Thursday, July 24, 2014
A WHO report on HIV prevention and care, is calling on nations to implement new policies and laws that would decriminalize injection and the use of drugs. I.V. drug use is one of the leading causes of the spread of HIV, decriminalizing the use of needles and syringes would permit needle and syringe programs to distribute clean needles, according to WHO.
The groundbreaking report argues for the legalization of opioid substitution therapy, like methadone and Suboxone for opioid addicts. What’s more, WHO encourages the banning of compulsory treatment for people who use and/or inject drugs.
WHO is not advocating decriminalizing cultivation, production, and trafficking, according to Dr. Andrew Ball, Senior Advisor on Strategy, Policy and Equity in WHO’s Department of HIV. He told The Huffington Post that the organization only recommends decriminalizing personal drug use.
“The guidelines recommend decriminalization of a range of behaviors of key populations – not just drug use – on public health grounds, so as to improve access to and utilization of health services, to reduce the likelihood of the adoption of riskier behaviors and to reduce incarceration rates,” he said.
Tuesday, July 22, 2014
In San Francisco, FedEx has been accused of conspiring to deliver pharmaceutical drugs from illegal online pharmacies and a federal grand jury has indicted the company for drug trafficking, according to USA Today. The indictment states that FedEx has known for a decade that their service was used by illegal online pharmacies.
“While some Internet pharmacies were managed by well-known pharmacy chains that required valid prescriptions and visits to the patient’s personal physician, others failed to require a prescription before filling orders for controlled substances and prescription drugs,” a U.S. Sentencing Commission news release states. “These Internet pharmacies filled orders based solely on the completion of an online questionnaire, without a physical examination, diagnosis, or face-to-face meeting with a physician. Such practices violated federal and state laws governing the distribution of prescription drugs and controlled substances.”
Since 2004, FedEx had been warned by government officials at least six times, according to the prosecutors involved in the indictment.
In a statement, FedEx said. “We’re proud to say that we have partnered with the FBI, the Department of Homeland Security, DEA, and other federal, state and local law enforcement teams around the world to help stop illegal drug activity and bring criminals to justice. These efforts include providing assistance to the DEA in combating rogue internet pharmacies.”
Thursday, July 17, 2014
Veterans who turn to their doctor for help are, more often than not, prescribed painkillers and sedatives to treat their issues. Service men and women are prescribed narcotic painkillers three times more often than civilians, according to the article. One in three veterans says they are on 10 different medications.
The fact of the matter is that treating disorders like PTSD is extremely difficult and requires countless hours of cognitive behavioral therapy for progress to be seen. After close to 15 years of war the VA is not equipped to handle the hundreds of thousands of veterans who have come home and require treatment. In many cases doctors are left with no other alternative but to over medicate to compensate for the lack of treatment options available.
Many doctors prescribe drugs off-label for conditions other than the ones approved by the Food and Drug Administration. This is why it not uncommon to see veterans with PTSD who are physically healthy, but are being prescribed drugs like oxycodone on top of their antipsychotics and sedatives.
In an attempt to reduce the use of opioids among veterans, the Department of Veterans Affairs (VA) initiated an Opioid Safety Initiative. Gavin West, who heads the initiative, told NPR, “We’ve undertaken a psychopharmacologic safety initiative, where we’re looking across the board at more safe and more effective use of medications.”
Despite rampant over-prescribing taking place throughout VA hospitals, it is important to point out that ceasing your medications without consulting a doctor is never safe, especially if one has been on a particular drug long term. Suddenly halting one's medication can lead to withdrawal with opioids and life threatening seizures with benzodiazepines, talk to your doctor before you make the move.
Tuesday, July 15, 2014
The ACA has given states the ability to expand Medicaid coverage to people with low incomes and so far 26 states have done so, the article points out. However, in order for a treatment center to qualify for accepting Medicaid the facility needs to have fewer than 16 beds. While more people are finding they have coverage for substance use disorder treatment every day, the reality is that finding a bed will prove extremely challenging due to the high demand for treatment. The 16 bed rule was intended to prevent Medicaid funds from covering treatment in state psychiatric hospitals, facilities that were far more common when it was passed in 1965.
“The federal government basically said to the states, ‘We’re not going to pay for your institutional care,’" Becky Vaughn, Executive Director of the State Associations of Addiction Services, told the newspaper. “Addiction services never should have been wrapped into that because we are not long term.”
Congress could act to change the rule which would help thousands get the treatment that they need and the coverage that they constitutionally deserve, but it seems unlikely at this point because nobody in Congress wants to get near health care issues any time soon.
Friday, July 11, 2014
Most hospitals only screen patients when they come into the Emergency Room; Mass. General will ask every patient, even if they are coming in for a routine procedure, a series of four questions related to drinking and drugs, according to the article. Nationwide, about a fourth of all patients who visit hospitals for routine medical procedures have substance use disorders. If the answers indicate a possible addiction, a special addiction team could be called-in to do a “bedside intervention” and arrange for treatment.
Doctors at Mass. General believe that tackling substance abuse in a traditional medical setting may help hospitals better coordinate care and lower costs.
Dr. Sarah Wakeman, Medical Director for Substance Use Disorders at Mass. General’s Center for Community Health Improvement, believes that hospitals are the perfect opportunity to reach people who are struggling with addiction. She called being in the hospital “a reachable moment,’’ where people in the field of addiction can bring initial treatment right to the patient at the bedside.
“We make it incredibly hard for people to access care for addiction,’’ she said. “Part of our goal is shifting the culture.’’