Rhode Island Makes Harm Reduction History By Legalizing Safe Consumption Sites
Jeffrey A. SingerRhode Island made history yesterday, as it became the first state to legalize safe consumption sites. Governor Daniel McKeesigned a bill that will set up two pilot programs within the state dubbed “harm reduction centers,” both of which will receive no taxpayer funding but will be financed by private donations and foundations.In 2019 and 2020 I testified before the Maryland legislature which was consideringlegalizing safe consumption sites. Alas, that didn ’t happen.Safe consumption sites, also called safe injection sites, have been in existence since the mid ‐1980s, and now operate in...
Source: Cato-at-liberty - July 8, 2021 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
The Real Reason Fentanyl is So Dangerous
Fentanyl plays a role in more and more opioid overdose deaths. Most fentanyl used ‘on the streets’ starts in China, with precursors shipped to California or Mexico before distribution throughout the US. Fentanyl acts very potently at the same receptors as heroin, morphine, and oxycodone. Reports of overdose deaths caused by fentanyl usually blame potency, but the real reason for fentanyl’s outsized role in overdose is rarely mentioned – at least outside operating rooms.
Fentanyl is as ubiquitous in the medical industry as it is on the street, in 50 microgram per cc, sterile vials rather than the ...
Source: Suboxone Talk Zone - June 16, 2021 Category: Addiction Authors: admin Tags: Uncategorized Source Type: blogs
The complications of drug regulation
When the“opioid crisis” is mentioned, most people think of heroin, prescription pills like oxycodone, or — more recently — the powerful synthetic opioid fentanyl. Fewer people would think of novel opioids like tianeptine, although an increasing number of Americans have taken this substance in the form of over-the-counter supplements like ZaZaRed or Tianna–Read more …Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - May 19, 2021 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/julie-craig" rel="tag" > Julie Craig, MD < /a > < /span > Tags: Meds Medications Source Type: blogs
In Massachusetts, as Elsewhere, It ’s The Prohibition, Not The Prescriptions
Jeffrey A. SingerEarlier this month, the Massachusetts Department of Public Health releasedData Brief: Opioid ‐Related Overdose Deaths Among Massachusetts Residents. The report found that opioid ‐related overdose deaths remained essentially unchanged at roughly 2,000 per year since 2016. From 2001 thru 2010 the annual overdose rate was relatively stable and then began to accelerate in 2011. (Figure 1 and Figure 2 of the Data Brief).While the overdose rate was 1 percent less in 2019 than in 2016, and 1 percent greater in 2020 than in 2019, neither change was statistically significant.As with ot...
Source: Cato-at-liberty - May 16, 2021 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
PROP ’s Disproportionate Influence on U.S. Opioid Policy: The Harms of Intended Consequences
ConclusionDespite being turned back from an effort to bluntly reduce opioid prescribing by the FDA in 2013 based on a lack of scientific evidence for its position (17,18), PROP has had a disproportionate effect on opioid policy in the Untied States for almost a decade. PROP found a willing federal regulatory partner in the CDC, and while PROP may not have “secretly written” the 2016 CDC Pain Guidelines (75), they certainly enjoyed disproportionate representation on CDC’s review panels and Core Expert Group (23-25) in a process that lacked transparency (22, 23, 26, 27). When the CDC admitted that its Pain Guideline ha...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 3, 2021 Category: Palliative Care Tags: CDC health policy kollas opioids pain prop Source Type: blogs
PROP s Disproportionate Influence on U.S. Opioid Policy: The Harms of Intended Consequences
ConclusionDespite being turned back from an effort to bluntly reduce opioid prescribing by the FDA in 2013 based on a lack of scientific evidence for its position (17,18), PROP has had a disproportionate effect on opioid policy in the Untied States for almost a decade. PROP found a willing federal regulatory partner in the CDC, and while PROP may not have secretly written the 2016 CDC Pain Guidelines (75), they certainly enjoyed disproportionate representation on CDCs review panels and Core Expert Group (23-25) in a process that lacked transparency (22, 23, 26, 27). When the CDC admitted that its Pain Guideline had been...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 3, 2021 Category: Palliative Care Tags: CDC health policy kollas opioids pain prop Source Type: blogs
Australia Contained COVID-19 Early On. Can It Do the Same with Synthetic Opioids?
Australia is at risk of a fentanyl problem, but it is better prepared than North America. If the country can make the same kind of concerted effort it did to keep COVID-19 at bay, that could save thousands of lives. (Source: The RAND Blog)
Source: The RAND Blog - April 30, 2021 Category: Health Management Authors: Bryce Pardo; Shann Hulme; Jirka Taylor Source Type: blogs
Senators Portman, Whitehouse, and Klobuchar Think They Know Better Than The CDC About How To Treat Acute Pain
This study came one year after a largerstudy of more than 568,000 “opioid‐naïve” patients treated for acute postsurgical pain from 2008–2016 found a total “misuse” rate of 0.6 percent.The press report onCARA 2.0 issued by Senator Portman ’s office states the three‐day limit is recommended by the CDC in its 2016Guideline for Prescribing Opioids for Chronic Pain (recommendation number 6). But these guidelines were aimed at treatingchronic pain, and were based on what the CDC stipulated was very limited evidence. The CDC also emphasized the guidelines were meant to be suggestive, not prescript...
Source: Cato-at-liberty - February 16, 2021 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
More Evidence That Prescription Drug Monitoring Programs Might Increase Overdose Deaths
Jeffrey A. SingerAt a Cato Institutepolicy forum in October 2019, Columbia University public health researcher David Fink presented data showing that Prescription Drug Monitoring Programs (PDMPs), designed to surveil opioid prescribing by health care practitioners to their patients in pain, have no appreciable effect on the fatal or non ‐fatal opioid overdose rate, but may have the unintended consequence of increasing overdoses from heroin. I havecited his work, along with the work of others, that draw similar conclusions.Now researchers at Indiana University are providing even more evidence that PDMPs, alon...
Source: Cato-at-liberty - February 14, 2021 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Chest pain after motor vehicle collision with an abnormal ECG - blunt cardiac injury? OMI? normal variant?
Discussion:Significant cardiac trauma occurs in approximately 10% of patients with severe blunt chest trauma. Isolated coronary artery dissection from blunt trauma is a very rare event. Traumatic dissections are most often seen in the LAD, followed by the RCA and LCX. It is thought that this is due to the relative anterior position of the LAD. The ECG is a report from the myocytes of their condition. They do not know the etiology of acute complete ischemia. No matter if its typical ACS, traumatic dissection causing acute occlusion, or spasm, it is the same result to the myocytes, and the same findings can be present o...
Source: Dr. Smith's ECG Blog - December 30, 2020 Category: Cardiology Authors: Pendell Source Type: blogs
Going After Scapegoats Is Easier Than Confronting The Truth
Jeffrey A. SingerYesterday the Department of Justicefiled suit against the giant retailer Walmart, accusing it of fueling the opioid crisis by encouraging its pharmacists to fill prescriptions –legally written by health care practitioners licensed by the Drug Enforcement Administration–they should have suspected of being inappropriately prescribed.The Justice Department seems uninterested in the fact that there isno correlation between the number of opioid prescriptions and the non ‐medical use of prescription pain reliever or the development of opioid use disorder. And while the number of opio...
Source: Cato-at-liberty - December 23, 2020 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
It ’s Time to End Any Level of Federal Marijuana Prohibition
Trevor BurrusEither today or later this week, the House will likely take the historic step and actually hold a vote on whether to deschedule marijuana from the Controlled Substances Act (CSA). In addition, the Marijuana Opportunity Reinvestment and Expungement (MORE) Act would expunge low ‐level marijuana offenses and impose a 5 percent federal sales tax. The bill is unlikely to get past the Republican Senate, and there are many other proposals —some with the seeming support of President‐elect Biden—that wouldreschedule rather thandeschedule the plant. But descheduling —removing the drug from the ...
Source: Cato-at-liberty - December 2, 2020 Category: American Health Authors: Trevor Burrus Source Type: blogs
Drug Makers and Distributors Commandeered by Cops
Jeffrey A. SingerIn the latest episode of “Cops Practicing Medicine,” a floor vote is scheduled in the House of Representatives for H.R. 3878, sponsored by Rep. David McKinney, (R-WV). Under current law, drug makers and distributors are required to report to the Drug Enforcement Administration any suspicious orders for controlled substances. H.R. 3878 would also require them to perform “due diligence” on their suspicions, document and report their due diligence to the DEA, and refuse to fill the order if their suspicions are not resolved by the due diligence.This amounts to the DEA commandeering the drug maker...
Source: Cato-at-liberty - November 16, 2020 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Opioid Policymakers Keep Tilting at Windmills, Striking Patients in the Process
Jeffrey A. SingerThe American Psychological Association Dictionary of Psychologydefines“denial” as “adefense mechanism in which unpleasant thoughts, feelings, wishes, or events are ignored or excluded from conscious awareness. It may take such forms as refusal to acknowledge the reality of a terminal illness, a financial problem, an addiction, or a partner ’s infidelity…”Many policymakers, including many in Congress, remain in a state of denial about the true cause of the overdose crisis:drug prohibition.The Centers for Disease Control and Prevention ’s October 4, 2020provisional report on...
Source: Cato-at-liberty - October 15, 2020 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
The Abuse ‐Deterrent Folly
Jeffrey A. SingerOn September 11 a Food and Drug Administration Advisory Committeerecommended rejecting Purdue Pharma ’s request to add to the label of the abuse‐deterrent formulation (ADF) of its drug OxyContin the claim that it reduces the incidence of non‐medical use and overdose from opioids.In the early part of this century law enforcement officialsreported that many non ‐medical users of the diverted prescription drug OxyContin, a concentrated, slow‐release formulation of oxycodone, would crush the pills and snort them, or dissolve them in liquid and inject them. In 2010, as its patent for ...
Source: Cato-at-liberty - September 12, 2020 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
