An open letter to Macklemore about the opioid epidemic
Dear Macklemore, Recently, you — the white-rapping, thrift-shopping, LGBT-activist-ing, Grammy-winning 2013 phenom — teamed up with President Obama to deliver a message to the country about the current opioid epidemic. Now let me preface this by saying, I like you, Macklemore. I like the mixture of equal parts political, earnest and downright goofy that you bring to your music. I like that you seem genuinely self-reflective and even a little uncomfortable with the chart-topping success your appropriation of black music has enjoyed. And I believe that the rampant opioid abuse and overdoses happening now in our c...
Source: Kevin, M.D. - Medical Weblog - June 3, 2016 Category: Journals (General) Authors: Tags: Physician Pain management Source Type: blogs

Doped
I’ll bet you pride yourself on living a pretty clean life. It’s doubtful that I’d stumble on you in some alley, track marks up your arms, lying in a puddle of your own urine, unconscious from a night of shooting up heroin, snorting coke, or smoking crack. And you probably have all or most of your teeth, unlike the toothless addicts on methamphetamine. Perhaps you even avoid or minimize your use of the softer recreational drugs in cigarettes and alcoholic beverages. You likely adhere to healthy practices and keep such indulgences to a minimum. The truth is that you’ve been doping it up for most of your life. You’v...
Source: Wheat Belly Blog - June 2, 2016 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle addiction addictive appetite Gliadin grains Inflammation opiates Source Type: blogs

Why taking morphine, oxycodone can sometimes make pain worse | Science | AAAS
There's an unfortunate irony for people who rely on morphine, oxycodone, and other opioid painkillers: The drug that's supposed to offer you relief can actually make you more sensitive to pain over time. That effect, known as hyperalgesia, could render these medications gradually less effective for chronic pain, leading people to rely on higher and higher doses. A new study in rats—the first to look at the interaction between opioids and nerve injury for months after the pain-killing treatment was stopped—paints an especially grim picture. An opioid sets off a chain of immune signals in the spinal cord that amplifies p...
Source: Psychology of Pain - May 31, 2016 Category: Anesthesiology Source Type: blogs

Senator Durbin Asks Medical Associations to Endorse Mandatory Opioid CME – AMA Shows Interest
Following last month's letter to the Pharmaceutical Research and Manufacturers of America (PhRMA), asking the group to "take financial responsibility for the drug industry's role in curtailing the opioid overdose epidemic," United States Senator Dick Durbin sent a letter to four physician associations asking them to endorse mandatory CME programs. The letter, which was sent to the American Medical Association (AMA), the American Academy of Family Physicians (AAFP), the American College of Emergency Physicians (ACEP), and the American Dental Association (ADA), noted several steps the Senator feels as though the associatio...
Source: Policy and Medicine - May 19, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

A family physician duped by a patient on chronic opioids
A woman in her mid-thirties with a terrible limp and a past surgical history in the dozens became my patient two years ago. Her prosthetic left leg served her well, but her right leg was moving awkwardly because of advanced hip arthritis and a formerly shattered ankle. She was on long-acting morphine and short acting oxycodone. Her Social Security disability insurance didn’t cover the long-acting form of oxycodone. She told me several times how much she hated being on narcotics, but they kept her functioning. She was able to do her own housework, and she was taking classes in medical coding and billing. Continue reading ...
Source: Kevin, M.D. - Medical Weblog - May 12, 2016 Category: Journals (General) Authors: Tags: Physician Medications Pain management Source Type: blogs

CNN Special Report on Prescription Addiction
We have been talking about the opioid addiction in America for several months now, from Congressional hearings, to new Centers for Disease Control (CDC) guidelines, to what solutions exist for patients and their loved ones. In response to the epidemic, CNN hosted a program entitled “Prescription Addiction,” hosted by Anderson Cooper and Dr. Sanjay Gupta. The program featured guests including: addicts of opioids and heroin, family members of addicts who are no longer “themselves,” family members of addicts who have passed on due to their addictions, physicians, treatment center owners, and others, and was a questio...
Source: Policy and Medicine - May 11, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

“@deathunderglass is taking over...
"@deathunderglass is taking over the@muttermuseum@instagram account this week to showcase some of the specimens in the museum collection related to forensic science!@deathunderglass is a collaboration between a forensic pathologist and forensic photographer that generates images of human tissue at high magnification. We tend to think that drug abuse is a social issue that popped up in the last 50 years. Think again - the history of drug abuse in America goes back quite a long way. Elixirs, tonics, and tablets containing cocaine were incredibly popular from the 1850s to the early 1900s and its use was promoted by medical l...
Source: Kidney Notes - May 10, 2016 Category: Urology & Nephrology Authors: Joshua Schwimmer Source Type: blogs

'You want a description of hell?' OxyContin's 12-hour problem - Los Angeles Times
The drugmaker Purdue Pharma launched OxyContin two decades ago with a bold marketing claim: One dose relieves pain for 12 hours, more than twice as long as generic medications. Patients would no longer have to wake up in the middle of the night to take their pills, Purdue told doctors. One OxyContin tablet in the morning and one before bed would provide "smooth and sustained pain control all day and all night." On the strength of that promise, OxyContin became America's bestselling painkiller, and Purdue reaped $31 billion in revenue. But OxyContin's stunning success masked a fundamental problem: The d...
Source: Psychology of Pain - May 10, 2016 Category: Anesthesiology Source Type: blogs

' You want a description of hell?' OxyContin's 12-hour problem - Los Angeles Times
The drugmaker Purdue Pharma launched OxyContin two decades ago with a bold marketing claim: One dose relieves pain for 12 hours, more than twice as long as generic medications. < br > < br > Patients would no longer have to wake up in the middle of the night to take their pills, Purdue told doctors. One OxyContin tablet in the morning and one before bed would provide & quot;smooth and sustained pain control all day and all night. & quot; < br > < br > On the strength of that promise, OxyContin became America & #39;s bestselling painkiller, and Purdue reaped $31 billion in revenue. < br > < br > But OxyContin & #39;s stunni...
Source: Psychology of Pain - May 10, 2016 Category: Anesthesiology Source Type: blogs

F.D.A. Again Reviews Mandatory Training for Painkiller Prescribers - The New York Times
A pain management specialist, Dr. Nathaniel Katz, was stunned in 2012 when the Food and Drug Administration rejected a recommendation from an expert panel that had urged mandatory training for doctors who prescribed powerful painkillers like OxyContin. That panel had concluded that the training might help stem the epidemic of overdose deaths involving prescription narcotics, or opioids. At first, Dr. Katz, who had been on the panel, thought that drug makers had pressured the F.D.A. to kill the proposal. Then an agency official told him that another group had fought the recommendation: the American Medical Association, the...
Source: Psychology of Pain - May 3, 2016 Category: Anesthesiology Source Type: blogs

The opioid epidemic: It’s time to place blame where it belongs
The media is full of stories about the current opioid crisis. But unlike many national crises, such as the Flint lead-contaminated water crisis, the focus is on solutions and not blame. A few weeks ago, the Centers for Disease Control and Prevention issued guidelines for prescribing opioids in chronic pain, Congress approved funding for prevention and treatment, and the US HHS released a “National Pain Strategy.” So to fulfill my duty as an American, allow me to place blame for our current opioid crisis. Allow me to start with physicians. We overprescribe opioids, just as we overprescribe antibiotics. But it is...
Source: Kevin, M.D. - Medical Weblog - April 6, 2016 Category: Journals (General) Authors: Tags: Physician Pain management Source Type: blogs

What You See Is Not What You Get - Purdue Pharma Executives Pleaded Guilty, but the Oxycontin Billionaires Went Unnoticed
What you see if often not what you get.   Nine years ago, three top executives of Purdue Pharma pleaded guilty to criminal charges of "misbranding" Oxycontin.  The case appeared to be a landmark.  In previous years, top executives of large health care corporations rarely faced legal consequences when their companies misbehaved.  Yet in the Purdue Pharma/ Oxycontin case, things were not what they seemed.  Maybe that is why this case never did yield a new era of accountability for top corporate health care leaders.Background - the Oxycontin Guilty PleasIn 2007, we posted about the executives' guilty ...
Source: Health Care Renewal - March 31, 2016 Category: Health Management Tags: anechoic effect conflicts of interest deception health care corruption legal settlements marketing narcotics Oxycontin Purdue Pharma Source Type: blogs

House Oversight Committee: America’s Heroin and Opioid Abuse Epidemic
Discussion Rehab Can't Be the Only Solution Republican John Mica, got quite vocal at the hearing, when he stated that rehabilitation is not enough when it comes to dealing with heroin and opioid addiction. As he stated, "treatment is at the end of the process. They've already been addicted." Mica called for immediate action, "we haven't killed this many people in multiple-year wars as we're killing in one year. We are going to lose half a million people in a decade at this rate. Every family has been affected by it, and now it's just a slaughter out of control." Emergency Fund Representative Carolyn Maloney was one...
Source: Policy and Medicine - March 24, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

CDC Releases Guidelines for Prescribing Opioids
The dramatic increase in overdose deaths due to opioids has been a major focus of political and medical leaders over the last few months, and the Center for Disease Control and Prevention recently released new guidelines for practitioners to think twice before prescribing opioid medications for their patients. The guidelines, which are voluntary, ask primary care providers who are treating adults with chronic pain to consider alternatives to prescription painkillers such as oxycodone and hydrocodone, to limit treatment length, and to monitor their patients to see if the opioids are the best choice for them. Even though...
Source: Policy and Medicine - March 21, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

I’m a doctor. I worry every time I prescribe painkillers to a patient. - Vox
"Please, I need my Oxycodone!" my patient, M, pleaded with me. My eyes met his. I observed every fleeting facial expression, hoping to gauge his intentions. The discussion about whether to continue to prescribe this medication was one I'd had too many times with too many patients over the past few months. "My arthritis is always worst in the winter," he said, rubbing his lower back. It was a snowy afternoon in clinic, and M and I were in the midst of a debate. Oxycodone is an opioid medication, and, like other painkillers such as Oxycontin, Percocet, and Vicodin, it carries a significant risk of ...
Source: Psychology of Pain - March 16, 2016 Category: Anesthesiology Source Type: blogs