Here ’s what you learn when a young patient dies
“This is a 17-year-old boy who came in as a category 1 trauma yesterday for a rollover MVC with bilateral uncal herniation, epidural hematoma and subdural hematoma currently intubated and sedated with propofol and fentanyl.”
As the overnight resident presented this patient on PICU, we could see everyone’s early morning smiles fading slowly and beginning to understand the grave consequences anticipated in this severe traumatic brain injury. We could see the wheels churning in the doctors’ brains, emotions churning in parents’ minds and tears turning in the rest of the family. The family understood how severe this ...
Source: Kevin, M.D. - Medical Weblog - January 4, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/shubham-bakshi" rel="tag" > Shubham Bakshi, MD < /a > Tags: Physician Critical Care Pediatrics Source Type: blogs
Narcan or Narcan’t?
Part 2 in a Four-part SeriesA 57-year-old man presented with acute onset altered mental status. His family said he had been behaving normally. Prior to dinner, however, he became difficult to arouse, and was speaking gibberish. He was somnolent but arousable to physical stimuli on arrival in the ED.He answered questions inappropriately and would then go back to sleep. His past medical history was consistent with hypertension, hypercholesterolemia, and spinal fusion a month ago. His medications included lisinopril, atorvastatin, and hydrocodone. His vital signs were a blood pressure of 110/65 mm Hg, heart rate of 90 b...
Source: The Tox Cave - January 2, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The Political Economy of Fentanyl
By KAREN SIBERT, MD
Just say No to Fentanyl.
No, I’m not talking about putting fentanyl into my own veins — a remarkably bad idea. I’m questioning the habitual, reflex use of fentanyl, a synthetic opioid, in clinical anesthesiology practice.
I’ve been teaching clinical anesthesiology, supervising residents and medical students, in the operating rooms of academic hospitals for the past 18 years. Anesthesiology residents often ask if I “like” fentanyl, wanting to know if we’ll plan to use it in an upcoming case. My response always is, “I don’t have emotional relationships with drugs. They are tools in our ...
Source: The Health Care Blog - January 2, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
PhRMA Releases New Policy Proposals
On December 11, 2017, the Pharmaceutical Research and Manufacturers of America (PhRMA) issued statements of support for several policy proposals focused on resolving the opioid crisis. The proposals included: limits on prescribing, a ban on prescribing of Schedule II opioids in an office setting, ongoing prescriber training, and expanded access to addiction treatment options.
Along with the policy proposals came an announcement that PhRMA and the Addiction Policy Forum have entered into a multi-year, multi-million dollar initiative to combat the opioid crisis and implement the Forum's plan to help solve the opioid crisis....
Source: Policy and Medicine - December 21, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Senate Appropriations Committee Takes on the Opioid Epidemic
On December 5, 2017, the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies held a hearing to discuss the opioid epidemic and the possible role that Congress could play in the prevention, treatment, and recovery.
Senator Roy Blunt, the Subcommittee Chairman, opened the hearing by discussing the fact that overdose related deaths outnumber the deaths at the peak of the AIDS/HIV epidemic. Overdose deaths have also overtaken automobile accident fatalities to become the number one cause of accidental death in the United States. Senator Blunt also spoke about the three propos...
Source: Policy and Medicine - December 12, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Congress Taking New Approach to Opioid Epidemic
Recently, Representative Bob Latta introduced a bill into the United States House of Representatives. The bill, known as the Indexing Narcotics, Fentanyl and Opioids (INFO) Act, is intended to help create a public electronic database of information and strategies to combat the opioid crisis. The information in the database would be used to help federal, state, and local officials develop the most effective strategies to prevent addiction, treat those that are addicted, and keep prescription drugs from falling into the wrong hands. The INFO Act would also track federal funding being used to combat the epidemic.
The bill re...
Source: Policy and Medicine - December 7, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
It Looks Like The Opioid Epidemic Is Staring To Really Hit Here In Australia.
This week Radio National has run two programs on our increasing problem with opioid over and mis-use.First we have this:Are doctor-shoppers really at the heart of our opioid crisis?Download audioTuesday 21 November 2017 5:30PM Around 600 Australians die each year from prescription drug overdoses, and the figure rises each year. When it comes to prescription opioid overdoses, they involve members of the community we might never normally associate with addiction.To tackle the epidemic, Australia is to introduce Real Time Prescription Monitoring next year, but is it enough?If this program raises any issues for you or anyone c...
Source: Australian Health Information Technology - November 30, 2017 Category: Information Technology Authors: Dr David More MB PhD FACHI Source Type: blogs
Explaining the Opioid Epidemic
The standard explanation for the opioid epidemic blames pharmaceutical companies and doctors for overstating the benefits and understating the risks of prescription opioids. See thisessay by Robert Verbruggen, the deputy managing editor ofNational Review.An alternative explanation is that opioids – like many substances – are dangerous mainly when heavily restricted or outlawed; thus, increased prescribing over the past several decades has generated overdoses by forcing more people into the black market, where they consume heroin of unknown purity that is sometimes laced with fentanyl. See my comment on Verbrugg...
Source: Cato-at-liberty - November 15, 2017 Category: American Health Authors: Jeffrey Miron Source Type: blogs
Senators Blumenthal and Grassley Ask CMS to Continue Funding Open Payments
In a letter to Acting Secretary of the U.S. Department of Health and Human Services (HHS) Eric D. Hargan, United States Senators Richard Blumenthal (D-CT) and Chuck Grassley (R-IA) ask HHS to prioritize funding for the Center for Medicare and Medicaid Services’ Center for Program Integrity (CPI), a program that enhances transparency in transactions between medical providers and pharmaceutical companies.
The CPI’s Open Payments database, created under the bipartisan Physician Payments Sunshine Act, mandates disclosure of billions of dollars in payments from manufacturers to prescribers and hospitals. This is of concern...
Source: Policy and Medicine - November 9, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
The Modern-Day Plague
Part 1 in a Four-part SeriesA 32-year-old man was taken to the ED by EMS after being found unresponsive in a subway station. His pupils were pinpoint, and he was breathing at fourth breaths per minute. He had a blood pressure of 94/63 mm Hg, pulse oximetry of 91% on room air, and a heart rate of 51 beats per minute. He was given 2 mg of intranasal Narcan by EMS and became more responsive, breathing at 14 breaths per minute with a blood pressure of 125/82 mm Hg, heart rate of 74 bpm, and 98% on room air. He admitted in the ED to using three bags of heroin.The opioid epidemic is a national public health crisis in the U...
Source: The Tox Cave - November 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Reducing Opioid Abuse, A Quick Guide to Internet Resources
By DAVID HARLOW, MD
The opioid crisis has been upon us for years now, and we are now seeing the problem become more pervasive, with more than 90 deaths per day in the U.S. due to this scourge. The president recently said he would be declaring a public health emergency (which would free up some funds) but has not done so as of this writing. The public health threat is so persistent that it calls for responses on many levels, and those responses are coming. Some have been in place for a while, some are more recent. These responses may be broken down into a number of different categories:
Broader availability of naloxone (an...
Source: The Health Care Blog - November 1, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Charlie Baker Harlow Internet Massachussetts Opioid Opioid crisis Source Type: blogs
“You want to give addicts a safe, clean space to inject illegal drugs?”
Absolutely. Opioid overdose deaths have rocketed past motor vehicle accidents and gun violence as the leading cause of accidental death in the Unites States, claiming the lives of 52,000 Americans in 2015 and over 2,000 Baltimoreans in 2016. Fentanyl, 50-100 times stronger than heroin and cheap to produce, is making things worse. We have an
The post “You want to give addicts a safe, clean space to inject illegal drugs?” appeared first on Johns Hopkins Nursing Magazine. (Source: Nursing Blogs at Johns Hopkins University)
Source: Nursing Blogs at Johns Hopkins University - November 1, 2017 Category: Nursing Authors: Online Editor Tags: Nursing Ethics On the Pulse accidental death baltimore community Fentanyl hiv opioid Public health safe consumption spaces Source Type: blogs
Founder and Owner of Insys Arrested
Late last week, John N. Kapoor, the founder and majority owner of Insys Therapeutics, Inc., was arrested and charged with leading a conspiracy to profit by using bribes and fraud to cause the illegal distribution of a Fentanyl spray intended for cancer patients experiencing breakthrough pain.
The superseding indictment includes allegations of RICO conspiracy, conspiracy to commit mail and wire fraud, and conspiracy to violate the Anti-Kickback law. It also includes additional allegations against former Insys executives and managers who were initially indicted in December 2016.
The Justice Department claims that Kapoor an...
Source: Policy and Medicine - October 30, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
