Discrimination Against Patients With Substance Use Disorders Remains Prevalent And Harmful: The Case For 42 CFR Part 2
The authors of a recent Health Affairs Blog post argue that 42 CFR Part 2, the law designed to protect confidentiality of patients with substance use disorders, is outdated and unnecessary. We could not disagree more. 42 CFR Part 2 provides bedrock protections for people with substance use disorders that are as critical now as they were in the 1970s when the law was first enacted. The purpose of the confidentiality law is to ensure that a person with a substance use disorder is not made more vulnerable to discriminatory practices and legal consequences as a result of seeking treatment. Unfortunately, patients with substan...
Source: Health Affairs Blog - April 13, 2017 Category: Health Management Authors: Karla Lopez and Deborah Reid Tags: Featured Population Health Public Health Quality 42 CFR Part 2 HIPAA opioid epidemic patient discrimination patient privacy substance use treatment Source Type: blogs
Medicaid Responds To The Opioid Epidemic: Regulating Prescribing And Finding Ways To Expand Treatment Access
Medicaid programs are at the center of the opioid epidemic. Nearly 12 percent of adults covered by Medicaid have a substance use disorder, including opioid use disorder. Available data suggest that Medicaid beneficiaries are prescribed painkillers at higher rates than non-Medicaid patients and have a higher risk of overdose, from both prescription opioids and illegal versions including heroin and fentanyl. In addition to the human toll, abuse of opioids has significant financial effects. In 2010, Arizona Medicaid paid for more than half of all opioid-related emergency department admissions, and in 2012, 81 percent of the $...
Source: Health Affairs Blog - April 11, 2017 Category: Health Management Authors: Amy Bernstein and Nevena Minor Tags: Costs and Spending Medicaid and CHIP Public Health opioid epidemic preferred drug lists prescription drug abuse prescription drug monitoring programs prior authorization requirements Section 1115 Waivers Source Type: blogs
Ten Gripes of Buprenorphine Doctors
I recently gave a lecture to medical students about opioid dependence and medication assisted treatment using buprenorphine, methadone, or naltrexone. I was happy to see their interest in the topic, in contrast to the utter lack of interest in learning about buprenorphine shown by practicing physicians. In case someone from the latter group comes across this page, I’ll list a few things to do or to avoid when caring for someone on buprenorphine (e.g. Suboxone).
1. Buprenorphine does NOT treat acute pain, so don’t assume that it will. Patients are fully tolerant to the mu-opioid effects of buprenorphine, so they...
Source: Suboxone Talk Zone - March 25, 2017 Category: Addiction Authors: admin Tags: Acute Pain Addiction Buprenorphine Chronic pain Suboxone surgery buprenorphine stigma Source Type: blogs
Ten Gripes of Buprenorphine Doctors
I recently gave a lecture to medical students about opioid dependence and medication assisted treatment using buprenorphine, methadone, or naltrexone. I was happy to see their interest in the topic, in contrast to the utter lack of interest in learning about buprenorphine shown by practicing physicians. In case someone from the latter group comes across this page, I’ll list a few things to do or to avoid when caring for someone on buprenorphine (e.g. Suboxone).
1. Buprenorphine does NOT treat acute pain, so don’t assume that it will. Patients are fully tolerant to the mu-opioid effects of buprenorphine, so they...
Source: Suboxone Talk Zone - March 25, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Acute Pain Addiction Buprenorphine Chronic pain Suboxone surgery buprenorphine stigma Source Type: blogs
Dr. Janet Woodcock on the Opioid Epidemic
The United States Food and Drug Administration (FDA) offers a podcast series, known as the Director’s Corner, that features the director of the FDA Center for Drug Evaluation and Research (CDER). One of the most recent episodes featured an interview with Dr. Janet Woodcock, by Colleen Labbe from the CDER Office of Communications, who discussed the way the FDA has been addressing the opioid epidemic affecting many communities around the United States.
CDER’s Response to FDA Labeling Changes
One of the first questions asked of Dr. Woodcock was what, exactly, CDER did with regard to the various opioid safety labeling ch...
Source: Policy and Medicine - March 20, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
De-stigmatization of the disgraceful mark of stigma in the opioid crisis
After attending Albany Government Law Review’s symposium, Script to Street: Opioids and the Law in the Capital District this past Thursday, there was several issues addressed but the one overarching concern was about the role of stigma in this opioid crisis. Many different types of stigma were identified and the different ways our negative judgments have impacted society. As one speaker during the first panel discussion stated, addiction is not a new problem. He described one historic painting that showed different reactions of society to addiction: disgust, numbness, shock, or simply ignoring the problem. All of the...
Source: blog.bioethics.net - March 14, 2017 Category: Medical Ethics Authors: Bioethics Today Tags: Health Care Drug syndicated Source Type: blogs
A primary care doctor delves into the opioid epidemic
Our nephew Christopher died of a heroin overdose in October 2013.1 It had started with pain pills and experimentation, and was fueled by deep grief.2 He was charismatic, lovable, a favorite uncle, and a hero to all the children in his life. His death too young was a huge loss to our family. I have always felt that I didn’t do enough to help prevent it, and perhaps, in a way, even contributed.
Good intentions with unintended consequences
My medical training took me through several big-city hospitals where addiction and its consequences were commonplace. Throughout all of it, great emphasis was placed on recognizing &#...
Source: Harvard Health Blog - February 20, 2017 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Addiction Behavioral Health Source Type: blogs
Opioid Induced Hyperalgesia Prevented by Buprenorphine?
“Buprenorphine is a kappa receptor antagonist. For these reasons, buprenorphine might be unique in its ability to treat chronic pain and possibly OIH.”
The opioid crisis has been fueled by the use of opioids to treat chronic pain. Practice patterns have changed, but doctors are still criticized for their roles in the overuse of opioids. I’ve sat through community ‘heroin forums’ (sometimes on stage) as sheriffs, politicians, and ‘recovered addicts’ firmly pointed fingers at health professionals. I, meanwhile, kept my finger under the table, but had the thought that some of the people pointing ...
Source: Suboxone Talk Zone - February 5, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Acute Pain Buprenorphine Chronic pain Suboxone treatment buprenorphine treats chronic pain chronic pain treatment opioid induced hyperalgesia opioid pain relief pain vs. addiction Source Type: blogs
Medications that Increase the Risks of Falling
Falls are the leading cause of both fatal and non-fatal injuries for adults 65 and older, and research suggests that those taking four or more medications are at an even greater risk than those who don ’t.ByAlzheimer's Reading RoomWhat ’s the Difference Between Alzheimer’s and DementiaHow to Test Your Memory for Alzheimer's and DementiaHow to Get Answers To Your Questions About Alzheimer's and Dementia“Falls are the leading cause of both fatal and non-fatal injuries for adults 65 and older, and research suggests that those taking four or more medications are at an even greater risk than those who don’t – perhap...
Source: Alzheimer's Reading Room, The - February 1, 2017 Category: Neurology Tags: alzheimer's care care of dementia patients dementia care health help alzheimer's help with dementia care medications falls Prescription Medications Risks risk of falling senior care Source Type: blogs
Repealing The ACA Could Worsen The Opioid Epidemic
As our country grapples with an “unprecedented opioid epidemic,” Congress is taking steps to take away an important tool to fight it — the Affordable Care Act (ACA). The annual cost of the epidemic is estimated to be $78.5 billion. In 2014, there were more deaths from opioid and other drug overdose than any other year; 60.9 percent of those overdoses involved an opioid. Every day, an average of 78 Americans die from opioid abuse. The coverage expansions and protections under the ACA can help lessen the epidemic and save lives.
The ACA Provides Coverage to People with Substance Use Disorders
Because of the ACA, a...
Source: Health Affairs Blog - January 30, 2017 Category: Health Management Authors: Lisa Clemans-Cope, Dania Palanker and Jane Wishner Tags: Following the ACA Medicaid and CHIP Public Health Essential Health Benefits Medicaid expansion opioid epidemic opioids Section 1115 Demonstration Waiver Substance Use Disorders Source Type: blogs
Youth Vaping Plummets in Wake of Surgeon General's Report
A survey conducted by the Pew Foundation this past weekend found that self-reported rates of youth vaping have dropped sharply following Thursday ' s release of the Surgeon General ' s report on e-cigarette use, which, after a 263-page review of the scientific evidence, warned that vaping is " not harmless " and that e-cigarette aerosol is not " just water vapor. "Foundation president Robert J. Pew said that although the survey results are subject to a margin of error, " the decline is so sharp that even with the maximum amount of error, the drop in vaping is significant. " While Pew acknowledged that the decline cannot " ...
Source: The Rest of the Story: Tobacco News Analysis and Commentary - December 11, 2016 Category: Addiction Source Type: blogs
LITFL Review 260
Welcome to the 260th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
A seriously good survival guide for central venous access devices from new DFTB author, Amanda Ullman. Includes tips to salvage almost any line. [JS]
The Best of #FOAMed Emergency Medicine
Check out First 10 EM articles of the month for November...
Source: Life in the Fast Lane - December 4, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Why painkillers sometimes make the pain worse | Science | AAAS
Mark Hutchinson could read the anguish on the participants' faces in seconds. As a graduate student at the University of Adelaide in Australia in the late 1990s, he helped with studies in which people taking methadone to treat opioid addiction tested their pain tolerance by dunking a forearm in ice water. Healthy controls typically managed to stand the cold for roughly a minute. Hutchinson himself,"the young, cocky, Aussie bloke chucking my arm in the water," lasted more than 2 minutes. But the methadone patients averaged only about 15 seconds."These aren't wimps. These people are injecting all sorts...
Source: Psychology of Pain - November 6, 2016 Category: Anesthesiology Source Type: blogs
Not Everyone Wants to Ban Kratom: Here Are Some Issues to Consider
Never heard of kratom? The media has been so focused on the ongoing opioid epidemic that it’s easy to miss a less frequently used or abused substance, like kratom. But a movement to ban or restrict the sale of kratom in cafes, at head shops and on the internet is gaining momentum across the country and states are taking legal action to curtail the public’s use of this drug. So what exactly is kratom, and why are people divided about its use?
Common in the United States for almost ten years before catching the attention of the federal government, kratom is a plant grown in Southeast Asia and cultivated as a kin...
Source: Cliffside Malibu - September 21, 2016 Category: Addiction Authors: Constance Scharff, PhD Tags: Abuse Addiction Recovery Addiction to Pharmaceuticals Addiction Treatment and Program Resources Alcoholism Behavioral Addictions Current Events Drug Rehab Information Drug Treatment Mental Health drug addiction drug treatment center Source Type: blogs
How Do We Finish The Job That The Comprehensive Addiction And Recovery Act Started?
There is much to celebrate about the enactment of the Comprehensive Addiction And Recovery Act (CARA), including promising provisions related to treatment and recovery. However, the impact of the new law in terms of its ability to fill the so called treatment gap is severely limited by the minimal level of funding for many of these promising new programs and initiatives to expand evidence-based treatment. Without appropriations, CARA is a powerful statement but not necessarily an actionable plan.
The treatment gap refers to the more than 1.2 million people who meet the diagnostic criteria for an opioid use disorder (OUD) b...
Source: Health Affairs Blog - September 12, 2016 Category: Health Management Authors: Richard Frank Tags: Costs and Spending Drugs and Medical Technology Featured Public Health Comprehensive Addiction And Recovery Act Congress medication-assisted treatment opiods Opioid Addiction opioid epidemic prescription drug abuse Source Type: blogs
