Overprescribing Is a Key Component of the Opioid Crisis — Here’s How to Stop It
By DAVE CHASE
Today’s opioid crisis is one of the most dire side effects driven by our dysfunctional U.S. healthcare system. A recent JAMA Surgery report found that many surgeons prescribe four times more opioids than their patients use. This opens the door for misuse and abuse later on. In fact, the total combined cost of misuse, abuse, dependence and overdose is about $78.5 billion.
Unfortunately, there’s a direct connection between the low-quality care many patients receive, and the astounding rates of opioid addiction. Often, insurance plans offer access to high-cost, volume-centric physicians and include high de...
Source: The Health Care Blog - January 29, 2019 Category: Consumer Health News Authors: matthew holt Tags: Patients Value-Based Care Dave Chase Opioid epidemic Source Type: blogs
More Than Just Dander
First, a sort of meta-comment in the form of a shout-out to HCRenewal ' s intrepid editor, Dr. Roy Poses, for his just-published analysis of what we might call " blogging: rise and fall. " He sees decline reflected in publications long devoted to health and health policy, yet now flaking off.Methinks, however, despite the usefulness of his overview of recent decades, Dr. P need not fret excessively. Water spilling out of the barrel ' s lip will slow down once folks come along and punch a whole bunch of little mid-section tweet-holes in it. Information still flows. (Sort of.) In any case, surely there ' s overla...
Source: Health Care Renewal - January 25, 2019 Category: Health Management Source Type: blogs
The Merchants of Death
This study by authors including my colleague Brandon Marshall nails them. For those of you who don ' t know, pharmaceutical companies promote their products by giving physicians free meals, paying for their travel to conferences, giving them speaking fees and honoraria, consulting fees, and otherwise crossing the palm with silver. They do this because it works -- it is associated with increased prescribing of their products.It turns out the more payments they made in a U.S. county to promote opioid prescribing, the more prescriptions were written, and in turn, the more overdose deaths there were. The strongest association ...
Source: Stayin' Alive - January 25, 2019 Category: American Health Source Type: blogs
The Mysteries Surrounding Rhodes Pharmaceuticals, the Sackler Family's Second Opioid Company
Mysteries still abound in the not so wonderful world of health care dysfunction, so, quick, the game ' s afoot...Today ' s mysteries involve beneficial ownership. Beneficial ownership questions are important to anti-corruption campaigners. Beneficial ownership simply refers to " anyone who enjoys the benefits of ownership of a security or property, without being on the record as being the owner. " (per Wikipedia). Concealing who really owns a company enables concealing sources of funds (as in money laundering), market power (when the owner also owns competitors), and sources of political influence, and en...
Source: Health Care Renewal - January 8, 2019 Category: Health Management Tags: anechoic effect concentration of power conflicts of interest dark money deception Donald Trump health care corruption marketing narcotics Purdue Pharma Source Type: blogs
Health IT Is In The Front Line To Try And Stem The Opioid Crisis in The US – Relevant Here Too!
This appeared last week:Providers turning to health IT to combat the opioid crisis By Marla Durben HirschPublished December 26 2018, 7:49am ESTProviders have begun to harness technology to improve their management of opioids and avoid misuse. It ’s not a moment too soon. The Centers for Disease Control and Prevention’s most recent reports, released in November, confirm that the opioid crisis is worsening. The number of drug overdose deaths in the United states in 2017 was 9.6 percent higher than in 2016. The rate of drug overdose deaths involving natural and semisynthetic opioids like oxycodone and hydrocodone has rise...
Source: Australian Health Information Technology - January 2, 2019 Category: Information Technology Authors: Dr David G More MB PhD Source Type: blogs
Today ’s Drug Abusers Did Not Derive From Yesterday’s Patients
We learned last week that the 2017 drug overdose numbers reported by the US Centers for Disease Control and Prevention clearly show most opioid-related deaths are due to illicit fentanyl and heroin, while deaths due to prescription opioids have stabilized, continuing a steady trend for the past several years. I’ve encouraged using the term “Fentanyl Crisis” rather than “Opioid Crisis” to describe the situation, because it more accurately points to its cause—nonmedical users accessing drugs in the dangerous black market fueled by drug prohibition—hoping this wi ll redirect attention and lead to reforms...
Source: Cato-at-liberty - December 4, 2018 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
No Let Up On The Bad News About Overdose Deaths
The National Center for Health Statistics (NCHS) just issued Data Brief Number 329, entitled “Drug Overdose Deaths in the United States, 1999-2017.” Drug overdose deaths reached a new record high, exceeding 70,000 deaths in 2017, a 9.6 percent increase over 2016. That figure includes all drug overdoses, including those due to cocaine, methamphetamines, and benzodiazepines. The actual breakdown according to drug category will be reported in mid-December. However, estimates are opioid-related deaths will account for roughly 49,000 of the total overdose deaths. The big takeaways, quoting the report:- The rate of ...
Source: Cato-at-liberty - November 29, 2018 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Has Opioid Hysteria Risen to the Point Where Innovation Is Forbidden?
On November 2 the Food and Drug Administration announced the approval of Dsuvia, a sublingual tablet containing the powerful fentanyl analog, sufentanil. Sufentanil has been used for years in the hospital setting, primarily in intravenous form for anesthesia. It is roughly 5 to 10 times more potent than fentanyl, and thus has a significant overdose potential. The FDA reached this decision following a 10-3 vote in favor of the drug’s approval by the Anesthetic and Analgesia Drug Products Advisory Committee (AADPAC),based on data from multicenter trials. It was not approved for outpatient use, but for use only in ...
Source: Cato-at-liberty - November 6, 2018 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Whistleblowers Wanted
Something happened to wheat in the 1970s during the efforts to generate a high-yield strain that required less fertilizer to make an 18- 24-inch, rather than a 48-inch, stalk. Multiple other changes occurred, including changes in the structure of wheat germ agglutinin, changes in alpha amylase (responsible for wheat allergy), increased phytate content . . . to name a few.
But chief among the changes in wheat were changes in the gliadin protein molecule. We know, for instance, that the Glia-alpha 9 sequence, absent from traditional wheat, can be found in virtually all modern wheat. This is likely the explanation un...
Source: Wheat Belly Blog - October 25, 2018 Category: Cardiology Authors: Dr. Davis Tags: News & Updates Gliadin gluten gluten-free grain-free grains opiates wheat belly Source Type: blogs
Market-based approaches solving the opioid epidemic
Mary first took oxycodone after a minor surgery and found she liked it. Returning to her surgeon a month later with vague ongoing pain, she received another prescription. Her primary care provider took over from there — until one day that physician checked a urine drug screen and a prescription monitoring program (PMP) report, only to find that she was obtaining various opioids from several providers. The physician cut her off and reported her to the PMP just as crackdowns on opioid prescribers arose. The prescriptions dried up. She tried buying pills from illicit sources but found that at roughly a dollar a milligram, t...
Source: Kevin, M.D. - Medical Weblog - October 17, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/julie-craig" rel="tag" > Julie Craig, MD < /a > Tags: Meds Pain Management Public Health & Policy Source Type: blogs
Take a close look at the number of opioid pills you ’re prescribing
Recently, a generally healthy friend of mine had two small, unrelated surgeries over the course of a few months. For the first, a small operation on his hand, he received a prescription for 30 oxycodone pills. He used one the night after surgery, to make sure pain wouldn’t wake him. Over the next few days he used a few over the counter acetaminophen tablets for his modest discomfort, and then was all done. Two months later, a small suspicious lesion had to be removed from his leg by a different doctor. Again, he got 30 tablets of oxycodone. He used one the first night and continued with acetaminophen. Problem solved.
But...
Source: Kevin, M.D. - Medical Weblog - October 15, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/tia-powell" rel="tag" > Tia Powell, MD < /a > Tags: Meds Pain Management Primary Care Source Type: blogs
Too Good to Be True? A Nonaddictive Opioid without Lethal Side Effects Shows Promise - Scientific American
With nearly 50,000 drug overdose deaths from opioids last year and an estimated two million Americans addicted, the opioid crisis continues to rage throughout the U.S. This statistic must be contrasted with another: 25 million Americans live with daily chronic pain, for which few treatment options are available apart from opioid medications.Opioid drugs like morphine and Oxycontin are still held as the gold standard when it comes to relieving pain. But it has become brutally obvious that opioids have dangerous side effects, including physical dependence, addiction and the impaired breathing that too often leads to death fr...
Source: Psychology of Pain - September 19, 2018 Category: Anesthesiology Source Type: blogs
Constipated Society
Our ancestors who lived without grains, sugars, and soft drinks enjoy predictable bowel behavior. They ate some turtle, fish, clams, mushrooms, coconut, or mongongo nuts for breakfast, and out it all came that afternoon or evening—large, steamy, filled with undigested remains and prolific quantities of bacteria, no straining, laxatives, or stack of magazines required. If instead you are living a modern life and have pancakes with maple syrup for breakfast and you’ll be lucky to pass that out by tomorrow or the next day. Or perhaps you will be constipated, not passing out your pancakes and syrup for days, passing it inc...
Source: Wheat Belly Blog - August 30, 2018 Category: Cardiology Authors: Dr. Davis Tags: News & Updates bloating bowel flora bran constipation Dr. Davis fiber grain-free grains hydrate Inflammation laxatives Opiate drugs Opiods prebiotic undoctored wheat belly Wheat Belly Total Health Source Type: blogs
Constipation Nation
Our ancestors who lived without grains, sugars, and soft drinks enjoyed predictable bowel behavior. They ate some turtle, fish, clams, mushrooms, coconut, or mongongo nuts for breakfast, and out it all came that afternoon or evening—large, steamy, filled with undigested remains and prolific quantities of bacteria, no straining, laxatives, or stack of magazines required. If instead you are living a modern life and have pancakes with maple syrup for breakfast, you’ll be lucky to pass that out by tomorrow or the next day. Or perhaps you will be constipated, not passing out your pancakes and syrup for days, passing it inco...
Source: Wheat Belly Blog - August 30, 2018 Category: Cardiology Authors: Dr. Davis Tags: News & Updates bloating bowel flora bran constipation Dr. Davis fiber grain-free grains hydrate Inflammation laxatives Opiate drugs Opiods prebiotic undoctored wheat belly Wheat Belly Total Health Source Type: blogs
Death Notification as Behavior Modification: Let's think this through
by Ben Skoch (@skochb)Opioid Problem. Opioid Epidemic. Opioid Crisis.Call it what you will (as long as you don ’t use the word narcotic, butthat ’s another article), but the United States has a real issue with opioids right now. It has been much talked about, publicized, criticized, politicized, has left some people ostracized, to a point where the concern has become supersized. Six years ago,a reportstated enough opioid prescriptions were written for every adult in the US to have a bottle of pills, about 259 million. Couple that with thereport from the CDC that over 42,000 people died from opioid (illicit and prescrib...
Source: Pallimed: A Hospice and Palliative Medicine Blog - August 24, 2018 Category: Palliative Care Tags: behavior change burnout california journal article opioids research skoch The profession Source Type: blogs
