21st Century Scourge

The CDC recently put out apaperin their Morbidity and Mortality Weekly Report (MMWR) that studied the likelihood of long term opiate use after initial treatment with an opioid medication for acute pain. The results, for me as a regular prescriber of opioid medications, were fairly shocking. The study randomly reviewed 10% of patient records from the Lifelink database over the time period of 2006-2015. If a patient was given a prescription for an opioid for longer than 10 days, there was a 1 in 5 chance that patient would be a regular opiate user one year later. That's just staggering.Few are unaware of the opioid epidemic sweeping through America. In 2015, 52,000 Americans died from opioid overdoses. That's more than the number of Americans who died during the peak of the AIDS epidemic. And this scourge has been particularly problematic in predominantly rural, working class areas. The mortality rate for white, middle aged Americans without a college degree has gone up a half a percent every year from 1999-2015. This precipitous drop in life expectancy amongst a demographic cohort is unprecedented in an advanced western democracy--- the only comparable decline was seen in Russian males in the immediate aftermath of the fall of the Soviet Union.  Many epidemiologists attribute much of the startling rise in death rates of white middle aged Americans to opiate overdoses. But it's far more complex than a simple x=y formulation...
Source: Buckeye Surgeon - Category: Surgery Authors: Source Type: blogs

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Conclusions and Relevance: Because there are 74.0 million children 0 to 17 years old in the United States, the projected numbers of severe cases could overextend available pediatric hospital care resources under several moderate CPIP scenarios for 2020 despite lower severity of COVID-19 in children than in adults.
Source: Journal of Public Health Management and Practice - Category: Health Management Tags: Research Reports: Research Full Report Source Type: research
Conclusions: The SF-6Dv2 classification system describes more distinct levels of health than SF-6D, changes the descriptions used for a number of dimensions and provides clearer wording for health state valuation. The second stage of the study has developed a utility value set using discrete choice methods so that the measure can be used in health technology assessment. Further work should investigate the psychometric characteristics of the new instrument.
Source: Medical Care - Category: Health Management Tags: Original Articles Source Type: research
Conclusions: We developed and applied a protocol to value the SF-6Dv2 using DCE. The results provide a provisional value set for use in resource allocation. The protocol can be applied internationally. Further work should investigate how to account for preference heterogeneity in value set production.
Source: Medical Care - Category: Health Management Tags: Original Articles Source Type: research
Publication date: Available online 27 May 2020Source: Urology Case ReportsAuthor(s): Ye Ji Lee, Ji Hyeong Yu, Jae Yoon Kim, Woo Yong Lee, Yun Hee Lim
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
I didn’t vote for you. You see, I was born with a brain injury. Doctors at Children’s Hospital in Boston told my parents I would never be able to walk normally. Young children are mean. As a young boy, insults, and laughs became a daily ritual. When I walked into a classroom, a restaurant, or down a street, people didn’t look into my eyes. They always looked down as I limped awkwardly along. But I overcame and became a varsity athlete at a prep school outside of Boston. As a teenager, I grew strong, and anybody that made fun of my limp or my awkward gate became irrelevant. Frankly, Mr. President, the day ...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
The Unites States of America is facing the worst health care crisis of our nation’s history. Over the past two-year period, more Americans died of opiate addiction than died in the entire Vietnam War. Drug overdoses now cause more deaths than gun violence and car crashes. In fact, accidental opioid overdoses are responsible for more deaths in 2015 than HIV/AIDS did at the height of the epidemic in 1995. However, the AIDS epidemic can be the blueprint for the United States approach to the opioid epidemic. Once America became mobilized against AIDS, Congress orchestrated intensive efforts devoted to training and ...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
Mr. President, what in God’s name are you doing? Your Attorney General, Jeff Sessions, has turned the clock back in our country almost 35 years. Our nation’s heroin epidemic is a health crisis and will never be solved with a lock-’em-up-and-throw-away-the-key solution. Despite all intelligent research leading to a mandate conclusion that incarceration will not ever diminish drug addiction and the radical negative effects it has on our economy, “My Favorite Martian,” Jeff Sessions, has just ordered federal prosecutors to chase far harsher sentences against drug-addict-criminals. Mr. Trump, who ...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
Check your mailbox over the next two weeks —there should be a letter from U.S. Surgeon General Vivek H. Murthy, MD, calling on all physicians throughout the nation to raise awareness and further efforts to end the opioid overdose epidemic. Physicians are in a unique position of leadership when it comes to this epidemic —they are on the front lines witnessing the impact every day from emergency department overdoses to substance use disorder treatment. The letter asks directly for physicians’ help to solve and bring an end to the opioid overdose epidemic.“We will educate ourselves to treat pain safel...
Source: AMA Wire - Category: Journals (General) Authors: Source Type: news
Conclusion Evaluating the potential harms of a commonly used drug—especially a complex substance like marijuana—is a challenging but vital task. Fully informed awareness of both the potential and proven benefits and the potential and proven harms of marijuana are necessary in order to have rational discussions with patients, teens, and decision makers regarding marijuana use. Based on a review of the current literature, we suggest the mnemonic DDUMB (dependence, driving, underachievement, mental illness, and “bad to worse”) as a tool that captures several of the more well-supported, brain-based risk...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Behavioral and Cognitive Neurology Child Adol Mental Disorders Cognition Current Issue Medical Issues Neurologic Systems and Symptoms Psychiatry Psychopharmacology Review Substance Use Disorders Cannabis dependence drug-related har Source Type: research
During a recent campaign stop, presidential candidate Hillary Clinton promised to make the "quiet epidemic" involving heroin and prescription opioids an important part of her presidential campaign -- and, presumably, of her presidency, should she be elected. She mentioned the issue of substance misuse again in her highly publicized speech on criminal justice reform last week. As someone intimately familiar with the devastating impact of this public health crisis on individuals, families and communities, I was very pleased to hear this, and thought of several ways she could make good on her pledge. Here are fi...
Source: Science - The Huffington Post - Category: Science Source Type: news
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