Articles Posted in Medications

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Breast cancer patients may get a welcome respite from one of the disease’s dreaded aspects — its aggressive and costly treatments. New research suggests that thousands of women with early-stage breast cancer who now are told to get chemotherapy don’t need it, while a larger, significant number of patients can benefit by halving the time they’re told to take an expensive drug with harsh side-effects, especially for the heart.

Although this information should be taken in a positive light, patients should consult with their doctors about appropriate treatment for their individual case.

The prospective shifts in breast cancer treatment, based on new findings, may add to rumblings and criticisms about over-treatment and whether doctors have taken too lightly the toll — physically, mentally, and financially — that this and other forms of cancer inflict on patients.

cdc-3suicide-300x117Uncle Sam’s sobering new report about suicide rates rising in all but one state between 1999 and 2016, with fatal increases across age, gender, race and ethnicity, became even more somber and urgent with the shock and grief expressed widely over the self-inflicted deaths of chef-raconteur Anthony Bourdain in France and fashion designer-entrepreneur Kate Spade in Manhattan.

Suicide no longer should be viewed solely as a personal mental health problem but also now as a public health crisis, the federal Centers for Disease Control and Prevention warned.  Anne Schuchat, the CDC’s principal deputy director, told the Washington Post: “The data are disturbing. The widespread nature of the [suicide rate] increase, in every state but one, really suggests that this is a national problem hitting most communities.”

The suicides of Bourdain, 61, and Spade, 55, hit many hard, as was reflected in the extensive media coverage and social media reactions. Both Bourdain and Spade rose from modest circumstances, with abundant hard work, talent, personality, and ambition, to lead lives in the spotlight, and with an economic comfort that others would envy and consider glamorous. They were “successes.”

MarijuanaOpioids-300x150There’s been a deadly side to the nation’s opioid drug abuse crisis and increasing number of states’ legalization of marijuana: A leading safety group says the number of drugged drivers killed in car crashes is rising dramatically.

The Governors Highway Safety Association reported that 44 percent of fatally injured drivers tested for drugs had positive results in 2016, which is up more than 50 percent compared with a decade ago, according to a blog post by the nonprofit, nonpartisan Pew Trusts, which added that, “more than half the drivers tested positive for marijuana, opioids or a combination of the two.”

As Pew reported, the District of Columbia and nine states “allow marijuana to be sold for recreational and medical use, and 21 others allow it to be sold for medical use. Opioid addiction and overdoses have become a national crisis, with an estimated 115 deaths a day. States are struggling to get a handle on drugged driving. Traffic safety experts say that while it’s easy for police to test drivers for alcohol impairment using a breathalyzer, it’s much harder to detect and screen them for drug impairment. There is no nationally accepted method for testing drivers, and the number of drugs to test for is large. Different drugs also have different effects on drivers. And there is no definitive data linking drugged driving to crashes.”

suicide-300x154Moms, dads, grandparents, teachers, and coaches all may need to increase even more the attention and concern they devote to teen-agers, especially young women, as hospitals and emergency rooms report dramatic increases in their treatment of youthful suicides.

Multiple news organizations reported that, as the New York Times noted, “the proportion of emergency room and hospital encounters for …  suicide-related diagnoses almost tripled, from 0.66 percent in 2008 to 1.82 percent in 2015. And the rate of increase was highest among adolescent girls.”

NPR reported: “Children ages 5 to 17 visited children’s hospitals for suicidal thoughts or attempts about twice as often in 2015 as in 2008.”

Did you hear it? Was that a giant sigh of relief by Big Pharma executives around the globe? Or was it the air deflating from any Americans who still had high expectations that President Trump, as he had promised for more than a year, really would offer a quick, powerful, and effective public policy prescription to slash skyrocketing drug prices?

The stock market made a big bet that Big Pharma would do just fine, sending drug manufacturer stocks higher.

maternalmorbidity-300x193Here is a  sobering public health angle on Mother’s Day.

Experts on international health and development, including the likes of Pulitzer Prize-winning foreign correspondent and columnist Nick Kristof, long have argued that a key way to major improvements in distant lands rests in boosting the lot of women and girls. It’s an issue that clearly also needs attention closer to home.

National Public Radio and Pro Publica, a Pulitzer-winning investigative site, deserve yet more credit for their continuing dig into a shame of contemporary American health care — why U.S. mothers die in childbirth at a far higher rate than in all other developed countries. Their latest disturbing reporting focuses on some unacceptable numbers:

deductibles-300x199More than 18 million U.S. adults and 6 million children have asthma, a chronic lung disease that inflames and narrows airways and causes recurring wheezing, chest tightness, shortness of breath, and coughing.

How and why Big Pharma jacked up prices for one of the common treatments for this disease tells a key story of not only the difficulty in controlling skyrocketing drug costs but also drug makers’ willingness and capacities to exploit an affliction that costs the country more than $56 billion annually and hits hard at the young, poor, minorities, and the under- or un-insured.

Good Rx, a website led by three technology entrepreneurs who say they want to help Americans with soaring drug costs, deserves credit for reporting on its blog the story of asthma inhalers, and how Big Pharma has kept pushing ever higher the price for them.

odmapapp-150x300Ss the nation’s opioid crisis spirals into ever-more risky territory where synthetic painkillers get mixed with illegal drugs with fatal results, reporters are digging deeper into how drug companies got the country into this mess and cities now are stepping up with different approaches to curb deadly overdoses.

Vox, an online news and information site, reported that experts aren’t sure why, but they’re seeing an ugly trend in users and dealers mixing fentanyl, a synthetic opioid and sometimes legally prescribed painkiller, and other illicit narcotics, notably cocaine and heroin.

Vox reporter German Lopez, in interviews with drug experts, finds they are divided: Some think the deadly mixtures are occurring on purpose, with users seeking even greater intoxication or dealers promoting this to them. It may be that the mixtures are occurring unintentionally, as fentanyl, even in the tiniest amount as a residue, packs a wallop. Or it may be that authorities, as they try to get a better handle on the opioid crisis, have developed sharper data on drug abuses.

eddie-300x169The Food and Drug Administration has cracked down on illegal sales of vaping devices to minors,  taking aim at the suddenly trendy, pricey, and small Juul e-cigarette. But this aggressive regulatory move itself added to criticism of the agency for its failure to clamp down on a key way kids get dosed with nicotine, a highly addictive substance the FDA hopes to slash from tobacco cigarettes.

April, the agency announced, not only has brought showers but also nationwide, month-long undercover raids and citations by enforcement agents for retailers accused of flouting FDA regulations that bar e-cigarette sales to Americans younger than 21.

The FDA also told Juul’s maker that it must produce a raft of documents and explain how and why its product exploded in popularity, dominating in market share and raising questions about how much nicotine users can get from the vaping device — typically as much as a pack of tobacco cigarettes.

roulette-300x188Although Americans may love to wager on ponies, lotteries, and even church bingo games, they’re getting restive and confused about playing the odds with their health — and doctors need to step up their game a lot to help patients better cope with medical uncertainties.

Dhruv Khullar, a physician at NewYork-Presbyterian Hospital and a researcher at the Weill Cornell Department of Healthcare Policy and Research, has written an excellent piece for the New York Times’ evidence-driven “Upshot” column, detailing a modern, thorny part of doctor-patient relationships:

Medicine’s decades-long march toward patient autonomy means patients are often now asked to make the hard decisions — to weigh trade-offs, to grapple with how their values suggest one path over another. This is particularly true when medical science doesn’t offer a clear answer: Doctors encourage patients to decide where evidence is weak, while making strong recommendations when evidence is robust. But should we be doing the opposite? Research suggests that physicians’ recommendations powerfully influence how patients weigh their choices, and that while almost all patients want to know their options, most want their doctor to make the final decision. The greater the uncertainty, the more support they want — but the less likely they are to receive it.

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