Articles Posted in Addiction

pills-drugs-300x215The epidemic of opioid drug abuse, which increasingly is claiming children’s lives, has plenty of blameworthy causes. Here’s a new one: health insurers which steer patients to cheaper, more addictive painkillers while playing Scrooge for less addictive but pricier alternatives.

Pro Publica, a Pulitzer Prize-winning investigative journalism site, and the New York Times get credit for their expose of  penny-wise and pound-foolish prescription management practices.

By analyzing “Medicare prescription drug plans covering 35.7 million people in the second quarter of this year,” the news organizations say they saw repeated patterns in which insurers and the spin-off businesses that run their drug payment plans (so-called pharmacy benefit mangers or PBMs) easily and quickly approve opioids for patients in pain, medications that cost relatively little. They throw up all kinds of obstacles, however, to doctors and patients who try to use less potent but more expensive drugs, including patches containing Butrans (a lesser opioid) or lidocaine. They also drag their feet on approving payments for addiction-fighting medications like Suboxone.

Heroin-Fentanyl-vials-NHSPFL-1600x900-300x169A Missouri  Senator has accused Insys Therapeutics, a major drug maker, of conducting a sneaky campaign to get more pain-wracked cancer patients to use its synthetic and super powerful opioid drug, thus helping to fuel the wildfire spread of increasingly lethal and debilitating prescription pain killers.

Sen. Claire McCaskill and investigators from a Senate committee, as well as federal prosecutors, have painted a harsh picture of how Insys created a special unit to boost sales and use of Subsys, its spray form of the potent painkiller fentanyl.

Through an elaborate ruse—which included carefully crafted scripts and bogus phone numbers—Insys workers contacted prescription benefit management (PBM) firms, making them believe they were patients seeking a required pre-approval for their doctors to prescribe them Subsys.

syphillis-150x150The myriad problems tied to the nation’s opioid drug abuse epidemic seem only to worsen and grow more complex by the day. They are, recent news reports say:

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.

us_inequality_600px
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.

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