Feeling like death is near

SAMHSA’s National Helpline | SAMHSA

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  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

  • Suggested Resources

    What Is Substance Abuse Treatment? A Booklet for Families
    Created for family members of people with alcohol abuse or drug abuse problems. Answers questions about substance abuse, its symptoms, different types of treatment, and recovery. Addresses concerns of children of parents with substance use/abuse problems.

    It's Not Your Fault (NACoA) (PDF | 12 KB)
    Assures teens with parents who abuse alcohol or drugs that, "It's not your fault!" and that they are not alone. Encourages teens to seek emotional support from other adults, school counselors, and youth support groups such as Alateen, and provides a resource list.

    After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
    Aids family members in coping with the aftermath of a relative's suicide attempt. Describes the emergency department treatment process, lists questions to ask about follow-up treatment, and describes how to reduce risk and ensure safety at home.

    Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction
    Explores the role of family therapy in recovery from mental illness or substance abuse. Explains how family therapy sessions are run and who conducts them, describes a typical session, and provides information on its effectiveness in recovery.

    For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

SAMHSA Behavioral Health Treatment Services Locator


Welcome to the Behavioral Health Treatment Services Locator, a confidential and anonymous source of information for persons seeking treatment facilities in the United States or U.S. Territories for substance use/addiction and/or mental health problems.

PLEASE NOTE: Your personal information and the search criteria you enter into the Locator is secure and anonymous. SAMHSA does not collect or maintain any information you provide.

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The Locator is authorized by the 21st Century Cures Act (Public Law 114-255, Section 9006; 42 U.S.C. 290bb-36d). SAMHSA endeavors to keep the Locator current. All information in the Locator is updated annually from facility responses to SAMHSA’s National Substance Use and Mental Health Services Survey (N-SUMHSS). New facilities that have completed an abbreviated survey and met all the qualifications are added monthly. Updates to facility names, addresses, telephone numbers, and services are made weekly for facilities informing SAMHSA of changes. Facilities may request additions or changes to their information by sending an e-mail to [email protected], by calling the BHSIS Project Office at 1-833-888-1553 (Mon-Fri 8-6 ET), or by electronic form submission using the Locator online application form (intended for additions of new facilities).

Ten signs that death is near

None of us can predict exactly when death will come. However, doctors and nurses who deal with the critically ill know that the approach of death is accompanied by certain symptoms.

The signs of impending death vary from person to person, and not all of the symptoms listed below are "mandatory". But there is still something in common.

1. Loss of appetite

The body's need for energy is getting smaller. A person may begin to resist eating and drinking, or eating only certain foods (for example, cereals). First of all, a dying person refuses meat, since it is difficult for a weakened body to digest it. And then the most favorite foods no longer cause any appetite. At the end of a patient's life, it happens that even physically he is not able to swallow what is in his mouth. nine0003

You cannot force-feed a dying person, no matter how much you worry about him not eating. You can periodically offer the patient some water, ice or ice cream. And so that his lips do not dry out, moisten them with a damp cloth or moisturize with lip balm.

2. Excessive fatigue and drowsiness

On the verge of death, a person begins to sleep atypically a lot, and it becomes more and more difficult to wake him up. Metabolism slows down, and insufficient intake of food and water contributes to dehydration of the body, which turns on a protective mechanism and hibernates. This patient should not be denied - let him sleep. Don't push him to wake him up. What you will say to a person in this state, he may well hear and remember, no matter how deep the dream may seem. In the end, even in a coma, patients hear and realize those words that are addressed to them. nine0003

3. Physical weakness

Due to loss of appetite and resulting lack of energy, the dying person cannot do even the simplest things - for example, he cannot turn over on his side, raise his head or draw juice through a straw. All you can do is try to make him as comfortable as possible.

4. Blurred consciousness and disorientation

Organs begin to fail, including the brain. A person may no longer understand where he is and who is next to him, start talking nonsense or thrashing about in bed. At the same time, you need to remain calm. Every time you approach a dying person, you should call yourself by name and speak to him as gently as possible. nine0003

5. Difficulty breathing

The breathing of the dying becomes irregular and irregular. Often they have the so-called Cheyne-Stokes breathing: superficial and rare respiratory movements gradually become deeper and longer, weaken and slow down again, then a pause follows, after which the cycle repeats. Sometimes the dying person wheezes or breathes louder than usual. You can help in such a situation by raising his head, putting an extra pillow or seating him in a reclining position so that the person does not fall on his side. nine0003

6. Self-isolation

As the vitality fades away, a person loses interest in what is happening around. He may stop talking, answer questions, or simply turn away from everyone. This is a natural part of the dying process, not your fault. Show the dying person that you are there by simply touching him or taking his hand in yours if he does not mind, and talk to him, even if this conversation is your monologue.

7. Violation of urination

Since there is little water in the body, and the kidneys work less and less, the dying person "walks small" really little, and concentrated urine has a brownish or reddish tint. That is why in hospices in the last days of life the terminally ill often put a catheter. Due to kidney failure, the amount of toxins in the blood increases, which contributes to the quiet flow of the dying into a coma and a peaceful death.

8. Swelling of the legs

When the kidneys fail, bodily fluids accumulate in the body, most often in the legs, instead of being expelled. Because of this, before death, many swell. Nothing can be done here, and it makes no sense: swelling is a side effect of approaching death, and not its cause. nine0003

9. "Icing" of the tips of the fingers and toes

A few hours or even minutes before death, blood drains from the peripheral organs to support the vital ones. For this reason, the limbs become noticeably colder than the rest of the body, and the nails may become pale or bluish. A warm blanket will help to provide comfort to the dying person, which needs to cover him more freely so as not to create a feeling of swaddling.

10. Venous spots

On pale skin, a characteristic "pattern" of purple, reddish or bluish spots appears - the result of poor circulation and uneven filling of the veins with blood. These spots usually appear first on the soles and feet.

Natalya Sinitsa

Material published on the resource www.medpulse.ru

Signs of approaching death named08-1952,

showed : every centimeter of height lost by women was associated with a 15% increase in the risk of death from any cause, and those who lost more than 2 cm of height had a 74% increase in the risk of death.

Changes in height correlated most strongly with risk of death from cardiovascular disease and stroke.

“There are some processes that lead to loss of height in women and also increase the risk of premature death,” the researchers concluded. “If we can find out what causes height loss, then by eliminating this cause, it will be possible to improve the overall health of women and increase overall survival.” nine0003

Another recently discovered risk factor for premature death is miscarriage. As Harvard researchers found, women who experienced miscarriages were, on average, 19% more likely to die prematurely. The highest risks were observed in those who experienced multiple miscarriages and in those who experienced a miscarriage before the age of 24.

About a quarter of pregnant women experience miscarriages. Previously, it was already known that women who have experienced a miscarriage are more likely to suffer from cardiovascular diseases, high blood pressure, and type 2 diabetes. Of course, the miscarriage was not the cause of these problems—certain factors obviously contributed to both the miscarriages and the health problems. nine0003

For men, the reason to worry about approaching death may be impotence. According to experts from Nanchang University in China, men with erectile dysfunction are 59% more likely to suffer from coronary heart disease or atherosclerosis, 34% more from stroke, and they also have a 33% higher risk of death from all causes.

Most at risk are men over 55 who have diabetes or smoke.

Potency problems are an important signal of possible problems with the cardiovascular system. Small vessels are the first to suffer, so a timely visit to a doctor will allow timely identification and inhibition of the developing pathology. Potency can also be affected by stress or alcohol consumption - which, however, also does not add health. nine0003

Flesh and blood

Risk of imminent death may be indicated by too fast heart rate - if in middle age it exceeds 75 beats per minute, the probability of early death from all causes is twice as high compared to those with a heart rate of 55 beats per minute and below. Although a pulse of up to 90 beats per minute is considered normal, its high frequency can be a sign of cardiovascular disease, the main cause of death in middle and old age. In addition, a high heart rate in itself overloads the heart, contributing to the development of pathologies. nine0003

Also, a fast heart rate may indicate increased susceptibility to stress, which increases the risk of developing obesity and associated diseases such as diabetes.

A person's death within the next five years can be predicted by analyzing blood . Finnish scientists have identified four biomarkers, the increased content of which indicates imminent death - albumin protein, alpha-1-acid glycoprotein, citrates (salts of citric acid) and particle size of very low density lipoproteins. As observations of 17,000 initially healthy people showed, an increase in these indicators correlates with a high probability of death from cancer, cardiovascular diseases and other diseases. However, what exactly will cause death, the analysis will not show. nine0003

Another way to estimate the risk of death over the next 10 years by blood was devised by researchers from the Institute for the Biology of Aging of the Max Planck Society.

They identified 14 biomarkers reliably associated with death, indicative of lipoprotein and fatty acid metabolism, glycolysis, fluid balance and inflammation.

Abnormalities in glucose and cholesterol levels have been used before and are associated with diabetes, heart disease and cancer. Glycoprotein acetyls and polyunsaturated fatty acids indicated inflammatory processes, albumin protein reported kidney and liver problems. nine0003

AI counted you

Perhaps in the future, neural networks will predict the approximate date of death. The prerequisites for this are already there. In 2018, Google demonstrated how AI can predict the likelihood of a patient dying with 95% accuracy.

The creators of the neural network trained it on the data of 215 thousand patients, using information about age, gender, race, medical history, as well as individual notes of doctors - more than 46 million facts in total. nine0003

The neural network was able to predict the duration of a patient's stay in the hospital with an accuracy of 86%, the probability of death - in 95%, and the probability of returning to the hospital after discharge - in 77%.

There are also simpler methods, such as "death calculators" that estimate life expectancy by comparing user-entered data with information about the risks associated with them.

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