Category Archives: Drugs & Medicines

The hefty price of ‘study drug’ misuse on college campuses

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Three red and white capsules

By Lina Begdache, Binghamton University, State University of New York
TheConversation.com

Nonmedical use of Attention Deficit Hyperactivity Disorder (ADHD) drugs on college campuses, such as Adderall, Ritalin, Concerta and Vyvanse, has exploded in the past decade, with a parallel rise in depression disorders and binge drinking among young adults.

These ADHD drugs act as a brain stimulant that are normally prescribed to individuals who display symptoms of ADHD. These stimulants boost the availability of dopamine, a chemical responsible for transmitting signals between the nerve cells (neurons) of the brain.

But now a growing student population has been using them as “study” drugs – that help them stay up all night and concentrate. According to a 2007 National Institutes of Health (NIH) study, abuse of nonmedical prescription drugs among college students, such as ADHD meds, increased from 8.3 percent in 1996 to 14.6 percent in 2006.

Besides helping with concentration, dopamine is also associated with motivation and pleasurable feelings. Individuals who use these ADHD drugs nonmedically experience a surge in dopamine similar to that caused by illicit drugs which induces a great sense of well-being.

My journey with investigating the effect of the stimulant use nonmedically on college campuses started with a question from a student seven years ago. The question was about the long-term effect of misuse on brain and physical health. Continue reading

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In Prince’s age group, risk of opioid overdose climbs

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Prince - Photo: imieye from flickr.com

Prince – Photo: imieye from flickr.com

By Kristin Espeland Gourlay, RINPR
Kaiser Health New

Evidence is mounting that opioid pain medication may have played a role in the death of pop legend Prince.

While the medical examiner hasn’t yet released the results of the autopsy and toxicology tests in this case, opioid overdose in middle age is all too common.

In 2013 and 2014, according to the The Centers for Disease Control and Prevention, people ages 45 to 64 accounted for more than 40 percent of all deaths from drug overdose.

Prince died on April 21 at his home and music studio Paisley Park in Minneapolis. He was 57.

Experts say there are a number of scenarios that increase risk of overdose, which is often accidental, for people over 55.

Imagine you are in that age group and you injured your shoulder a while back. It just hasn’t gotten better, so you take prescription painkillers — an opioid like OxyContin — to help with the pain. Let’s say you’ve been taking it for a couple of years. Your body has built up a tolerance to the drug, and now, you need to change it up to get the same amount of relief.

When it comes to the potential for overdose, said Boston Medical Center epidemiologist Traci Green, this is one of the most dangerous crossroads. Continue reading

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Americans want more action against drug abuse, poll

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By Lisa Gillespie
Kaiser Health News

The fight against the growing abuse of prescription painkillers and heroin is not robust enough at any level — not federal and state governments’ efforts or those of doctors and users themselves, according to most Americans in a new poll out Tuesday.

Lack of access to care for those with substance abuse issues is a major problem, said 58 percent of those surveyed by the Kaiser Family Foundation. (KHN is an editorially independent program of the Foundation.)

kff_opioid-poll_770

The poll found that Americans had somewhat different views of heroin and prescription drug abuse. More than a third called heroin abuse an extremely serious health problem in the U.S., while just over a quarter of those surveyed said the same about the abuse of strong prescription painkillers. In contrast, fewer than a fifth regarded alcohol abuse in the same way.

The fight against opioid abuse has generated heavy news coverage in recent months, as well as government concerns. President Barack Obama recently proposed adding $1 billion to the federal budget for treatment programs. Yet more than 60 percent of respondents generally faulted federal efforts as too little. Similar shares were dissatisfied with state governments’ actions and those of doctors who prescribe painkillers, the Kaiser poll found.

But more than 70 percent believed drug users themselves aren’t doing enough. Continue reading

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Opioid epidemic fueling hospitalizations, hospital costs

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Tablet Thumb BlueBy Shefali Luthra
Kaiser Health News

Every day, headlines detail the casualties of the nation’s surge in heroin and prescription painkiller abuse: the funeralsthe broken families and the patients cycling in and out of treatment.

Now, a new study sheds light on another repercussion — how this public health problem is adding to the nation’s ballooning health care costs and who’s shouldering that burden.

The research comes as policymakers grapple with how to curb the increased abuse of these drugs, known as opioids.

Hospitalizations related to use and dependence on opioids have skyrocketed, from about 302,000 in 2002 to about 520,000 a decade later.

State legislators in New YorkConnecticutAlaska and Pennsylvania have tried to take action by adding new resources to boost prevention and treatment.

In addition, President Barack Obama laid out strategies last month intended to improve how the health system deals with addiction. Continue reading

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Shortages of emergency drugs increase, study

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Vaccine SquareBy Michelle Andrews
Kaiser Health News

At some hospitals, posters on the wall in the emergency department list the drugs that are in short supply or unavailable, along with recommended alternatives.

The low-tech visual aid can save time with critically ill patients, allowing doctors to focus on caring for them rather than doing research on the fly, said Dr. Jesse Pines, a professor of emergency medicine and director of the Office for Clinical Practice Innovation at the George Washington University School of Medicine and Health Sciences, who has studied the problems with shortages.

The need for such workarounds probably won’t end anytime soon. According to a new study, shortages of many drugs that are essential in emergency care have increased in both number and duration in recent years even as shortages for drugs for non-acute or chronic care have eased somewhat.

The shortages have persisted despite a federal law enacted in 2012 that gave the Food and Drug Administration regulatory powers to respond to drug shortages, the study found. Continue reading

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Synthetic drugs send states scrambling

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By Sarah Breitenbach
Stateline

626a9a5d49384bf599c632587887dc1a (1)Vials of a confiscated synthetic amphetamine called flakka that killed 61 people in Broward County in a little more than a year. States have been reworking drug laws to make it easier to classify synthetic drugs as illegal.

It’s been four months since anyone in Broward County, Florida, has died from an overdose of alpha-PVP, known as flakka, a crystal-like synthetic drug meant to imitate cocaine or methamphetamine. But the drug has already taken a deadly toll, and left health and law enforcement officials scrambling to stem a new public health crisis.

In small doses, flakka elicits euphoria. But just a little too much sends body temperatures rocketing to 105 degrees, causing a sense of delirium that often leads users to strip down and flee from paranoid hallucinations as their innards, quite literally, melt. If someone survives an overdose, they are often left with kidney failure and a life of dialysis.

Because the drugs were largely unregulated when they first hit the market, some states have struggled to combat them.

Flakka is among a growing number of addictive and dangerous synthetic drugs being produced easily and cheaply with man-made chemicals in clandestine labs in China.

But because the drugs were largely unregulated when they first hit the market, some states have struggled to combat them. Now legislators, health professionals and police are trying to eradicate the drugs by making it easier to qualify them as illegal and ramping up the criminal penalties for selling them.  Continue reading

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Opioid treatment model spawns imitators

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Two white tabletsBy Christine Vestal
Stateline

BALTIMORE — Dr. Kenneth Stoller held court on the sidewalk outside the Broadway Center for Addiction on a sunny afternoon last week, chatting with a troop of lingering patients.

He beamed as he patted a young man on the shoulder and said he’d see him tomorrow.

“It’s important for patients to see this as a place that’s safe and accepting,” he said. “For some, it’s the first place they’ve gotten positive reinforcement in their lives.”

Operated by Johns Hopkins Hospital and located two blocks from its main campus, the Broadway Center — or “911” as it’s called because of its address at 911 N. Broadway — has provided methadone maintenance therapy for people with opioid addiction for more than two decades.

But unlike most of the roughly 1,400 methadone clinics across the country, the Broadway Center offers not only methadone, but the two other federally approved addiction medications, buprenorphine and naltrexone, and a full complement of mandatory addiction counseling and group classes. In most other places, addiction treatment is fragmented, leaving patients to shop around for the care they need or settle for whatever is offered at their local opioid treatment clinic.

Unlike most of the roughly 1,400 methadone clinics across the country, the Broadway Center offers not only methadone, but the two other federally approved addiction medications, buprenorphine and naltrexone, and a full complement of mandatory addiction counseling and group classes.

“If you went to a doctor for any other disease, you’d expect to be offered all available treatment options,” said Dr. David Gastfriend, scientific adviser at the Philadelphia-based Treatment Research Institute, which studies substance abuse treatment. “Addiction treatment should be no different.”  Continue reading

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Why are so few kids getting the HPV vaccine

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9400_loresBy Michael Ollove
Stateline

Ten years after the federal government approved the first vaccines to combat the cancer-causing human papillomavirus, nine years after those vaccines were recommended for all adolescent girls, and five years after they were recommended for all adolescent boys, less than half of girls and only a fifth of boys are getting immunized.

In 2014, only 40 percent of girls ages 13 to 17 have completed the three-vaccine course of HPV immunization. (And just 22 percent of boys.)

Despite state efforts to raise vaccination rates, public health officials say that for a variety of reasons, mainly wariness over the HPV’s association with sex, parents and especially doctors have not embraced the potentially life-saving vaccine.

According to the Centers for Disease Control and Prevention, as of 2014, only 40 percent of girls ages 13 to 17 had completed the three-vaccine course of HPV immunization. (And just 22 percent of boys had done so.)

That’s well short of the 80 percent goal set in 2010 by the federal government in its Healthy People 2020 report, which established health objectives for the nation.

Even states that require HPV inoculation for school admission or mandate that schools teach students about the virus have fallen far short of the federal benchmark.

“We think the rates are dismally low and very alarming,” said Amy Pisani, executive director of Every Child by Two, a nonprofit that aims to reduce instances of vaccine-preventable illnesses. “We clamor and clamor for a vaccine to get rid of these terrible diseases and yet we aren’t implementing them.”

Some states fare significantly worse. In Tennessee, for example, the vaccination rate for girls was 20 percent — the lowest rate in the nation — and 14 percent for boys.

Even the best performing state, Rhode Island, one of only two states plus the District of Columbia that require HPV inoculation for school admission, has rates well below the national goal, with 54 percent of girls and 43 percent of boys receiving all three HPV vaccinations. Continue reading

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Hospital safety software often fails to flag unsafe prescriptions, report

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Photo by Creativity103 under creative commons license.

By Shefali Luthra
Kaiser Health News

Medical errors are estimated to be the third-highest cause of death in the country.

Experts and patient safety advocates are trying to change that.

But at least one of the tools that’s been considered a fix isn’t yet working as well as it should, suggests a report released Thursday.

That’s according to the Leapfrog Group, a nonprofit organization known for rating hospitals on patient safety.

Almost 40 percent of potentially harmful drug orders weren’t flagged as dangerous by the systems.

Leapfrog, working with San Francisco-based Castlight Health, conducted a voluntary survey of almost 1,800 hospitals to determine how many use computerized-physician-order-entry systems to make sure patients are prescribed and receive the correct drugs, and that medications won’t cause harm.

The takeaway? While a vast majority of hospitals surveyed had some kind of computer-based medication system in place, the systems still fall short in catching possible problems.

(Photo by Creativity103 under creative commons license.)
Continue reading

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By not discussing cost issues, doctors, patients may miss chances to lower out-of-pocket costs

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Twenty-dollar bill in a pill bottleBy Shefali Luthra
Kaiser Health News

Talking about money is never easy. But when doctors are reluctant to talk about medical costs, a patient’s health can be undermined. 

A study published in Monday’s Health Affairs explores the dynamics that can trigger that scenario.

Patients are increasingly responsible for shouldering more of their own health costs. In theory, that’s supposed to make them sharper consumers and empower them to trim unnecessary health spending. But previous work has shown it often leads them to skimp on both valuable preventive care and superfluous services alike.

Doctors could play a key role in instead helping patients find appropriate and affordable care by talking to them about their out-of-pocket costs. But, a range of physician behaviors currently stands in the way, according to the study. Continue reading

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As fentanyl deaths spike, states and CDC respond

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DeafentanylBy Christine Vestal
Stateline

ATLANTA — When Ohio tallied what many already knew was an alarming surge in overdose deaths from an opioid known as fentanyl, the state asked the U.S. Centers for Disease Control and Prevention to investigate.

The rash of fatal overdoses in Ohio — a more than fivefold increase in 2014 — was not an isolated outbreak. Fentanyl is killing more people than heroin in many parts of the country. And the death toll will likely keep growing, said CDC investigators Matt Gladden and John Halpin at the fifth annual Rx Drug Abuse and Heroin Summit here.

At least 28,000 people died of opioid overdoses in 2014, the highest number of deaths in U.S. history. Of those, fentanyl was involved in 5,554 fatalities.

Fentanyl, used in its legal pharmaceutical form to treat severe pain, represents the latest evolution of an epidemic of opioid addiction that began with prescription painkillers and moved to heroin, as users demanded cheaper drugs and greater highs.

At least 28,000 people died of opioid overdoses in 2014, the highest number of deaths in U.S. history. Of those, fentanyl was involved in 5,554 fatalities, a 79 percent increase over 2013, according to a December CDC report.

Unpublished data for the first half of 2015 indicate an even steeper spike in fentanyl deaths, Gladden said.

Cheap and Lethal

Continue reading

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Pregnant and addicted: the tough road to a healthy family

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Amanda Hensley holds her daughter Valencia

Amanda Hensley holds her daughter Valencia

By Sarah Jane Tribble, WCPN
Kaiser Health News

Amanda Hensley started abusing prescription painkillers when she was just a teenager. For years, she managed to function and hold down jobs. She even quit opioids for a while when she was pregnant with her now 4-year-old son. But she relapsed.

Hensley says she preferred drugs like Percocet and morphine, but opted for heroin when short on cash.

By the time she discovered she was pregnant last year, she couldn’t quit.

“It was just one thing after another, you know — I was sick with morning sickness or sick from using,” said Hensley, who is 25 and lives in Cleveland. “Either I was puking from morning sickness or I was puking from being high. That’s kind of how I was able to hide it for a while.”

Hensley said she was ashamed and hurt, and she wanted to stop using but didn’t know how. She had friends who would help her find drugs — even after they found out she was pregnant. But finding help to get sober and protect her child proved much more difficult, though.

The number of people dependent on opioids is increasing and that includes women of child-bearing age, like Hensley. Researchers estimated that every 25 minutes a baby was born dependent on opioids in 2012, the most recent year for which data are available.

By the time Hensley was about six months pregnant, she was living on couches, estranged from her mother and her baby’s father, Tyrell Shepherd. Her son went to live with her mother.

That’s when Hensley reached out for help. One moment, she dialed to get her fix. The next, she called hospitals and clinics.

“Nobody wants to touch a pregnant woman with an addiction issue,” she said.

Shepherd wasn’t happy when he realized Hensley was taking opioids while pregnant. “If you don’t care about yourself,” he said, “have enough common decency to care about the baby you’re carrying. Be adult. Own up to what it is you’re doing and take care of business. Regardless of how bad you’re going to feel, there’s a baby that didn’t ask to be there.”

After being rejected by two hospitals and several clinics, Hensley let herself go into withdrawal and then went to the emergency department of MetroHealth System, Cleveland’s safety-net hospital. Continue reading

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Pharmaceutical company has hiked price on aid-in-dying drug

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By April Dembosky, KQED
Kaiser Health News

When California’s aid-in-dying law takes effect this June, terminally ill patients who decide to end their lives could be faced with a hefty bill for the lethal medication. It retails for more than $3,000.

Valeant Pharmaceuticals, the company that makes the drug most commonly prescribed by physicians to aid patients who want to end their lives, doubled the drug’s price last year, one month after California lawmakers proposed legalizing the practice.

“It’s just pharmaceutical company greed,” said David Grube, a retired a family doctor in Oregon, where physician-assisted death has been legal for 20 years. Continue reading

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How to use your new Marketplace health coverage

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From Healthcare.gov

Congratulations on enrolling in 2016 health coverage! Now that you’re covered, here are a few tips to help you stay healthy and get the care you need.

using-your-new-health-coverage

 

3 ways to use your health insurance to stay healthy

  • Find a doctor and get medical care: If you don’t have a doctor, check your plan to find one in your network. If you get medical services from a provider in your plan’s network, you’ll pay lower prices than you would without insurance. That can save you hundreds of dollars per year, even if you don’t meet your deductible.
  • Learn about your prescription benefits: Health plans help pay the cost of certain prescription medications. Some plans offer reduced prices on generic drugs even before you’ve met your deductible.
  • Stay healthy with preventive benefits: All health plans sold through the Marketplace cover a set of preventive services at no cost to you when delivered by a network provider. These include some screenings, check-ups, patient counseling, and wellness services.

If you’ve never had health insurance or if it’s been a while, you can get more information about using your coverage and improving your health using our Roadmap to Better Care and a Healthier You (PDF).

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