The AMA Opioid Task Force 2020 Report Should Come as No Surprise to Those Who Follow the Data
Jeffrey A. SingerThe American Medical Association recently released itOpioid Task Force 2020 Report. The Task Force found there was a 37.1 percent decrease in opioid prescriptions between 2014 and 2019; a 64.4 percent increase in the use of state prescription drug monitoring programs (PDMPs) in the last year (739 million queries in 2019); and hundreds of thousands of physicians accessing continuing medical education courses on opioid prescribing (now mandatory in some states). However, the report states:Despite these efforts, illicitly manufactured fentanyl, fentanyl analogues and stimulants (e.g. methamphetamine...
Source: Cato-at-liberty - August 31, 2020 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
The Quigley Maneuver for Ankle Fractures
Certain emergency department procedures bring us a sense of accomplishment. We cheer after a shoulder returns to its correct position from our relocation technique and smile when a laceration closes just right. Emergency department procedures can be very rewarding for providers and patients, especially during times of stress in the workplace. Sometimes, just stapling a scalp or molding the perfect splint may seem cathartic. There are days where we can only see so much abdominal and chest pain—and COVID-19.The double-person Quigley maneuver technique for an ankle fracture. Photo by Martha Roberts.This month we want to ...
Source: The Procedural Pause - August 3, 2020 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Prehospital ECG of a 50-something male with Syncope and Chest Pain
This case was sent by an excellent medic:A 50-something yo male started to chop wood when he experienced a short syncopal episode followed by 8/10 chest pain. Ground EMS arrived, administered ASA and sublingual nitro to which he passed out again.Flight crew was called to transport for signs of shock/syncopal episodes, not ACS.Ground crew had recorded this prehospital ECG:Sinus rhythm with one PVC (first complex)And anything else?These are hyperacute T-waves diagnostic of LAD occlusion. They begin at V3, and there is no inferior ST depression, so this is probably a mid-LAD occlusion. The hyperacute T-waves...
Source: Dr. Smith's ECG Blog - July 25, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
The DEA ’s Opioid Production Quotas Threaten Hospitalized Patients, Yet Supply of Street Fentanyl is Plentiful
Jeffrey A. SingerThe COVID-19 pandemic has placed another stumbling block in the way of the Drug Enforcement Administration ’sfutile effort to reduce the country ’s drug overdose rate through quotas on the manufacture of all forms of prescription opioids.The DEA ’s annual quotas have brought production levels more than 50 percent below 2016 levels. But, in response to the COVID-19 pandemic, the agency increased this year’s quota by 15 percent, to allow drug makers to respond to pandemic‐induced shortages. Intravenous opioids such as fentanyl are va luable tools used to manage patients on ventilators—as well ...
Source: Cato-at-liberty - July 24, 2020 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
As the War on Drugs Relentlessly Grinds On, Overdose Deaths Relentlessly Mount
Jeffrey A. SingerWhen the Centers for Disease Control and Preventionannounced last January that drug overdoses in 2018 declined by 4.1 percent –from 70,237 in 2017 to 67,367 in 2018 –many in thepress took that as a sign of possible progress in America ’s longest war, the war on drugs. However, a deeper look at the data painted a very different picture.The CDC report stated:The age ‐adjusted rate of drug overdose deaths involving synthetic opioids other than methadone, which include drugs such as fentanyl, fentanyl analogs, and tramadol, increased from 0.3 per 100,000 standard popula...
Source: Cato-at-liberty - July 16, 2020 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Will Isotonitazene Replace Fentanyl on the Black Market?
Jeffrey A. SingerWaging a war on drugs is like playing a game ofWhac ‐A‐Mole.In 2005 Congress addressed the “meth crisis” by passing theCombat Methamphetamine Epidemic Act that, among other things, made the popular decongestantSudafed,used by homegrown labs to make meth, a behind ‐the‐counter drug and restricted its sale to patients. It didn’t take long for Mexican drug cartels to fill the void created by the crackdown on domestic meth labs, and to findother and better ways to manufacture meth. Now the Centers for Disease Control and Prevention report methamphetamine ‐related d...
Source: Cato-at-liberty - July 10, 2020 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Cato and the ACLU Join Forces to Protect Philadelphia ’s Supervised Injection Site
Trevor BurrusThe first major federal drug law, the Harrison Narcotics Act, went into effect in 1915. As the federal drug war moves into its second century, we are still faced with an unprecedented opioid crisis that isgetting worse during the current pandemic. Yet while other countries such asPortugal andSwitzerland are approaching the problem with new, more humane ideas, the federal government is stuck in the prohibitionist mindset of the past, which not only doesn ’t work but makes the problem worse. Safehouse is a nonprofit public ‐health organization that seeks to mitigate the harms of the opioid crisi...
Source: Cato-at-liberty - July 8, 2020 Category: American Health Authors: Trevor Burrus Source Type: blogs
Wait, Other People Don ’ t Think about Suicide?
The most startling thing I’ve heard in my life is that not everyone thinks about suicide every day. Or now and then. Or even once in a long while.
Can that be?
I heard this from a co-worker a while ago. We were collaborating on a dreary project, and I joked about it being the kind of work that makes you want to kill yourself and what a relief that would be.
“I know, right?” I expected her to say. Instead, she chuckled uncomfortably, then asked if I really thought that way. When I said yes, she was taken aback and a little disbelieving.
“You never have?” I asked.
“Of course not!”
I was taken aback. And a littl...
Source: World of Psychology - April 28, 2020 Category: Psychiatry & Psychology Authors: Rich Pliskin Tags: Personal Suicide Depression Suicidal Thoughts Source Type: blogs
Want to Know if a New Drug Crisis Is Growing? Check the Wastewater
Few people foresaw how quickly fentanyl would displace heroin, doubling or tripling opioid overdose deaths in some pockets of the United States from 2013 to 2017. But we could have been warned — if only we ' d checked our wastewater. (Source: The RAND Blog)
Source: The RAND Blog - March 25, 2020 Category: Health Management Authors: Bryce Pardo; Debra Knopman Source Type: blogs
What's new in midwifery - 4th March 2020
Where is last week ' s? Some disruption to service caused by the current University and College Union industrial action. Why are we striking? Read more at https://ucu.org.uk/strikeforuss andhttps://ucu.org.uk/he2019.Some recent things you may need to know. Official statisticsConceptions in England and Wales, 2018Quarterly conceptions to women aged under 18 years, England and Wales, October - December 2018Female Genital Mutilation October 2019 - December 2019 (NHS Digital)Maternity Services Monthly Statistics November 2019, experimental statisticsStatistics on Women ' ...
Source: Browsing - March 4, 2020 Category: Databases & Libraries Tags: midwifery Source Type: blogs
Will Arizona Join The Majority of States (And Developed Countries) That Permit Syringe Services Programs?
Jeffrey A. SingerToday I providedwritten and oral testimony before the Arizona House Health Committee regarding a bill that would allow syringe services programs (SSPs) to operate legally within the state. Arizona is one of20 states that do not explicitly authorize syringe services programs and/ or have drug paraphernalia laws that prevent syringe services programs from operating. More commonly referred to as “needle exchange” programs, these programs have been proven unequivocally, since the 1970s, to reduce the spread of hepatitis, HIV, and other blood‐borne infectious disease s, as well as sof...
Source: Cato-at-liberty - February 6, 2020 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
White collar crime
John Kapoor, CEO of Insys Therapeutics, was sentenced yesterday to 5 1/2 years in prison. That ' s a pretty stiff sentence, right?Well let ' s see now. What did he do exactly?His company sold fentanyl under the brand name Subsys. As you probably know, fentanyl is an extremely powerful synthetic opioid that is responsible for a high percentage of the overdose deaths in the current epidemic of opioid addiction. As a prescription drug, it was approved by the FDA only for so-called breakthrough pain in cancer patients. But Insys literally bribed doctors to prescribe it inappropriately, resulting in8,000 known deathsand countle...
Source: Stayin' Alive - January 24, 2020 Category: American Health Source Type: blogs
Australia's Fires, Artificial Intelligence, Fentanyl: RAND Weekly Recap
This weekly recap focuses on Australia ' s devastating fires, how artificial intelligence could manipulate the masses, the fentanyl crisis, and more. (Source: The RAND Blog)
Source: The RAND Blog - January 23, 2020 Category: Health Management Authors: RAND Corporation Source Type: blogs
Policymakers Obsess Over Pain Prescribing and Ignore the Giant Elephant in the Room: Prohibition
Jeffrey A. SingerOn January 20th, theCincinnati Enquirer ran a story on the recentreport from the Centers for Disease Control and Prevention that showed a 30.1 percent drop in prescription opioid volume from 2010 – 2011 to 2016 – 2017. While the CDC report was non‐judgmental, it was greeted by hospital administrators and emergency physicians in the Cincinnati area as good news.The article quotes one physician/ hospital spokesperson as saying:“The patient can know, ‘My encounter with the ED will … lead to a good outcome. I will not be exposed to unnecessary threats … downstre...
Source: Cato-at-liberty - January 20, 2020 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Fentanyl: The Most Dangerous Illegal Drug in America
America ' s fentanyl crisis is unlike previous drug epidemics and is likely to get worse. Deaths involving it and other synthetic opioids have surged from around 3,000 in 2013 to more than 30,000 in 2018. Solving the problem requires innovative approaches and unprecedented resources. (Source: The RAND Blog)
Source: The RAND Blog - January 12, 2020 Category: Health Management Authors: RAND Corporation Source Type: blogs
