Articles Posted in Addiction

booze-256x1024It’s more than happy hour chardonnays with office mates or malt liquors  at a summer barbecue.

Public health experts are warning that alcohol drinking is rising sharply, and in especially worrisome fashion for women, seniors, African Americans, Latinos, and Americans of Asian descent. As the nation struggles with addiction crises—especially a plague of opioid drug abuse—booze woes may be getting less than their deserved attention.

Our heavy and increasing alcohol consumption, as captured in a sizable and regular survey of Americans’ tippling habits, should be of big concern. That’s because experts note that it can “portend increases in many chronic co-morbidities in which alcohol use has a substantial role.”

cig-300x225The nation’s long war on one of its leading preventable killers has taken a surprising tactical turn, as the head of the federal Food and Drug Administration has declared that tobacco companies will face new regulations aimed at slashing nicotine in cigarettes.

FDA Commissioner Scott Gottlieb argues that cutting the noxious and addictive nicotine will help Americans unhook themselves from tobacco use, prompting less cigarette smoking, and, potentially increasing the use of possibly less harmful health vices, like nonburning “e-cigarettes” for vaping.

Gottlieb, at the same time, put further off a planned FDA crackdown on e-cigarette makers, delaying for several years requirements that they disclose ingredients in their colorful, flavored vaping liquids and demonstrate that they and other e-cigarette products do not cause health harms.

nucarmen-189x300Although smaller community hospitals may provide treatments that are as good and as safe, Americans flock to academic medical centers for specialized care and complex procedures. They’re lured to the big, pricey institutions by their stellar reputations, state-of-the-art facilities, and top-line specialists. These tall, shiny complexes, combining medical education, research and clinical care, also have deep roots in their communities and become political powerhouses in their own right.

Which is why many in the nation’s No. 2 city are abuzz over a Los Angeles Times investigation into the “secret life” of Carmen A. Puliafito, a Harvard-trained eye expert. Until 18 months ago, he had served for a decade as the $1 million-a-year dean of the University of Southern California’s Keck School of Medicine. As Keck’s top doc, the paper says, he “oversaw hundreds of medical students, thousands of professors and clinicians, and research grants totaling more than $200 million … [and] was a key fundraiser for USC, bringing in more than $1 billion in donations, by his estimation.”

The university—which is Los Angeles County’s largest employer, a haven for affluent offspring of West Coast elites, and long has craved global recognition—hired and backed Puliafito to boost the medical school’s  standing.  But during his tenure, the Los Angeles Times found, Puliafito also “kept company with a circle of criminals and drug users who said he used methamphetamine and other drugs with them.” As the paper describes it:

Pinocchio_Smoking-300x169Tougher ratings for movies targeting teen-agers and higher cigarette taxes may be two good ways to crack down on Big Tobacco’s persistent and harmful peddling of its poisonous wares, health experts say, based on information flowing from the sprawling Golden State.

The federal Centers for Disease Control and Prevention has just assessed Hollywood’s progress in reducing depictions of tobacco in the movies, finding that, under pressure from anti-smoking campaigns,  Tinsel Town had slashed its showing of the use or implied use of cigarettes, cigars, pipes, hookah, smokeless tobacco products and electronic cigarettes from 2005 to 2010. But that progress has reversed since then, and now, based on top 10 grossing movies in any calendar week, cinematic depictions of tobacco use has soared by 80 percent.

Although pictures rated G or PG, those films most accessible to the broadest movie-going audiences, saw reductions in their showing of smoking and other tobacco use, depictions of these negative health practices rose sharply in movies aimed more at teenagers and older youths  in those works with ratings of PG-13 (by 43 percent) and R (by 90 percent).

opioid-graficAlthough Americans may like to think that it doesn’t or shouldn’t matter as much as it does, where they live can have major effects on their health. Geography isn’t an absolute determinant, but key differences have been discerned in how it affects the prescribing dangerous opioid drugs, cancer death rates, some air pollution harms, and risks of insect-related infections. Let’s look at specifics:

Opioid prescribing dips but data show big regional differences

The federal Centers for Disease Control and Prevention has provided a rare glimmer of good news about the nation’s epidemic of powerful painkiller abuse, finding that the peak of doctors’ opioid drug prescribing appears to have occurred in 2010 and has dropped sharply since.

overdose-300x225Taken from a most favorable point of view, Big Pharma and doctors tried to address a big physical problem for patients when they pushed ahead in recent years with potent painkillers. But now, it’s those troubled Americans’ mental health woes that  officials may need to deal with to better battle what has become an epidemic of opioid drug abuse.

It’s a crisis that may worsen still and claim as many as 650,000 lives in the next decade, says the online health information site, Stat, which consulted 10 leading experts to develop its forecast.

Stat and other news organizations also have reported on newly published research showing the depths of the mental health challenges of those who abuse opioid drugs, with adults with a mental illness each year receiving more than half of the 115 million opioid prescriptions in the United States.

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Although most Americans finally may be breaking out of cigarette smoking’s killer grip, Big Tobacco keeps inflicting terrible harm on some of the nation’s most vulnerable—the poor, uneducated, and those who live in rural areas.

The federal Centers for Disease Control has just offered its annual assessment on Americans’ smoking habits, providing some rare good news about most of us and especially kids: Cigarette smoking among the nation’s youth is diving to new lows, and the use of smokeless or e-cigarettes for “vaping” showed its first declines.

Anti-smoking campaigns may be working, persuading teens and many adults to avoid smoking or to quit the bad habit that has been proven to cause cancers and to contribute to heart disease and other damaging conditions, the CDC says. The agency also notes that youth vaping and smoking may have declined due to new age-based restrictions on product sales and advertising.

actemraBig Pharma and medical device makers have opened their wallets for a 2017 lobbying spree, throwing  tens of millions of dollars around the nation’s capital, including to campaign with lawmakers and regulators to defend their soaring prices and to speed the path for their products to get to markets. But credit’s due to officials and organizations like Stat, the online health information site, for building a greater urgency behind a different narrative: It may be as crucial to monitor and regulate drugs and medical devices after they’re publicly available as pre-approval.

A two-part Stat report, aptly titled “Failure to warn,” dismantles existing oversight of prescription medications, especially regulators deeply flawed, big-data driven initiative dubbed Sentinel. The eight-year-old, $207 million program is supposed to mine insurance records to surface side-effects of drugs recently approved by the federal Food and Drug Administration.

But by examining 500,000 reports of side-effects from drugs targeted at the 1.5 million Americans with debilitating rheumatoid arthritis, Stat shows Sentinel’s shortcomings with Roche’s billion-dollar RA product Actemra. The FDA has received 1, 128 reports, complaining about patients who have died while taking it. But the agency, Stat says, “doesn’t have sophisticated tools to determine whether the drug was a culprit or a bystander in those deaths.”

ohio-300x185With more than 4,000 overdose deaths last year alone and a fifth of its residents having received prescriptions for powerful painkillers, the state of Ohio has sued five Big Pharma companies, accusing them of mispresenting opioid drugs’ risks and fueling the medications’ epidemic abuse.

Ohio joins Mississippi in suing makers of increasingly lethal drugs like OxyContin and Percocet, whose addictive nature was hidden and downplayed by Big Pharma, critics say. The abuse of prescription opioids has fueled heroin use, with 33,000 Americans dying last year alone due to overdoses, federal and state health and law enforcement officials have said.

Fatal drug overdoses now exceed gun- or vehicle-deaths and they are matching the terrible tolls exacted at the height of the HIV-AIDS pandemic. Heartland America, and particularly white men, have been hard hit by the opioid drug crisis, with Ohio, Kentucky, New Hampshire and West Virginia recording the nation’s highest numbers of overdose deaths.

vaper-300x112The Trump Administration has sent disturbing signals on whether it will keep Big Tobacco from hooking more Americans on high-tech, nicotine-addictive products—so-called e-cigarettes used, especially by the young, for “vaping,” as well as cigars and hookahs.

The federal Food and Drug Administration, almost exactly a year ago, announced it would crack down, in particular, on e-cigarettes, forcing their makers to submit them for regulatory approval and oversight. Uncle Sam also barred makers from targeting the young with certain kinds of product advertising and giveaways. E-cigarettes still cannot be sold to consumers younger than 18 and free samples are still barred.

But the Washington Post has reported that the administration is delaying key aspects of its rules on vaping, cigars, and hookahs so newly installed federal health officials can get up to speed in their posts.

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