Articles Posted in Pain

fentanylA steady flow of news reports shows how our nation’s opioid crisis can be fairly blamed on just about every actor in the medical field that should have known better: Big Pharma, doctors, hospitals, and regulators. It’s been a toxic mix of incompetence, indifference and out-and-out  deceptive conduct that produced the epidemic that now claims tens of thousands of American lives each year.

Take, for instance, the drug fentanyl, a lab-created painkiller 100 times more powerful than morphine. How did it escape the confines of legitimate prescription pain control to become a killer street drug? The Washington Post reports, based on research from Johns Hopkins experts, on how doctors, hospitals, and the federal Food and Drug Administration bungled a plan to safeguard the administration of this highly potent drug that had obvious abuse potential from the day it came onto the market.

Meantime, two other news organizations — the Pulitzer Prize-winning investigative website Pro Publica and the online health site Stat — have pried loose disturbing, sealed court testimony, showing how a wealthy, philanthropic family approved a lethal deceit about the potency of OxyContin, a billion-dollar opioid pushed relentlessly by Purdue, the Big Pharma firm they owned.

HepatitisCInvestigators have teased out yet another damaging thread in the villainous web of harms of the opioid crisis. A spike in hepatitis C infections is a costly, long-term, and major health consequence of the hype and disastrous reformulation of OxyContin, the powerful painkiller made by Purdue Pharmaceuticals owned by the wealthy Sackler family.

Purdue, in the 1990s, promoted and sold OxyContin to doctors and hospitals in a relentless campaign that stressed how this drug was supposedly safer and longer acting, releasing its potent effects over as long as a 12-hour span instead of requiring many pills that needed to be taken more often.

Although those claims of the drug’s benefits were dubious to start, patients — especially those abusing the highly addictive prescription medication — found they could get around OxyContin’s delayed release, getting an immediate jolt or walloping high, by crushing their pills. They then snorted Oxy as a powder or mixed it with a liquid and injected it.

cbpbust-300x200If  anyone around doubts still the threat that the opioid crisis poses to the nation, a drug bust involving a vegetable truck in Arizona should provide powerful persuasion: Federal agents, suspicious about the vehicle’s floor, loosed a drug-sniffing dog, resulting in the seizure of not just 395 pounds of methamphetamines but also 254 pounds of fentanyl.

Fentanyl is a synthetic opioid, a lab-created super drug that experts say is 50 times stronger than heroin and up to 100 times more potent than morphine. It packs a wallop for users in tiny grains or flecks.

The record-setting seizure at the Arizona border stop amounted to 144 or so kilograms of fentanyl, with drug enforcement officials estimating that just 1 kilogram of fentanyl can produce 1 million fatal doses. That means just this one bust had the potential to cause 144 million deaths.

artsacklerdc-300x129A plutocratic clan that has labored to portray itself as enlightened patrons of the arts, science, and medicine, instead has been depicted in new court documents as drug profiteers, eager to exploit the misery and even deaths of tens of thousands of Americans.

The stories in the New York Times, Wall Street Journal, Washington Post, and at the online medical science news site Stat paint a damning picture of the Sackler family and their avarice with the family-owned Big Pharma firm Purdue. The company made the clan billions of dollars but also has become the focus of news stories, official investigations, and now a barrage of lawsuits, all asserting that Purdue played a crucial role in fomenting the nation’s opioid drug crisis.

The Sacklers had sought to distance themselves from the horrors unleashed by powerful opioid painkillers, including their company’s top-selling drug OxyContin. The opioid crisis last year alone claimed 70,000 lives, and the prescription and illicit painkillers of their ilk have become a leading cause of death for Americans younger than 50. Overdoses now savage white men, especially in ex-urban and rural areas; women 30 and older; blacks in big cities; and even children.

knees-300x81With a graying nation projected to see millions of patients undergoing knee replacements each year at an annual cost to taxpayers running in the billions of dollars, it may be past time to ask if surgeons and hospitals promote and perform these popular procedures to excess.

Liz Szabo, in a story written for the nonprofit, nonpartisan Kaiser Health News Service (KHN) and published in the Washington Post, reported that knee surgeries have their “risks and limitations,” and “doctors are increasingly concerned that the procedure is overused and that its benefits have been oversold.”

As she wrote:

commishfda-300x200

FDA Commissioner Scott Gottlieb

If the federal Food and Drug Administration expected any public goodwill for putting forward long-term proposals to change a fundamental way that medical devices win agency clearance, forget about it.

Instead, FDA Commissioner Scott Gottlieb and lawmakers should be reeling still from a salvo of news organization investigations into unacceptable ways that patients in this country and around the planet suffer pain, injury, and other harms from products that go in or on the body. Under industry pressure and spurred by pro-business lawmakers, the FDA, the investigations show, has exercised a weak, poor, and unacceptable oversight of medical devices, including:

dsuvia-300x225Big Pharma is a broad commercial sector with many diverse enterprises large and small, but they keep showing they’re united in their giant gall when it comes to their unacceptable products and practices, as timely news reports demonstrate.

Just consider:

hpvshot-300x231Women may need to double-up on their consultations with their specialists about treatment for serious gynecological concerns, as new studies have raised troubling questions about a much-touted minimally invasive surgery for early-stage cervical cancer.

These concerns, in a more perfect world, also would prompt greater questioning and oversight by doctors, hospitals, regulators, and lawmakers of surgical “innovations.”

The procedure now in question removes the uterus, part of the vagina, and other surrounding tissues via small incisions and with special laparoscopic instruments, including robots. Surgeons have advocated for this surgery rather than making a large incision in an “open” procedure, arguing the less invasive approach promotes less discomfort and faster healing for patients.

emergency-300x199As the nation struggles with grief from the latest mass shooting at a Pittsburgh synagogue, new research shows how grievous the mayhem that guns cause for the young, with weapons injuries over nine years sending 75,000 children and teen-agers to emergency rooms at a cost of almost $3 billion.

The Associated Press reported that researchers at Johns Hopkins found in their published study that:

[M]ore than one-third of the wounded children were hospitalized, and 6 percent died. Injuries declined during most of the 2006-14 study, but there was an upswing in the final year. … 11 of every 100,000 children and teens treated in U.S. emergency rooms have gun-related injuries. That amounts to about 8,300 kids each year. The scope of the problem is broader though; the study doesn’t include kids killed or injured by gunshots who never made it to the hospital, nor does it count costs for gunshot patients after they’re sent home.

leapfrog-300x300A familiar health care advocacy group will expand its grading of 2,000 or so hospitals across the country to also provide new safety and quality information on 5,600 stand-alone surgical centers that perform millions of procedures annually.

It may seem like a small step, and the devil will be in the details of the new data that will be voluntarily reported, analyzed, and then made public by the Leapfrog Group, a national health care nonprofit that describes itself as being “driven by employers and other purchasers of health care.”

Surgical centers have burgeoned because they can be nimbler than the hospitals and academic medical centers they now outnumber. The centers can be set up without hospitals’ high overhead costs, including for staff and equipment that may be unnecessary for a specialty practice. The facilities also can be set up closer to patients, theoretically offering them greater access and convenience, including with easy navigation and parking.

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