Dying at home: The problem hospices have with stolen opioids
Nothing seemed to help the patient — and hospice staff didn’t know why.
They sent home more painkillers for weeks. But the elderly woman, who had severe dementia and incurable breast cancer, kept calling out in pain.
The answer came when the woman’s daughter, who was taking care of her at home, showed up in the emergency room with a life-threatening overdose of morphine and oxycodone. It turned out she was high on her mother’s medications, stolen from the hospice-issued stash.
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Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how...
Source: Kevin, M.D. - Medical Weblog - August 31, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/melissa-bailey" rel="tag" > Melissa Bailey < /a > Tags: Meds Pain Management Palliative Care Primary Care Source Type: blogs
It Seems Victoria Is Being Sensible In Getting Going On The Prescription Monitoring System.
This appeared last week:7 August 2017Victoria goes it alone on real-time monitoringPosted by Julie Lambert The Victorian government ’s decision to go it alone with a mandatory real-time prescription monitoring for high-risk medicines has exposed some disarray in the plans for a national scheme.Victoria’s Health Minister, Jill Hennessy, recently announced a $29.5 million plan to roll out the surveillance program to crack down on the misuse of dangerous prescription drugs within the next year, including $1 million to train doctors and pharmacists.“In an Australian first, and following worldwide best practice, using the...
Source: Australian Health Information Technology - August 15, 2017 Category: Information Technology Authors: Dr David More MB PhD FACHI Source Type: blogs
More Than 1 Million Young Caregivers Live In the United States, But Policies Supporting Them Are Still ‘Emerging’
Being a family caregiver today is a demanding responsibility. If caregiving is stressful for the “typical” caregiver—a 49-year-old woman—think how much more is at stake when the caregiver is a child or teenager. Yet more than a million youngsters ages 8–18 take on challenging tasks to help a parent, grandparent, sibling, or other relative. While that number is undoubtedly an underestimate, it does not even include an emerging subgroup—children whose parents are struggling with opioid addiction.
If we have limited information about the young people taking care of those with diabetes, cancer, and ...
Source: Health Affairs Blog - August 7, 2017 Category: Health Management Authors: Carol Levine Tags: Featured Population Health Public Health Quality Agnes Leu child caregivers family caregivers National Alliance for Caregiving Saul Becker United Hospital Fund Source Type: blogs
Stopping Epidemics At The Source: Applying Lessons From Cholera To The Opioid Crisis
On September 8, 1854, acting on the advice of Dr. John Snow, London municipal authorities removed the pump handle from the Broad Street well in an effort to halt a major outbreak of cholera. Although an anesthesiologist by profession, Snow had methodically mapped the homes of new cases of cholera. He found that many clustered around the Broad Street pump.
Snow’s findings, still regarded as a classic example of epidemiology, established the principle: “that the most important information to have about any communicable disease is its mode of communication.” Dr. Snow did not establish the biologic mechanism of cholera o...
Source: Health Affairs Blog - August 4, 2017 Category: Health Management Authors: Chester Buckenmaier III and Eric Schoomaker Tags: Featured Public Health Quality Department of Veterans Affairs military health care Opioid Addiction opioid epidemic Source Type: blogs
‘Extreme’ Use of Painkillers and Doctor Shopping Plague Medicare, New Report Says - ProPublica
In Washington, D.C., a Medicare beneficiary filled prescriptions for 2,330 pills of oxycodone, hydromorphone and morphine in a single month last year — written by just one of the 42 health providers who prescribed the person such drugs.In Illinois, a different Medicare enrollee received 73 prescriptions for opioid drugs from 11 prescribers and filled them at 20 different pharmacies. He sometimes filled prescriptions at multiple pharmacies on the same day.These are among the examples cited in a sobering new report released today by the inspector general of the U.S. Department of Health and Human Services. The IG...
Source: Psychology of Pain - July 14, 2017 Category: Anesthesiology Source Type: blogs
Kitty update
First of all, many many many thanks to everyone who’ve sent, and are still sending!, best wishes for my cats’ recovery…on the blog, via private email, AND on Facebook. I appreciate it so much!
They’re both home. Yes, yes, that’s great news, but we’re still not out of the woods, yet. In fact, far from it. Let’s start with Puzzola, our eldest.
I brought her home on Wednesday afternoon, after just one night spent in the vet hospital. Since she’s become so dreadfully skinny, the vets wanted to do a bunch of tests on her, and it was just easier to have them done there, especially ...
Source: Margaret's Corner - July 8, 2017 Category: Cancer & Oncology Authors: Margaret Tags: Blogroll Source Type: blogs
Why coffee might ease your pain (especially if you ’re a sleepy mouse)
This study reminded me of something I learned in medical school. I was taught that one of the most common causes of headache was caffeine withdrawal. An effective “treatment” includes coffee, another caffeine-containing drink or food, or a headache medicine that contains caffeine. But now I’m wondering if the pain-relieving properties of coffee might be less related to caffeine withdrawal and more related to the findings of this study. Maybe wake-promoting agents reverse pain sensitivity in sleep-deprived people, as this study found among mice.
This novel observation could change how we understand and treat certain t...
Source: Harvard Health Blog - June 12, 2017 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Pain Management Sleep Source Type: blogs
Safe injection sites and reducing the stigma of addiction
Imagine a chronic medical condition in which the treatment itself has serious side effects. Examples of this are plentiful in medicine. For example, in diabetes, giving too much insulin can cause hypoglycemia (low blood sugar), a dangerous and potentially life-threatening condition. That doesn’t happen very often, but imagine that it was a common complication of treating diabetes because doctors couldn’t really tell how powerful a given dose of insulin actually was. And suppose that doctors and patient safety experts advocated for places where patients with diabetes could be carefully monitored when taking their insuli...
Source: Harvard Health Blog - June 2, 2017 Category: Consumer Health News Authors: Scott Weiner, MD Tags: Addiction Behavioral Health Brain and cognitive health Mental Health Pain Management Source Type: blogs
Mandating Coverage Of Abuse-Deterrent Opioids Would Be A Costly Distraction From More Effective Solutions
The devastating societal effects of the national opioid crisis are as far reaching as they are complex and require multimodal and highly coordinated interventions involving policy makers, public health, law enforcement, the medical community, payers, and community stakeholders.
In the face of this crisis, policy makers and health care providers have responded vigorously with numerous recommendations and proposed reforms to reduce the risk of harm. While we applaud the recognition of the problem and the effort to solve it, it is imperative that recommendations, and particularly mandates, are evidence-based and are not so co...
Source: Health Affairs Blog - May 26, 2017 Category: Health Management Authors: Chronis Manolis, C. Bernie Good and William Shrank Tags: Costs and Spending Drugs and Medical Innovation Public Health abuse-deterrent opioids Department of Veterans Affairs Food and Drug Administration opioid epidemic Substance Use Disorders University of Pittsburgh Medical Center Source Type: blogs
This Nurses Week: Ask your nurses if they are burned out
July 10 will mark my tenth year as a nurse. When I began, I was shy and naive. Now I am already an old nurse, surprised by nothing and filled with battle stories. I’ve spent the last seven years working in a medical ICU, and I’ve seen and done so much. I counseled a bewildered husband on withdrawing care on his cancer-stricken wife. I got in a fight with a hematologist who insisted we transfuse a man who kept going into pulmonary edema. I’m convinced my antagonism prevented an intubation. I’ve pushed morphine, and through tears, told a widow-to-be to hold her husband’s hand while he breathed his last. They were b...
Source: Kevin, M.D. - Medical Weblog - May 9, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/emily-weston" rel="tag" > Emily Weston, RN < /a > Tags: Conditions Nurse Source Type: blogs
Brandeis and CDC Wrong on Buprenorphine PDMP Data
I’ll share an interesting story about the data used for the prescription drug database in Wisconsin and other states. I’ve been holding back on writing about this issue in hopes that the reason for the story would be corrected, and I would have no story to tell. But that hasn’t happened.
A new law in Wisconsin requires all prescribers to check the prescription drug database when prescribing any controlled substance. I’m surprised that no privacy advocates have complained about the database, which tells prescribers about the controlled substances used by their patients over the past 5 years, the pharmacies the...
Source: Suboxone Talk Zone - April 28, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Buprenorphine pharmacology Public policy risks Brandeis University CDC drug database PDMP Source Type: blogs
Brandeis and CDC Wrong on Buprenorphine PDMP Data
I’ll share an interesting story about the data used for the prescription drug database in Wisconsin and other states. I’ve been holding back on writing about this issue in hopes that the reason for the story would be corrected, and I would have no story to tell. But that hasn’t happened.
A new law in Wisconsin requires all prescribers to check the prescription drug database when prescribing any controlled substance. I’m surprised that no privacy advocates have complained about the database, which tells prescribers about the controlled substances used by their patients over the past 5 years, the pharmacies the...
Source: Suboxone Talk Zone - April 28, 2017 Category: Addiction Authors: admin Tags: Addiction Buprenorphine pharmacology Public policy risks Brandeis University CDC drug database PDMP Source Type: blogs
Brandeis and CDC Wrong on Buprenorphine PDMP Data
I’ll share an interesting story about the data used for the prescription drug database in Wisconsin and other states. I’ve been holding back on writing about this issue in hopes that the reason for the story would be corrected, and I would have no story to tell. But that hasn’t happened.
A new law in Wisconsin requires all prescribers to check the prescription drug database when prescribing any controlled substance. I’m surprised that no privacy advocates have complained about the database, which tells prescribers about the controlled substances used by their patients over the past 5 years, the pharmacies the...
Source: Suboxone Talk Zone - April 28, 2017 Category: Addiction Authors: admin Tags: Addiction Buprenorphine pharmacology Public policy risks Brandeis University CDC drug database PDMP Source Type: blogs
Thanks for listening
When we walked into the room, you could sense the anger and frustration on the patient’s face, as well as two other relatives in the room. We knew that the patient had had lung cancer for several months and had failed radiation and chemotherapy. He had labored breathing and looked miserable.
I went to his bed and asked if I could sit down on his bed. I took his wrist and began checking his pulse. Then I asked him to tell his story.
The 50-something patient had many pack years of cigarettes. He understood his diagnosis and wanted to pursue further treatment options. His breathing had worsened, partly due t...
Source: DB's Medical Rants - April 16, 2017 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
OPDP Picks Up Steam on Enforcement Letters
After a fairly slow 2016, the United States Food and Drug Administration’s (FDA) Office of Prescription Drug Promotion (OPDP) issued a quick burst of letters in the span of nine days in December. This flurry of activity more than doubled the enforcement letters that had been issued up to that point in the year.
Although there was an apparent increase in enforcement activity in December (perhaps related to the new Administration and the mark the old Administration wanted to leave on the industry), the type of activity and the nature of Draft Guidances issued in 2017 prior to the Trump Administration taking office indicat...
Source: Policy and Medicine - April 5, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
