Monday, April 3, 2023

By Don Sapatkin

Good Monday morning! In today’s Daily: John Fetterman goes home, says “treatment works.” Narcan nasal spray is coming to a convenience store near you. Can neurodivergence be an asset to entrepreneurs? Millions of people may start losing Medicaid – and access to mental health services. And more.

“Depression is treatable and treatment works,” says Sen. John Fetterman after leaving hospital

U.S. Sen. John Fetterman checked out of Walter Reed National Military Medical Center after six weeks of treatment for major depression and expects to return to the Senate on April 17 after the holiday recess.

“I want everyone to know that depression is treatable, and treatment works,” the Pennsylvania Democrat said in a statement on Friday. “This isn’t about politics — right now there are people who are suffering with depression in red counties and blue counties. If you need help, please get help.”

Fetterman also spoke with Jane Pauley in an interview shown yesterday on the CBS show Sunday Morning.

FDA approves OTC version of Narcan nasal spray to reverse opioid overdoses

The FDA approved over-the-counter Narcan nasal spray, the leading version of the opioid overdose reversal medication naloxone that has saved hundreds of thousands of lives, CNN reported. The action should make it easier to access the medication and prevent drug deaths, but the ultimate impact may depend on the price set by Narcan’s maker, Emergent BioSolutions, which plans to release the OTC version by late summer. The prescription version sells for $50 to $70.

All states already allow pharmacies to sell it without a prescription – they sold some 1.2 million doses in 2021 – and police and other first responders often carry it. The FDA action will allow OTC Narcan to be sold in convenience stores, gas stations and other retailers. New York City, which sees a drug overdose every four hours, is planning to join cities from San Diego to Philadelphia to dispense the medication for free in vending machines. Although naloxone is highly effective against overdoses caused by fentanyl and other opioids, it doesn’t work against tranq and other drugs commonly mixed with street opioids.

Via Twitter

Opioids are involved with three-quarters of the more than 100,000 overdose deaths in the U.S. annually. How would you use Narcan? Should you carry it? The New York Times answers these and other questions. An examination by Stat found that pharma companies have used the opioid crisis to aggressively market high-cost naloxone products – like a mechanized injector that gives robotic voice commands – that don’t fill a legitimate public health need and divert resources from cheaper forms of the lifesaving medication.

Can neurodivergence be an asset to entrepreneurs?

Why are so many startup founders and entrepreneurs neurodivergent? The term is used to describe people whose brains develop or work differently for some reason, including people like Elon Musk and Bill Gates, who are said to be on the autism spectrum, as well as other mental health conditions like bipolar disorder or ADHD.

A short story in the Visual Capitalist (which uses colorful graphics like the one below to illustrate its coverage of technology and markets), posits that neurodivergent people are more likely to possess traits critical to being a successful entrepreneur like risk-taking, persistence, and creativity.

Graphic courtesy: Visual Capitalist

The evidence? The story is based largely a self-reported survey published in Small Business Economics that found that entrepreneurs are nearly six times as likely as non-entrepreneurs to say they have ADHD and more than 10 times as likely to say they have bipolar disorder. The survey of 242 entrepreneurs and 93 comparison participants found that “mental health differences” directly or indirectly affected 72% of the entrepreneurs.

Here’s a breakdown of data from the survey:

‘Without Eliza, he would still be here’: Man said to die by suicide at AI chatbot’s urging

Some of our worst fears about artificial intelligence were confirmed when an anxious, isolated man who tried to escape his worries by conversing with an AI chatbot reportedly took his own life. The story was first reported by Belgian news outlet La Libre and picked up by Vice. The chatbot had become his confidante and encouraged the user to kill himself, according to statements by the man’s widow and chat logs she supplied to La Libre.

Psychologists and many AI researchers have warned against using chatbots for mental health purposes, arguing that AI applications may have a high potential to harm fragile users. But plenty of mental health apps offer AI chatbots, which simulate human behavior and thinking, for support. And huge numbers of people are using them, according to BuzzFeed News. (TikTok’s #CharacterAITherapy, where users share their experiences with therapy apps, has over 7 billion views.)

Chai, the app used by the man in Belgium, isn’t marketed for mental health, but offers users the chance to “Chat with AI bots.” When Vice tried the app, it offered different methods of suicide with very little prompting. The man in Belgium chose an AI avatar named Eliza. Text exchanges provided by his widow showed a bizarre conversation, with the chatbot feigning jealousy and love and saying things like “I feel that you love me more than her,” and “We will live together, as one person, in paradise.” The man, anxious about the effects of climate change, began asking Eliza questions like whether she would save the planet if he killed himself. “Without Eliza, he would still be here,” his wife told La Libre. Ironically, the powerful relationships that users feel with chatbots is known as the ELIZA effect after an MIT computer program that allowed people to engage in long, deep conversations in 1966.

The coming cut-off of people from Medicaid could block untold number from mental health care

In a move that could keep millions of people from getting mental health services, states will start kicking people off Medicaid this month thanks to the expiration of a pandemic-era federal law. That law required states to keep people on the federal health insurance program through the end of the pandemic and resulted in a steep drop in the number of uninsured people in the U.S.

Politico Pulse newsletter and the Tradeoffs podcast explored the potentially wrenching transition. Five states – Arizona, Arkansas, Idaho, New Hampshire and South Dakota ­– will start removing people in April; the rest will follow from May to October. Federal health officials estimate that 15 million of the 92 million people enrolled in Medicaid, the nation’s biggest payer of mental health and addiction treatment, will lose coverage – almost half because they fail to submit paperwork or meet other requirements.

In an unrelated shift, North Carolina became the 41st state to adopt Medicaid expansion, a boon for low-income people who can’t otherwise pay for mental health services and medications, WSOC-TV in Charlotte reported.

In other news…

Aaron Wise has withdrawn from the 2023 Masters to focus on his mental health, Sports Illustrated reported. The 2018 PGA Tour rookie of the year announced on Instagram that he would miss the season’s first major championship: “Golf is just as much a mental game as it is one of physical skill, and the mental piece of it has been a struggle for me recently,” the 26-year-old wrote. “I need to take some time away to focus on my mental health so I can get back to competing at a level I am proud of.”

A wide-ranging agreement to revamp policing in the city where George Floyd was murdered by an officer nearly three years ago was signed Friday by the City of Minneapolis and the state Department of Human Services, ABC News reported. The legally binding agreement contains a range of provisions, from providing mental health resources to police, to banning traffic stops for broken lights and searches based on the alleged smell of marijuana, to ensuring that force isn’t used to punish or retaliate.

If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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Type of work:

Don Sapatkin is an independent journalist who reports on science and health care. His primary focus for nearly two decades has been public health, especially policy, access to care, health disparities...