Teen dating violence is just as serious as adult domestic violence. And it’s common. About 2 in 10 teen girls say they have been physically or sexually abused by a dating partner. About 1 in 10 teen boys reports abuse in dating relationships.

Teen dating abuse is a pattern of abusive behavior used to control another person. It can be:
•Any kind of physical violence or threat of physical violence to get control.
•Emotional or mental abuse, such as playing mind games, making you feel crazy, constantly texting you, or constantly putting you down or criticizing you.
•Sexual abuse, including making you do anything you don’t want to do, refusing to have safer sex, or making you feel bad about yourself sexually.

Who’s at risk?

Like adult domestic violence, teen relationship abuse affects all types of teens, regardless of how much money your parents make, what your grades are, how you look or dress, your religion, or your race. Teen relationship abuse occurs in straight, gay, and lesbian relationships.
Relationship abuse is not just dangerous for you physically and emotionally. It can also put you at risk for other health problems, such as:
•Eating disorders.
•Depression.
•Low self-esteem.

Teens in abusive relationships are also more likely to take sexual risks, do poorly in school, and use drugs, alcohol, and tobacco. Girls are at higher risk for pregnancy and sexually transmitted infections (STIs).

Is it abuse?
Abusive relationships can have good times and bad times. Part of what makes dating violence so confusing is that there is loved mixed with the abuse. This can make it hard to tell if you are really being abused. But you deserve to be treated in a loving, respectful way by your boyfriend or girlfriend.

Does your boyfriend or girlfriend:
•Act bossy and make all the decisions?
•Put you down in front of friends?
•Try to control who you see and talk to?
•Threaten to hurt or kill himself or herself?
•Blame you for “making” him or her treat you badly?
•Pressure you to have or force you to have unprotected sex?
•Stalk you? This can include constantly texting or calling you to find out where you are and who you’re with. You might think that’s about caring, but it’s really about controlling the relationship.

Do you:
•Feel less confident about yourself when you’re with him or her?
•Feel scared or worried about doing or saying “the wrong thing”?
•Find yourself changing your behavior out of fear or to avoid a fight?

If you answered “yes” to any of these questions, you might be in an abusive relationship. There are people who can help you. You’re not alone. Talk to your parents or another adult family member, a school counselor, a teacher, or someone else you trust. Call a help center or hotline to get help.

How parents can help

Teens may not have the experience or maturity to know if their relationships are abusive. A teen may think of dating violence as only physical violence—pinching, slapping, hitting, or shoving. Teens may not realize that any relationship involving physical violence, sexual violence, emotional abuse, or the threat of violence is an unhealthy relationship.

For example, a teen may think his or her partner cares when he or she calls, texts, emails, or checks in all the time. But that kind of behavior is about controlling the relationship.

Talk with your teen about what makes a healthy relationship. Explain that a caring partner wouldn’t do something that causes fear, lowers self-esteem, or causes injury. Let teens know that they deserve respect in all of their relationships. Think about values and messages that you want to pass on.

You might start by asking your teen:
•Is your boyfriend or girlfriend easy to talk to when there are problems?
•Does he or she give you space to spend time with other people?
•Is he or she kind and supportive?

Hotlines for help
These national hotlines can help you find resources in your area.
•National Domestic Violence Hotline toll-free: 1-800-799-SAFE (1-800-799-7233), or see the website at www.ndvh.org.
•National Teen Dating Abuse Hotline toll-free: 1-866-331-9474 or (1-866-331-8453 TTY) or see the website at www.loveisrespect.org.

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Drones have been a part of military operations for decades as they have engaged in drone warfare and performed reconnaissance and surveillance missions. Civilian drones are popular with drone enthusiasts of all ages. Whether it is to take a hobby such as aerial photography or drone golf to the next level, keep the kids entertained, or to simply enjoy flying these unmanned winged vehicles, drones continue to trend on the hottest gift lists.

Zero emission unmanned aerial vehicles (UAVs) are already being utilized across a number of industries including reshaping search and rescue operations. Scores of emergency services including volunteer rescue teams, police officers, and firefighters deploy drones to save lives in natural disasters and to ensure public safety. Commercial drones are now going airborne and transforming healthcare services delivery, including the delivery of prescription medications.

On November 1, 2019, the United Parcel Service (UPS) drone delivery division, UPS Flight Forward (UPSFF), and CVS Pharmacy made the first commercial residential drone deliveries of prescription drugs in the United States (US). For the maiden flight, pharmacists loaded the drones with prescription medications at a CVS drugstore in Cary, NC. The Matternet M2 drones flew to nearby residences and slowly lowered the small packages to the ground from a hover height of about 20 feet over the properties. A remote drone operator was on standby to step in, if needed. One of the revenue-generating deliveries was made to a front lawn of a private home while the other to the public space at a nearby retirement home. Per UPS, one of the packages was delivered to a CVS customer with limited mobility, for whom traditional store pick up was a challenge. UPS drone deliveries are expected to fly on pre-planned routes, carry packages up to 5 pounds, and deliver in 5 to 10 minutes. Prior to these deliveries, UPS had deployed Matternet quadcopter drones in the hospital setting at the WakeMed Raleigh, NC hospital campuses for commercial transport of medical supplies. As of early November 2019, this business-to-business model had yielded over 1,500 revenue-generating deliveries at WakeMed, since launching in March 2019. UPS is already partnering with the drone logistics startup Matternet on its next iteration of delivery services to medical campuses.

What is remarkable about the UPS/CVS autonomous delivery in Cary, NC is that it was for prescription medications flown directly to a patient’s home. Wing, a drone delivery service owned by Google’s parent company Alphabet, has partnered with FedEx and Walgreens Pharmacy for a home delivery pilot for health and wellness products in the Christiansburg, VA community. In partnership with local merchants, Wing already has drone deliveries of goods available in select areas of Australia and Finland. In June 2019, Amazon’s drone operator system, Prime Air, announced its plans to launch a drone delivery service in the “coming months.” Amazon’s UAVs are expected to fly up to 15 miles and deliver packages under 5 pounds. According to Amazon, 75% to 90% of purchased items weigh less than 5 pounds. These drones will employ “sense and avoid” technology fueled with computer vision, machine learning algorithms, and artificial intelligence to navigate around obstacles such as trees, birds, power lines, people, and pets. Zipline, a CA drone startup, has been actively delivering lifesaving medical supplies including blood and vaccines in Rwanda and Ghana. Notably, Rwanda will be home to the world’s first “droneport” – an airport for drones.

“Drone-to-Door” delivery of prescription medications is a pharmacy quantum leap. This innovation opens the door to swiftly delivering medications at the point of need and can benefit an array of people. Immobility can be a barrier to getting medications for patients with disabilities or those who have sustained injuries because it can be difficult for these patients to get to the pharmacy. Likewise, it can be challenging for the elderly or parents with a sick child at home to make it to the pharmacy, and people who work or travel may not be able to conveniently access a pharmacy. Patients in assisted living facilities also benefit from drone delivery of life-saving medications directly to the site of need. With a number of independent pharmacies and smaller hospitals closing their doors, consumers in rural communities are left without access to vital prescription medications and medical supplies. Drones can rise to fill part of this void. CVS Pharmacy is exploring these options in rural, as well as suburban and urban, markets. Moreover, medication delivery by sustainable UAVs saves time and provides consumers with convenience.

While questions about safety, privacy, intrusiveness, theft, medication exposure, noise, and light pollution remain, there are still significant regulatory hurdles to overcome before drone delivery becomes commonplace. Drones require aviation regulation similar to commercial airplanes. In September 2019, UPS became the first company to receive full Part 135 Standard Certification by the Federal Aviation Authority (FAA) granting UPS its highest certification. This allows the carriers to fly at night and out of operator’s line of sight, to fly as many drones supported by as many operators as needed to meet customer demand, and to collect payment for drone deliveries. In April 2019, Wing received a similar but more restrictive certificate limiting it to a single pilot allowing it to only complete one flight at a time. The FAA guidelines to inform how UAVs will operate in US airspace are anticipated in 2021.

The ascent of “The Airborne Pharmacy” is an inflection point in the delivery of medications to consumers and provides an aerial glimpse of its mainstream future. When imagining that future, the sky’s the limit for real-world, everyday life applications of drone-centric technology. What originated as a part of military infrastructure can now change how life-saving medications reach patients at home or in the inpatient and outpatient settings. “Drone-to-Door” not only has the potential to reshape how medications are delivered but also to transform the consumer experience by providing convenience in an on-demand healthcare economy.

People from all walks of life drink to cope with stress from work. While the rate of alcohol abuse varies by industry and occupation, no workplace is immune. In the short term, drinking can result in feelings of relaxation, but ongoing reliance on alcohol to manage stress often leads to physical and psychological problems.

Prevalence of Binge Drinking

According to the 2017 National Survey on Drug Use and Health (NSDUH), 26.4 percent of people ages 18 and older reported that they engaged in binge drinking in the past month, and 6.7 percent reported heavy alcohol use in the past month. Binge drinking is defined as having 5 or more drinks within 2 hours for men, and 4 or more drinks within 2 hours for women. Heavy alcohol use is defined as binge drinking on 5 or more days in the past month, or 60 days a year.

Binge drinking has been on the rise over the past twelve years, particularly in women ages 30 to 44. While most excessive drinkers don’t meet the clinical criteria for alcohol dependence, binge or heavy drinking can still take a toll on workplace productivity, health, and relationships.

A Paradoxical Effect

Using alcohol to relieve stress and anxiety can have a paradoxical effect. Drinking may provide temporary feelings of relaxation, but habitual use alters the balance of chemicals in the brain that regulate mood. Alcohol can contribute to and worsen symptoms of depression, anxiety and other mental health disorders, and it can interfere with sleep. It becomes a vicious cycle: the person drinks in response to stress, feels worse later on, and turns to alcohol again to avoid dealing with painful feelings instead of learning healthy coping skills.

Drinking to self-medicate can also have serious health consequences. Heavy drinking is linked to higher risk of developing an alcohol use disorder or alcohol addiction, characterized by tolerance, withdrawal symptoms, strong cravings and an inability to cut down on drinking. Other medical conditions associated with excessive drinking include heart and liver disease, stroke, high blood pressure and cancer. Long-term alcohol use can also cause neurological problems such as cognitive deficits and dementia.

Impact on Employers

Most people who drink excessively or have an alcohol use disorder are employed, and many try to hide the problem. Nevertheless, U.S. companies lose billions of dollars a year due to lost productivity, workplace accidents and injuries, absenteeism, and illness related to employees’ alcohol and drug use.¹

An Employee Assistance Program is a valuable resource for employers. EAPs are designed to address work-related stress, substance use, mental health issues and other problems that negatively impact employees’ well-being and job performance. Besides offering confidential counseling and referral services for employees, EAPs can provide a range of health promotion activities and help for supervisors dealing with troubled employees.

¹”National Drug-Free Workplace Alliance.” National Drug-Free Workplace Alliance, https://www.ndwa.org/drug-free-workplace/industry-statistics/.

It’s officially the holiday season—bring on the parties, travel, end-of-year work activities, and squeezing in quality time with loved ones! This year, remember to make time to take care of yourself and start 2020 off with your healthiest, most vibrant YOU. Here are our top three holiday health hacks:

Be mindful of your alcohol intake.

Avoiding triggers can be challenging this time of year. Dr. Caroline Carney, chief medical officer of Magellan Rx, was quoted in a helpful Huffington Post article that offers 14 useful tips for navigating the holidays when you’re not drinking.

Be mindful of your plate.

The celebration over food and eating during the holidays can be tough…but it doesn’t have to be! With a little planning and preparation, you can make healthy choices. Check out these 10 easy tips to for managing your diet this holiday season.

Be mindful.

Close your eyes, take a deep breath through your nose, and exhale slowly through your mouth. It will do wonders when you’re sitting in all that holiday traffic.

Wishing you and yours a happy and healthy holiday!

The following is an excerpt from the 2018 Magellan Community Impact Report.

Standing tall is a tall order. How do  you know what the right thing is? Answers aren’t often cut and dried. Instead, we know by having lived through similar, difficult experiences ourselves and standing beside those we support—standing together as peers on the path to recovery.

Living through the same kinds  of challenges

Magellan’s recovery support navigators represent our best practice approach to tapping the power and potential of peer support. Peer support is an evidence-based practice, and numerous studies continue to validate the effectiveness of these supports. Recovery support navigators are professionals who have lived experiences with some of the same challenges our members face. They have experienced substance use disorders or psychiatric disabilities and may have personally been homeless, had their utilities turned off or experienced food insecurity. They can relate to the members they support, empathize, and then draw on real-world solutions to help them.

Sharing our stories

Every day recovery support navigators show up and not only listen to and support our members, but also share pieces of their own stories to inspire hope and change. Dana Foglesong, director of recovery and resiliency services for Magellan Complete Care of Florida, knows first-hand the transformative power a peer specialist can have. She knows not just because she has been certified as a peer recovery specialist since 2010, but because Dana had the support of a peer support specialist herself.

Dana describes her journey: “In my late teens and early twenties, I bounced from state hospitals to crisis stabilization units. I was desperate to end my life. I had no hope that my former goals could ever be realized. When I started working with a peer specialist, I began to view myself and my future more positively. My peer specialist expected me to recover and connected me to the resources that empowered my recovery process.”

Dana not only recovered—she has thrived! She recently completed a master’s degree in social work and leads Magellan’s diverse team of recovery support navigators. She has been awarded for her commitment to providing help and hope to others, including for her work founding the Peer Support Coalition in Florida, which expands leadership, advocacy and employment opportunities for people, like her, with lived experience. Dana describes her life now, saying: “At Magellan, I have the opportunity to do such meaningful, passion-filled work. It keeps me inspired and grateful to be a part of helping our members lead healthy, vibrant lives.”

Leading the way

Magellan was the first managed care company in the United States to recognize and incorporate peer support services into the continuum of care. Since 1999, we have been a leader in increasing access to peer support through partnerships with the recovery community and providers. We have assisted state customers in developing robust certified peer specialist capabilities, driven in large part by our depth and breadth of experience. Magellan continues to create shared learning opportunities for the peer workforce and others to improve and enhance the knowledge, skills, and competencies of the peer workforce.

The following is an excerpt from the 2018 Magellan Community Impact Report.

It is estimated that 130 Americans die every day from an opioid overdose. The opioid epidemic has become a national crisis and is continuing to grow rapidly, affecting families in every city across our nation.

No one is exempt from experiencing the effects of the opioid crisis. Magellan’s own Janet Edwards, RN, senior clinical director of Magellan’s Chronic Pain Management program, describes how close to home the opioid epidemic hit her:
It is estimated that 130 Americans die every day from an opioid overdose. The opioid epidemic has become a national crisis and is continuing to grow rapidly, affecting families in every city across our nation.

“My daughter, Nikki, was 26 when she  died of a Fentanyl overdose. As the mother of a six-year-old and a critical care nurse working in a respected healthcare organization, Nikki was the picture of success. But to handle the pressures of nursing school, a full-time job, and life as a single mother, Nikki sought prescriptions for Adderall and Xanax from multiple physicians. Over time, her addiction to these substances gave way to a new addiction: Fentanyl, which she began to confiscate from the critical care unit where she worked.
Like many others, Nikki didn’t show any signs of addiction. But five years after her son was born, Nikki sat at my kitchen table and admitted that she was addicted to heroin. She was afraid to get help, because she did not want to lose her job or the respect of her peers. She insisted she could recover on her own. Even though I, as a nurse, knew the odds were not good that Nikki could manage her recovery alone, I respected my daughter’s wishes. It’s a decision I will forever regret. Eleven months later, Nikki died of an accidental overdose in front of her son and a friend.”

Following the loss of her daughter, Janet has openly shared Nikki’s story, becoming an advocate for helping prevent opioid addiction. Further, Janet has taken on clinical leadership of Magellan’s Chronic Pain program, which offers alternatives to opioid use.

Meeting opioid users where they are

No matter where or how someone encounters opioids or where they may be in the cycle of use, dependence or addiction, Magellan offers many other ways to address the opioid problem. Our behavioral health products forged from decades of serving the public, our specialty healthcare solutions supported by clinical excellence, and our customized pharmacy programs are ready to answer the call as organizations and individuals look for answers.
Hosting a forum for sharing successes  and discussing solutions

In September 2018, Magellan brought together  national and local leaders in Pennsylvania to  exchange ideas, share successes and  discuss solutions to the opioid  epidemic in our communities.  The free, second-annual  conference featured  keynote addresses and  workshops and highlighted  the proactive efforts of local  organizations. Participants included  national and state officials, county human  services and drug and alcohol leaders, legislative  staff, providers and community stakeholders.

Not staying silent on the silent epidemic

Magellan is actively helping individuals and families on their path to recovery. Further, to educate the public, doctors and other healthcare providers, we offer resources on our Magellan Health OPIOID INSIGHTS microsite. The site includes links to blog posts, videos, resources and published articles.

Hosting a forum for sharing successes and discussing solutions

InSeptember2018, Magellan brought together national and local leaders in Pennsylvania to exchange ideas, share successes and discuss solutions around the challenge we face together in addressing the opioid epidemic in our communities. The second-annual conference featured keynote addresses and workshops and highlighted the proactive efforts of local organizations. Participants at the free one-and-a-half-day conference included national and state officials, county human services and drug and alcohol leaders, legislative staff, providers and community stakeholders.

While there have been significant drug shortages in the past as a result of unforeseen circumstances, such as Hurricane Maria’s effect on Puerto Rico’s drug manufacturing facilities in 2017, drug shortages often crop up and continue despite no obvious reason. The ongoing shortage of vincristine, an older, traditional chemotherapy agent used for several cancers, has compelled tough decisions by providers and families. In some cases, there are few other treatment options for patients or the treatment regimen is incomplete without vincristine. Other shortages, including those for heparin, critical antimicrobials, and immunoglobulin, have also made national news. The United States (US) Food and Drug Administration (FDA) monitors and reports drug shortages and has historically worked with manufacturers and public health partners to mitigate the impact of shortages. For instance, during Hurricane Maria, the FDA allowed temporary importation of certain products from select manufacturers and worked to expedite reviews of drug applications that could alleviate shortages of affected medications. According to the FDA, the biggest causes for drug shortages are quality or manufacturing issues (37%), lack of raw materials (27%), and manufacturing delays and capacity concerns (27%).

Due to the ongoing issues associated with drug shortages and prompting from a bipartisan Congressional group in June 2018, the FDA developed an interagency Drug Shortages Task Force. This group was tasked with studying shortages, determining their root causes, and developing strategies to limit the occurrence and widespread effect of drug shortages. The Task Force evaluated products that were affected by a shortage between 2013 and 2017 and solicited public and key stakeholder feedback. In late October 2019, the FDA issued a press release announcing the publication of a report from the Task Force entitled, “Drug Shortages: Root Causes and Potential Solutions.” Notably, the Task Force confirmed that drug shortages not only persist but also have continued to rise again recently since falling from their peak in 2011. As an example of their impact, the group highlighted select medications whose shortages have had a significant clinical impact (e.g., pediatric oncology medications, medications for septic shock). Of the 163 drugs in shortage they analyzed, 63% were sterile injectables and 67% were products available as a generic. The median time since first approval was nearly 35 years and most were considered relatively “cheap,” as they were several years off-patent (median price of $2.27/unit for oral drugs and $11.05 for injectables).

The Task Force identified 3 root causes associated with drug shortages: (1) lack of incentives for manufacturing less profitable drugs; (2) lack of recognition and incentives for mature quality and production management, as well as production contingency plans; and (3) logistical and regulatory hurdles that limit production responsiveness. Moreover, the Task Force proposed solutions to alleviate the impact of drug shortages. The first recommendation is to create a shared understanding of the impact of drug shortages, including quantifying costs, frequency, persistence, and intensity, as well as improving transparency of contracted price and stipulations. The group also recommends the development of a rating system to incentivize a manufacturer’s investment in maturing quality management, beyond the minimum threshold of Current Good Manufacturing Practices (CGMPs), to improve voluntary transparency. Finally, the group recommends the promotion of sustainable private sector contracts. This recommendation would involve providing incentives for manufacturers that would mitigate the financial risk of introducing or keeping products on the market, in addition to quality-based manufacturing financial incentives. The Task Force further identified legislative proposals that could limit product availability interruptions (including improved data sharing), risk assessment to identify vulnerabilities, and additional expiration date/shelf-life data. Likewise, the Task Force also stated that the FDA plans to publish guidance for the industry. These would be regarding FDA notification of permanent or temporary manufacturing of a product and risk management plans to prevent and limit shortages.

In addition, other legislation has been proposed, such as the Mitigating Emergency Drug Shortages (MEDS) Act, introduced to legislation by Senator Susan Collins (R-ME) and Senator Tina Smith (D-MN). According to Collin’s office, shortages can add approximately $230 million in drug costs and $216 million in labor costs annually in the US. Key priorities of the Act include strengthening transparency to disclose causes, expected impact, and estimated durations of shortages; extending reporting requirements to include active ingredients (not only the finished product); requiring contingency and redundancy plans for critical medications; and incentivizing manufacturing of products in shortage. Furthermore, the proposed legislation would require the Department of Health and Human Services (DHHS) and Department of Homeland Security (DHS) to conduct a risk assessment associated with shortages of critical drugs that could affect national security. So far, the MEDS Act has support from several healthcare organizations, including the American Pharmacist’s Association (APhA), American Society of Health-System Pharmacists (ASHP), American Society of Clinical Oncology (ASCO), and the American Hospital Association (AHA).

In the meantime, drug shortages continue to creep into national news. While a lack of drug accessibility is often linked to cost, drug shortages are a reminder that cost is not the only roadblock to treatment. Despite the innovation of the US healthcare system, and the novel drug and biologic discoveries that have dramatically altered care, some Americans, because of a variety of factors and causes, still find themselves scrambling to obtain routine or essential medications.

The Drug Shortages Task Force’s report may be found here: https://www.fda.gov/media/131130/download.

As an Adolescent Support and Counseling (ASACS) Counselor, it has always been a passion of mine to provide counseling and prevention serves to teens and their families. I’ve been very fortunate to fulfill that calling and having a platform to make an impact at Daegu Middle High School in Daegu, South Korea.

In supporting and working with the Daegu students, I developed a year-round leadership club called the Role Model Club. The goal of this club is to develop middle and high school students so they serve as peer leaders for younger students in elementary school.

All Role Model Club candidates are selected by their teachers and are interviewed for entry into the Club.  Once selected, students participate in several field trips, planned by ASACS, to the elementary school and school-age services for Red Ribbon Week (an awareness week that raises awareness on the importance of a drug-free, healthy youth) and Military Children’s Month. The club members also assist fifth graders as they being their transition into sixth grade.

Role Model Club members also participate in the planning and facilitating of various campaigns and serve as a positive advocate for youth in the community. Role models learn to act as ambassadors through positively influencing their peers and learn important skills to engage and connect with peers that are graduating to the next grade level. 

Through weekly meetings, students create educational skits to promote healthy decision-making skills. We focus on a variety of topics such as: drug refusal, fire and bullying prevention, developing interpersonal skills, technology management, positive body image and many others.

Throughout the school year, I actively engage with parents of Role Model Club students, making sure they are informed of activities, fieldtrips, contests, and various campaigns that students plan and implement throughout the school year and summer months.

The positive feedback that this program has received from both students and their parents truly reaffirms my belief that the Role Model Club is a unique and enriching experience for teens to learn leadership skills that will last a lifetime.

About Jasmin Coty

Ms. Jasmin Coty has been an ASACS Counselor since December 1989 helping military and civilian families throughout Germany for over 20 years and in the last five years assisting teen and their families at Daegu MHS in Daegu, South Korea.