issues with PSSD, withdrawal syndromes, etc.

3.) Antipsychotics frequently have even worse side effects (e.g. tardive dyskinesia, etc.) than SSRIs/SNRIs.

 

I really question the wisdom of casting a broad net trying to find previously undetected cases of anxiety. You may well end up doing more harm than good.

 

The fact is, we really aren't very good at treating anxiety pharmacologically.  And drugs are how these new found cases will be treated. No one wants to invest the time and money on things that might actually help (CBT, talk therapy, physical exercise, etc) so all these new cases will have pills thrown at them.  That is what modern psychiatrists and GPs do - they write prescriptions.

 

In my opinion, the harm done will very likely outweigh the good. In many cases you are probably better off living with your anxiety than gobbling down pills that aren't a solution and can often times result in you being worse off than when you started.

 

 

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I agree with everything you say, including SSRIs and SNRIs.  Doctors would be screening .....actually indirectly suggesting, ergo, promoting treatment.....for something there is no safe and effective treatment for.  It's a farce, nothing more than a great big wet kiss for Big Pharma. 

 

Is there a benzo awareness org that's addressing this?  Maybe I could help beyond my comment in some way.

 

clearbluesky

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https://uspreventiveservicestaskforce.org/uspstf/draft-recommendation/anxiety-adults-screening

 

There is a public comment section open until October 17th. I hope benzoinfo.com puts out a call for public comment. Everyone here, please see this as a push to prescribe, as stated on their website, and make a public comment.

 

“Treatment or Interventions

 

Treatment for anxiety disorders can include psychotherapy (e.g., cognitive behavioral, interpsonal, family, and acceptance and commitment therapy) and pharmacotherapy (e.g., antidepressants, antihistamines, beta-blockers, anticonvulsant medications, or benzodiazepines). Anxiety treatment may also include relaxation and desensitization therapies. Transdiagnostic treatment approaches have also been developed for use with patients who have anxiety, depression, or both conditions because of the overlap between depression and anxiety.”

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Yes, thank you!  The link works.  I used it to submit the comment above.  I am also interested in finding out the name of an advocacy/awareness type org.  I fully understand if BB does not get into that kind of work.  The moderators and others who donate their time here have their hands full as it is.  I'm continually in awe of their kindness, patience, generosity and expertise!  Just wondering if another org is involved in the political end.

 

clearbluesky

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Oops, sorry to be redundant. I didn’t scroll down through the whole thread.

 

Mad In America is all that comes to mind, but not sure how much advocacy work they do as opposed to awareness. Benzo Information Coalition was what I was referring to. I’ve seen them put out calls to action before.

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I was first made aware of this Task Force by some doctor interview on CNN but I cannot find that interview on Youtube.  (Apparently this task force made the same recommendations that teenagers be screened for anxiety).  When the doc said "treatment" for anxiety that means benzodiazepines as far as I'm concerned, unless other non drug forms are identified - which were not.

 

I have not seen anything on Mad in America or BenzodiazepineInformationCoalition about this report but it is new so they may look into it.

 

Kaiser Permanente has more money than God. https://www.healthcaredive.com/news/kaiser-record-net-income-covid-nonprofit/618783/

Their integrated business operation is a mystery.  I smell a rat with regard to gov/pharma involvement.  But, not being an investigative reporter with time, money and influence -  I can't find the rat just yet.  And it is depressing to think that all of these soon-to-be screened people/patients --will believe that anxiety is a pathology and that it must be fixed.  Anxiety is a human reaction to the times we live in.  The potential suffering at the hands of Pharma and task forces like this is staggering.

 

I will draft something for the public comment.  But I think that's a scam, too.

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Kaiser Permanente is very intertwined with the government in the US.

 

I don't whether Kaiser Permanente has their tentacles in the Government, or the Government has it's tentacles in Kaiser Permanente. Most likely they have their tentacles in each other to the point it's difficult to see where the one stops and the other starts.

 

If KP makes a recommendation, there's a significant chance it will result in legislation and eventually law.

 

 

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You know, if medicine was any good at all at treating anxiety, maybe voluntarily screening people for it would be a good idea.

 

But the fact is, we're lousy at treating anxiety, at least when it comes to drugs. And rest assured that people found to have anxiety issues through these screenings will be drugged.

 

If this rolls through look for the major drug companies to roll out new and improved (which is to say on patent) benzos and z-drugs. Because if the gravy train starts chugging, they certainly are not going to allow these plebeian generic drug makers to horn in on the gravy.

 

 

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Check this out.  Conveniently prior to this misbegotten anxiety screening proposal....and in the Lancet, no less....

 

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00934-X/fulltext

 

Looks like BB is going to need to double up on moderators.

 

clearbluesky

ps.....I saw no response to the anxiety screening news on the Benzodiazepine Information Coalition website or any other.  Speaking of voices crying in the wilderness, coming back here I mistakenly clicked on Community News and saw that a longterm BB member, Zman, had taken his own life.  I did not know him, but it makes me so angry.  These struggles go unquantified, unknown, untold in the public. 

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From the Lancet, the sentences I've put in bold sicken me.

 

In their Seminar, Brenda Penninx and colleagues1 have strongly cautioned against the long-term use of benzodiazepines for anxiety disorders, commenting that these drugs only act acutely, lead to relapse after discontinuation, and are associated with dependency. Penninx and colleagues propose that benzodiazepines should only be administered as a short-term adjunct and never as monotherapy. We believe that this conclusion is not evidence-based and risks biasing clinicians against an important medication for refractory anxiety disorders.

 

A systematic review2 showed that benzodiazepine monotherapy for generalised anxiety disorder was effective, with the mean difference in favour of benzodiazepines compared with placebo of −2·29 (95% credible interval −3·19 to −1·39), as measured by the mean difference in the Hamilton Anxiety Scale. The risk of abuse or dependence is also overestimated and is relatively uncommon in patients who do not have a previous history of substance abuse.3 Furthermore, tolerance does not develop to the anxiolytic effects of benzodiazepines.3 Long-term benzodiazepine treatment is associated with the maintenance of therapeutic benefit, without requiring dose escalation.3

 

Benzodiazepines are effective for the management of anxiety disorders and should be judiciously considered after screening of relevant risk factors for negative outcomes, including history of substance abuse, current use of opioids and alcohol, older age (65 years or older), risk of falls, and cognitive impairment.4 In contradistinction to Penninx and colleagues' findings,1 we believe that the risks of benzodiazepines have been overestimated, while the benefits have been minimised, which could result in clinicians underprescribing for carefully selected populations with refractory anxiety disorders.

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Thank you, Pamster.  I'm also appalled by the report's conclusions, and wondering how this proposed anxiety screening can be addressed....

 

---if the link to public comments was posted in various BB forums, so members are aware of the input opportunity, would the post be allowed to remain or moved to the News thread?  I understand such a post should not tell members what to say in a task force comment, just mentioning potential hazards of the proposal and leaving a task force comment up to them.

 

---there is nothing on the website of Benzodiazepine Information Coalition.  Are they aware of this?

 

---I wonder if investigative journalism orgs like ProPublica might be interested in looking into this issue.

 

---the head of Psychiatry at the Mayo Clinic has expressed qualms about these screenings.  I wonder if he would be someone to write to:

 

https://www.nytimes.com/2022/09/20/health/anxiety-screening-recommendation.html

 

---does this screening initiative require Congressional approval?  Doesn't sound like it.  Who is responsible for oversight?

 

Just wondering what else can be done....

 

clearbluesky

 

 

 

 

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I feel like it’s part of the overall “mental health” push we are currently witnessing. It seems coordinated, dangerous and also geared to afflict poor and vulnerable communities that are at a socioeconomic disadvantage. They seem to be running full force with this campaign. I’ve not been able to locate a breakdown of where this funding will be going. Most of the announcements and press releases are pretty vague.

 

https://www.samhsa.gov/newsroom/press-announcements/202103110230

 

HB1667 passed in March. https://legiscan.com/gaits/subject/13314?status=passed

 

Not sure if all of these actions are related but I watch the political sphere pretty closely, mainly messaging, and there is a consistent messaging around mental health as a whole.

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---if the link to public comments was posted in various BB forums, so members are aware of the input opportunity, would the post be allowed to remain or moved to the News thread?  I understand such a post should not tell members what to say in a task force comment, just mentioning potential hazards of the proposal and leaving a task force comment up to them.

 

---there is nothing on the website of Benzodiazepine Information Coalition.  Are they aware of this?

 

 

The team is discussing this and reaching out to our sister organizations.

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Tinkered:  thanks for the link.  Isn't it funny that where federal funding appears, corporate interests appear out of nowhere to feed out of the trough?  (And I say this as a lifelong liberal and Biden supporter.  I am also NOT anti-vaxx.  But as an environmental activist, I've noticed such things.)

 

The NYTimes has a whole series running right now on mental health.  Is it related to this task force proposal?  Who knows.  They've also run a couple stories on psych polypharmacology in young people recently that were utterly shocking.

 

clearbluesky

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Tinkered:  thanks for the link.  Isn't it funny that where federal funding appears, corporate interests appear out of nowhere to feed out of the trough?  (And I say this as a lifelong liberal and Biden supporter.  I am also NOT anti-vaxx.  But as an environmental activist, I've noticed such things.)

 

The NYTimes has a whole series running right now on mental health.  Is it related to this task force proposal?  Who knows.  They've also run a couple stories on psych polypharmacology in young people recently that were utterly shocking.

 

clearbluesky

Interesting phenomenon that is. Probably some interesting stock activity too. Yes, I lean left as a survival mechanism, but both parties appear to be equally corrupt while keeping us divided with culture wars. It’s exhausting and cruel. I think with the media they throw out a few pieces because they have to. Too many people are getting vocal about it. But if you look at the messaging from either side of the spectrum it usually differs enough that neither side is getting the full picture, the waters get muddied and corporate interests are always the winner, kind of like the house always wins in gambling.

 

Pardon me for being so cynical and pessimistic but I am, and rightfully so.

 

Did you see this note on leaving a comment? Lol, please do try to be worthy with your layperson language, peasant.

 

“How to Comment

 

Any visitor to this site can comment on any of the listed USPSTF draft documents. However, readers should note that the USPSTF writes these documents for researchers, primary care doctors, and other health care providers, using medical and scientific language as appropriate for these audiences.”

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I hate to see this thread devolve into a political discussion, this is the quickest way I know to divide us on a topic in which we pretty much all agree.  Thanks for your cooperation.
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Underprescribing of benzo's?  That's really scary.  Also their saying that benzo's don't cause tolerance is BS.  We all know that they do eventually.
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