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Thursday, October 30, 2014

Legalization of Marijuana 2014

As we move closer to Election Day 2014 our nation's candidates are not the only thing on peoples' minds. Just two years after Washington and Colorado voted in favor of marijuana legalization, Oregon, Alaska and Washington, D.C. have measures on their ballots, according to the New York Times.

After two years of marijuana legalization being viewed as a way to reduce prison overcrowding and law enforcement budgets, conservative opposition to legalization has significantly diminished and democrats aren't as concerned about being labeled soft on crime for their support on legalization, according to the report. Many believe that the outcome of these three initiatives could determine whether there will be a national tide of legalization.

It seems that there is a good chance that we’ll be seeing more states where recreational marijuana use is legal after the ballots are counted. Consider that pro-legalization groups have crushed their opponents’ fundraising efforts by more than 25 to 1 in Oregon and by 9 to 1 in Alaska. Much of the pro-legalization money is coming from the vast coffers of the legal marijuana industry already in place

“The support coalition is definitely broader, and the opposition has splintered,” said Corey Cook, a follower of the debate and an associate professor of politics at the University of San Francisco.

The Washington, D.C. based Marijuana Policy Project and the Drug Policy Alliance, based in New York have handled much of the fundraising for the pro-legalization measures, according to the article.

“The opposition made good traction for 50 years, and it was built around locking people up. A massive industry was built around it,” said Richard Branson, the entrepreneur who founded Virgin Group and a member of the Drug Policy Alliance’s international honorary board.

Critics of legalization are concerned about the exposure to young people and highway safety, pointing out apparent flaws in both Colorado and Washington programs. “Legalization in practice has been the biggest enemy of legalization,” said Kevin Sabet, a co-founder of a national anti-legalization group, Smart Approaches to Marijuana.

Tuesday, October 28, 2014

Prescription Opioid Overdose ER Visits

It is a common misconception amongst addicts that prescription drugs are safer than illicit narcotics, because they are prescribed by a doctor. Many do not realize just how dangerous drugs like oxycodone and hydrocodone can be, which often times leads to overdose deaths. New research indicates that more than two-thirds of emergency department visits for opioid overdoses involve prescription drugs, HealthDay reports.

Tens of thousands of opioid overdoses nationwide were analyzed by Stanford medical student, Michael Yokell, along with a team of research colleagues at the Stanford University School of Medicine. The findings indicated that approximately 68 percent of all overdoses involved prescription drugs, according to the article.

It turns out that the number of overdoses tied to prescription opioids could be even higher, since 13 percent of cases did not specify the drugs involved. The research showed that multiple narcotics were involved in three (3) percent of cases. The findings showed that 16 percent of overdose cases involved heroin.

“Opioid overdose exacts a significant financial and health care utilization burden on the U.S. health care system,” the researchers wrote. “Most patients in our sample overdosed on prescription opioids, suggesting that further efforts to stem the prescription opioid overdose epidemic are urgently needed.”

Prescription opioid overdoses occurred most commonly in urban areas at 84 percent, 40 percent of overdoses were in the South. Interestingly, women made up 53 percent of prescription opioid overdoses.

The findings were published in JAMA Internal Medicine.

Thursday, October 23, 2014

Synthetic Marijuana Related ER Visits

People who use synthetic marijuana are often unaware just how dangerous it can be; in fact, many users believe the drugs to be fairly benign. Drugs like “K2” and “Spice” have been responsible for a number of emergency room visits in recent years. Research in a new government report showed that emergency rooms visits due to synthetic marijuana more than doubled between 2010 and 2011, HealthDay reports.

“These injury reports compel us to get the word out to all segments of the community — especially youth — that these products can cause significant harm,” noted Pamela Hyde, Administrator at the Substance Abuse and Mental Health Services Administration (SAMHSA) in a news release.

More than 28,500 emergency room visits can be linked to synthetic marijuana in 2011, up from 11,400 in 2010, according to the report. The number of teens ages 12 to 17, that went to the ER because of synthetic marijuana rose from about 3,800 to nearly 7,600 during that year. Young adults ages 18 to 20 rose from about 2,000 to more than 8,000.

Synthetic marijuana physical effects can include:
  • Seizures
  • Vomiting
  • Loss of Control
  • Increased Agitation
  • Pale Skin
  • Profuse Sweating
  • Lack of Pain Response
  • High Blood Pressure
  • Elevated Heart Rate and Palpitations
  • Uncontrolled/Spastic Body Movements
Mental effects can include:
  • Severe Paranoia
  • Delusions
  • Hallucinations
  • Agitation
While the Synthetic Drug Prevention Act of 2012, which prohibits the sale or possession of some types of synthetic marijuana, has had some effect; policing synthetic drugs continues to be extremely difficult. “Manufacturers of these compounds continue to modify their chemical structures in an attempt to evade current laws,” notes SAMHSA.

Tuesday, October 21, 2014

CVS Fight Against Tobacco

If you happened to venture into a CVS pharmacy this fall, you may have noticed that something was missing at the checkout counter - cigarettes. In September, CVS stopped selling tobacco products, much to the dismay of many long time customers. CVS has taken their efforts one step further, now the company is pressuring other pharmacies to follow their lead, according to The Washington Post.

New rules issued by Caremark, the pharmacy benefits management arm of CVS, will require some customers to pay a $15 co-payment on prescriptions filled at non-CVS pharmacies that sell tobacco products. The new rules will have a two-fold effect, it will encourage customers to fill their prescriptions at CVS pharmacies and put a financial squeeze on other pharmacies in the Caremark network to stop selling tobacco products, according to the report.

“For clients who choose a tobacco-free network, plan members would be provided with a full list of participating pharmacies in advance of any network change,” CVS spokeswoman Carolyn Castel told the newspaper. “A tobacco-free network would include CVS/pharmacy and Target nationally as well as other local or regional pharmacies including numerous independent pharmacies that do not sell tobacco products.”

An unrestricted grant from CVS funded a study which found that 6 percent of customers that filled an asthma or COPD medicine, also made at least one cigarette purchase within the same week. The findings indicated that 5.1 percent of people taking high blood pressure medicines purchased tobacco products and 4.8 percent of those buying oral contraceptives.

The Caremark network includes more than 54,000 pharmacies; more than 20,000 of those are independent pharmacies.

Thursday, October 16, 2014

Prescription Drug Monitoring Programs

The battle against prescription drug abuse continues, with the closing of “pills mills,” limiting refills, and making it difficult to “doctor shop” through prescription drug monitoring programs (PDMPs); many wonder how successful the fight has been and whether or not doctors are taking advantage of PDMP’s? The Office of National Drug Control Policy (ONDCP) and the U.S. Centers for Disease Control and Prevention (CDC) advocate the use of prescription drug monitoring systems.

Researchers from Oregon Health and Sciences University surveyed doctors in Oregon who are registered to use their PDMP, in order to find out the differences between doctors who use the program and those who do not, according to NewsWise.

The survey randomly sampled 650 high frequency PDMP users, 650 low frequency users, and 2,000 non-users, from a database of more than 22,000 clinicians.

The research indicated that 95 percent of doctors registered say they consult the PDMP when they suspect a patient is abusing or diverting medication. Out the doctors registered, 54 percent of doctors reported that they made mental health or substance abuse referrals after consulting it, and 36 percent said they sometimes discharge patients from their practices as a result of PDMP use. Less than half of doctors check the PDMP for every new patient or every time they prescribe a controlled drug. Almost all doctors who use the program say they discuss worrisome data with patients.

Researchers point out that the registered users of the state’s database prescribed controlled substances more frequently than doctors who did not use the PDMP, according to the article.

“Clinicians reported frequent patient denial or anger and only occasional requests for help with drug dependence,” the researchers report in The Journal of Pain.

The findings are published in the peer-reviewed publication of the American Pain Society, The Journal of Pain.