How Corporate Health Care Leaders Maintain Their Impunity: The Case of Purdue Pharma's Funding of the Washington Legal Foundation to Attempt to Weaken the Responsible Corporate Officer Doctrine
The ongoing epidemic ofnarcotic (opioid) abuse, and the resulting rise in the deaths due to overdoses, has focused attention on pharmaceutical companies ' aggressive promotion of these drugs which minimized their substantial risk.A recent article in the Intercept showed how the leadership of one such company tried to insulate itself from responsibility for such actions even while such promotions were continuing.Background: Impunity of Top Leaders of Big Health Care OrganizationsFor years, we have railed against theimpunity of top leaders of health care organizations.  We have noted that despite numerous legal settleme...
Source: Health Care Renewal - March 6, 2018 Category: Health Management Tags: impunity legal settlements narcotics Purdue Pharma responsible corporate officer doctrine tobacco Source Type: blogs

The Agony of Withdrawal
​Part 3 in a Four-Part Series​A 26-year-old man presented with fatigue. He complained of body aches, diarrhea, and nausea. His history was significant for chronic back pain, for which he had been prescribed oxycodone that he has taken daily for three years. He reported that he had stopped taking it two days before his visit.He denied other medication or drug use. He was alert but restless and diaphoretic. His ECG showed sinus tachycardia. His labs included a WBC of 12, Hgb of 12, glucose of 89 mg/dL, creatinine of 1.0 mg/dL, sodium of 140 mEq/L, potassium of 3.8 mEq/L, and CK of 140 U/L. He was experiencing opioid with...
Source: The Tox Cave - February 28, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

There ’s no easy way out of the opioid epidemic
Across the United States at least forty people die each day from overdosing on opioids like Vicodin, codeine, heroin, and oxycontin. Seven percent of drivers who died in car crashes last year were found to have prescription opioids in their systems — seven times more than in 1995. Considering these alarming rates of overdosing and DUIs, this is serious business. Authorities view it in their traditional way: the problem is drugs. Thus doctors should curtail prescribing, and patients should clean up and go through rehab. But the situation’s less about drugs than, frankly, rampant suicide. These drugs’ risks...
Source: Kevin, M.D. - Medical Weblog - February 21, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/jeff-kane" rel="tag" > Jeff Kane, MD < /a > Tags: Physician Pain Management Psychiatry Source Type: blogs

Welcome to the DOG Patch: first in a series?
Lately my dander is up so often and so copiously, over what ' s happening in health care and the world at large, I ' m exhausted. Covered with nasty dander. Cowering under the sheets. Others seem to share this dysphoria. But I found if not a cure, at least a palliative. There ' s so much dander I can scrape it off with a great big shovel and toss as much as I can your way. Here ' s my first DanderOmnium Gatherum, or DOG, from the Cetona DOG Patch. Remember, these stories are all DOGs.Litmus Test for New HHS Secretary. The new sheriff at Health& Human Services, Alex Azar, has barely had a chance to wipe his feet in...
Source: Health Care Renewal - February 15, 2018 Category: Health Management Source Type: blogs

As We All Know We Have To Work Hard To Avoid The Downside Of Technology In Health Care. Here Is A Digital Health Disaster We All Need To Learn From!
This appeared last week:Paul Lau died at Sydney hospital after wrongly being prescribed fentanyl: inquestGeorgina Mitchell Published: February 5 2018 - 4:58PMA patient who went to a north-west Sydney hospital for an "uneventful" day surgery died within hours after an anaesthetist accidentally prescribed him a potent opioid meant for someone else, an inquest has heard.Paul Lau, 54, was a keen skier who went to Macquarie University Hospital on June 18, 2015, for a reconstruction of the anterior cruciate ligament on his left knee.Mr Lau, a father of two, had a successful surgery and was taken to recovery. He rarely ...
Source: Australian Health Information Technology - February 14, 2018 Category: Information Technology Authors: Dr David More MB PhD FACHI Source Type: blogs

A Doctor ’s Painful Struggle With an Opioid-Addicted Patient - Siddhartha Mukherjee - The New York Times
I once found myself entrapped by a patient as much as she felt trapped by me. It was the summer of 2001, and I was running a small internal-medicine clinic, supervised by a preceptor, on the fourth floor of a perpetually chilly Boston building. Most of the work involved routine primary care — the management of diabetes, blood pressure and heart disease. It was soft, gratifying labor; the night before a new patient's visit, I would usually sift through any notes that were sent ahead and jot my remarks in the margins. The patient's name was S., I learned. She had made four visits to the emergency room complaining o...
Source: Psychology of Pain - February 5, 2018 Category: Anesthesiology Source Type: blogs

Head Impact and Hyperphosphoralated Tau in Teens
We all agree that repeated blows to the head are bad for the brain. What we don ' t yet know is:who will show lasting cognitive and behavioral impairmentswho will show only transient sequelae (and for how long)who will manifest long-term neurodegeneration...and by which specific cellular mechanism(s)Adding to the confusion is the unclear terminology used to describe impact-related head injuries. Is aconcussion the same as a mild traumatic brain injury (TBI)? Sharp and Jenkins say absolutely not, and contend thatConcussion is confusing us all:It is time to stop using the term concussion as it has no clear definition and no ...
Source: The Neurocritic - February 5, 2018 Category: Neuroscience Authors: The Neurocritic Source Type: blogs

Think twice before tapering opioids in some patients
Bill is a 58-year-old male with a history of head and neck cancer as well as chronic low back pain who presents to his new primary care doctor for a routine checkup and visit for a medication refill. He works in construction and has been on chronic opioid therapy after his cancer — with a stable dose of 15 mg of oxycodone for over five years. At his new primary care visit, after a few meet and greet pleasantries, his new primary care doctor discusses his current medication regimen with him — ibuprofen 400mg TID and oxycodone 15mg BID. His physician expresses significant concern with his medication regimen, telling Bill...
Source: Kevin, M.D. - Medical Weblog - February 4, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/casey-grover-and-lee-goldman" rel="tag" > Casey Grover, MD and Lee Goldman, MD < /a > Tags: Conditions Oncology/Hematology Source Type: blogs

Psychology Around the Net: February 3, 2018
Well, ol’ Punxsutawney Phil saw his shadow yesterday, so we might be looking at six more weeks of winter — “might,” because he’s usually wrong. However, if he’s right, there’s plenty of cozy wintertime activities to get us through the days and nights when it’s too cold or snowy to go out. One of my favorites? Reading! Coincidentally, in this week’s Psychology Around the Net we have a list of 10 new mental health books out in 2018! We also have the latest on the anti-diarrhea medicine overdoses, a psychologist’s controversial research regarding how we distinguish p...
Source: World of Psychology - February 3, 2018 Category: Psychiatry & Psychology Authors: Alicia Sparks Tags: Addiction Books Habits Industrial and Workplace Medications Phobia Psychology Around the Net Research Substance Abuse anti-diarrhea medicine books about mental illness business coaches Gaydar Imodium Michal Kosinski Opioids Source Type: blogs

The Opioid Crisis – In Your Cupboard
The opioid epidemic of the last 20 years has served to illustrate the powerful addictive properties of anything that binds to opioid receptors of the human brain. Lives are ruined by opioid addiction, more than 100 deaths now occurring every day from overdose as people either take more and more to overcome the partial tolerance or new potent drugs like fentanyl make their way into street versions. Drugs such as oxycodone, hydrocodone, and fentanyl bind to the brain’s opioid receptors provoking a “high” while causing the user to desire more opioids as partial tolerance develops. And make no mistake: Much o...
Source: Wheat Belly Blog - January 30, 2018 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle addiction addictive eating disorder opiates opioids undoctored Source Type: blogs

Burnout Returns to Center Stage
A recentMayo Clinic Proceedings guesteditorial, by Yale University physician Kristine Olson, asks the question--to some of us it ' s far from a rhetorical one--whether burnout among her fellow physicians is in fact " A Leading Indicator of Health System Performance? "Seems to me that her gist is: yes, it surely must be just such an indicator. If she ' s right, then our system ' s performance is in a heap of trouble.What is burnout? Our fearless editor, Dr. Poses, has addressed it repeatedly, including a few months agohere in these pages. But burnout is actually hard to delineate and hard to quantify. People quitting? ...
Source: Health Care Renewal - January 30, 2018 Category: Health Management Source Type: blogs

RWJF Opioid Challenge: You Can Help
By CHELSEA POLANIECKI AND CHANLY PHILOGENE Opioid overdoses are the leading cause of death for Americans under 50 years old. In fact, the majority of drug overdose related deaths involve an opioid. According to the National Center for Health Statistics, deaths from prescription opioids—drugs like oxycodone, hydrocodone, and methadone—have more than quadrupled since 1999. The U.S. is currently experiencing an opioid epidemic, as more than 2 million Americans have become dependent on, or abused prescription pain pills and street drugs. Substance misuse is not only affecting the users but also their families, friends, a...
Source: The Health Care Blog - January 29, 2018 Category: Consumer Health News Authors: Matthew Holt Tags: Catalyst @ Health 2.0 Opioid Source Type: blogs

Federal Grand Jury Indicts Three in Opioid Scheme
With the opioid crisis rapidly gaining steam, we are starting to see some of the legal ramifications from the overprescribing of opioids. Recently, two doctors and their business partner were indicted in federal court for allegations that they were illegally distributing drugs. George P. Naum, a physician from Wheeling, WV; Felix Brizuela, Jr., a physician from Harrison City, Pennsylvania; and their business partner Eric Drake from Weirton, West Virginia were the three men indicted. Dr. Brizuela was indicted on 21 counts of distribution of controlled substances outside the bounds of professional medical practice; one cou...
Source: Policy and Medicine - January 24, 2018 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

More on the Opiate Abuse Epidemic: Where Again Does the Finger Point?
In arecentblog post we pointed to conservatives ' efforts to implicate Medicaid funding as somehow causative of, or at least promoting, the opiate " crisis. " After all, funding for medications means people will use, and sometimes abuse, those medications. Meds they might otherwise ill be able to afford. (Implied solution: cut Medicaid.)We also alluded to some of the logical fallacies in such thinking. Here, though, let ' s take it to another level: the blame game, where does it lead? Where does the finger point? Those who agree with Ronald Reagan that government is the problem, not the solution, fall into the trap of blam...
Source: Health Care Renewal - January 23, 2018 Category: Health Management Source Type: blogs