Another Biden campaign promise – expanding OUD MAT treatment – appears to be broken

Posted on January 28, 2021 by Pharmaciststeve

Biden Administration to Reverse Trump’s HHS Directive Expanding OUD MAT Prescribing Policy

https://www.lexology.com/library/detail.aspx?g=476bb89e-15c5-4a3e-bbcf-10a23200393d&utm_source=Lexology+Daily+Newsfeed&utm_medium=HTML+email+-+Body+-+General+section&utm_campaign=Lexology+subscriber+daily+feed&utm_content=Lexology+Daily+Newsfeed+2021-01-28&utm_term=

We last alerted you on the Trump administration’s last-minute directive on reducing the “X-waiver” mandate which limits prescribers’ ability to prescribe medications aimed at battling the opioid use disorder (OUD) epidemic. According to the American Medical Association, the OUD epidemic has seen a sharp rise in 2020, especially in overdose-related deaths. Issue brief: Reports of increases in opioid-related overdose during COVID pandemic | AMA (ama-assn.org). In response, the Trump administration hurried through this HHS directive to enable more physician-prescribers to readily treat OUD. This January 14, 2021 move was applauded by prescribers and patient advocate groups who view the “X-waiver” as an unnecessary burden in prescribing medication-assisted therapies (MAT) for OUD patients.

Previously, to obtain an “X-waiver, prescribers were required to undergo an eight-hour training series before being permitted to prescribe drugs such as buprenorphine. Buprenorphine is an opioid medication approved by the FDA to treat OUD. According to the HHS’ Substance Abuse and Mental Health Services Administration (SAMSHA):

[b]uprenorphine is an opioid partial agonist. It produces effects such as euphoria or respiratory depression at low to moderate doses. With buprenorphine, however, these effects are weaker than full opioid agonists such as methadone and heroin. When taken as prescribed, buprenorphine is safe and effective. Buprenorphine has unique pharmacological properties that help:

  • Diminish the effects of physical dependency to opioids, such as withdrawal symptoms and cravings;
  • Increase safety in cases of overdose, and
  • Lower the potential for misuse.

The January 14, 2021 directive eliminated the need for physicians to obtain an “X-waiver” to treat their OUD patients with buprenorphine. To ensure patient safety and greatly lessen the potential for abuse, physicians without an “X-waiver” were limited to treatment of only 30 in-state patients. Non-physician prescribers such as NPs and PAs were still required to obtain the waiver.

In what many frontline operators in the OUD battle see as a disappointing move, the Biden Administration plans to retract this Trump administration HHS directive. While the immediate reason is unclear, anonymous sources in the Biden administration hint that they are concerned with the Trump directive’s authority to effectuate limited the “X-waiver” program by possibly circumventing Congress’ authority and the speed with which it went through HHS.

Biden moving to nix Trump plan on opioid-treatment prescriptions – The Washington Post. This is particularly surprising because Biden’s campaign platform vowed to expand OUD treatment and lift undue restrictions on prescribing medications for substance use disorder. See The Biden Plan to End the Opioid Crisis | Joe Biden for President: Official Campaign Website. The hope is, perhaps, the Biden administration will keep its campaign promises to better combat the OUD epidemic by effectuating their own changes to MAT limitations.

The Biden administration has been issuing 3-5 executive orders (EO) per day, which is potentially circumventing Congress’ authority and the number of his EO’s exceeds the total number of his 4 predecessors’ EO’s  all together in a similar time frame.  President Biden’s son Hunter – is at best a substance abuser/addict in recovery.

So, Biden has no immediate interest in all those 200+ substance abuser/addicts that die every day of a opiate overdose… to postpone potential treatment of untold number of substance abuse/addict that may have received treatment and not OD’d ? Lives that could have been potentially saved, but for what appears another incident of Biden just putting a STOP to anything that Trump had implemented.  Regardless of the costs to others… including unnecessary opiate OD’s that may have been prevented.

 

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Opioid Deaths Fall When Cannabis Stores Rise, Analysis Suggests

Posted on January 28, 2021 by Pharmaciststeve

Opioid Deaths Fall When Cannabis Stores Rise, Analysis Suggests

Can legal marijuana ease the opioid crisis?

https://www.medpagetoday.com/neurology/opioids/90922

Access to legal cannabis stores was linked with fewer opioid deaths in the U.S., a new analysis suggested.

The number of marijuana dispensaries in a county was negatively related to log-transformed opioid mortality rate, adjusted for age (β -0.17, 95% CI -0.23 to -0.11), reported Balázs Kovács, PhD, of Yale University School of Management in New Haven, Connecticut, and Greta Hsu, PhD, of University of California Davis Graduate School of Management.

This means that increasing the number of storefront dispensaries from one to two was tied to a 17% reduction in death rates of all opioid types, and an increase from two to three stores was associated with a further 8.5% reduction in mortality, Kovács and Hsu noted.

The relationship was stronger — leading to an estimated 21% drop in mortality — when only deaths from synthetic non-methadone opioids like fentanyl were considered (β -0.21, 95% CI -0.27 to -0.14), they wrote in The BMJ.

“We find this relationship holds for both medical dispensaries, which serve only patients who have a state-approved medical card or doctor’s recommendation, as well as for recreational dispensaries, which sell to adults 21 years and older,” Kovács said.

As business school researchers, Kovács and Hsu first became interested in the increasing prevalence of legal cannabis stores as an organizational issue.

“We tracked evolving cannabis markets across the U.S. from 2014 onwards in an effort to understand how this new category of organizations emerged,” Kovács told MedPage Today. “We realized, however, that our county-level database could also be used to examine whether the availability of legal cannabis in an increasing number of geographic areas has any implications for opioid misuse.”

Their findings add to a mixed evidence base about the relationship between legal marijuana and opioid overdoses. In 2014, an analysis suggested that states with medical cannabis laws experienced slower increases in opioid overdose mortality. However, a subsequent study showed that those findings didn’t hold over a longer period, and that associations between state medical cannabis laws and opioid-related mortality reversed direction and remained positive after accounting for recreational cannabis laws.

Kovács and Hsu based their analysis on data from 812 counties in 23 states (plus the District of Columbia) that allowed legal cannabis dispensaries to operate by the end of 2017. They combined 2014-2018 CDC mortality data with census data and storefront information from Weedmaps, collecting data on dispensaries operating within each county on a monthly basis from 2014 to December 2017. Mortality analysis focused on deaths of people 21 and older.

Eight states and the District of Columbia allowed for recreational storefronts; 15 allowed for medical dispensaries only. An increase from one to two medical dispensaries led to an estimated 15% mortality rate reduction in the study; an increase from one to two recreational dispensaries led to an 11% drop.

Two points about this analysis need to be considered, noted Sameer Imtiaz, PhD, of the Institute for Mental Health Policy Research in Toronto, and colleagues, in an accompanying editorial.

First, the mechanism underlying the association is unclear. “In the context of medicinal cannabis legalization, reduced deaths from opioid overdose do not coincide with reduced non-medicinal use of pain relievers or with opioid distribution, defined as the flow of substances from the manufacturers to retail distributors,” they wrote. “The absence of concurrent changes in such opioid-related outcomes questions the premise of substitution.”

Moreover, inferences about individuals cannot be drawn from aggregate-level data in an ecologically designed study like this, the editorialists pointed out. Both harmful and beneficial associations between opioids and cannabis have been seen at the individual level, they observed.

The findings suggest a potential relationship between the increased prevalence of cannabis dispensaries and reduced opioid-related mortality and do not show causality, Kovács emphasized. “While we find a particularly strong association between the prevalence of storefront dispensaries and fentanyl-related opioid deaths, it is not clear whether cannabis use and fentanyl mortality rates are more specifically linked, or if the strength of the association is due to the rise in fentanyl use and mortality rates during the study period,” he said. Potential harms of cannabis, including the cognitive development of adolescents, medical conditions such as schizophrenia, and public safety risks, should not be ignored, he added.

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Moderna’s vaccine is less potent against one coronavirus variant but still protective, company says

Posted on January 27, 2021 by Pharmaciststeve

Moderna’s vaccine is less potent against one coronavirus variant but still protective, company says

https://www.statnews.com/2021/01/25/moderna-vaccine-less-effective-variant/

Moderna is studying adding booster doses to its vaccine regimen after finding its Covid-19 vaccine was less potent against a coronavirus variant that was first identified in South Africa, the company said Monday.

In lab research that involved testing whether blood from people who had received the vaccine could still fend off different coronavirus variants, scientists found that there was a sixfold reduction in the vaccine’s neutralizing power against the variant, called B.1.351, than against earlier forms of the coronavirus, Moderna reported.

There was no loss in neutralization levels against a different variant, called B.1.1.7, that was first identified in the United Kingdom. Both variants are thought to be more transmissible than other forms of the SARS-CoV-2 virus.

Moderna said that despite the reduction in neutralizing antibodies against B.1.351, the antibody levels generated by its vaccine “remain above levels that are expected to be protective.” Still, it said it was going to start testing whether adding a booster dose to its existing two-dose regimen could increase the levels of neutralizing antibodies even further, and that it was going to start investigating a booster specifically designed against B.1.351.

“These lower titers [of antibodies against B.1.351] may suggest a potential risk of earlier waning of immunity to the new B.1.351 strains,” Moderna said.

The announcement from Moderna gets at a nuance that scientists have been trying to stress as fears around vaccines and variants grew. Both the Moderna vaccine and the immunization from Pfizer-BioNTech produce such powerful levels of immune protection — generating higher levels of antibodies on average than people who recover from a Covid-19 infection have — that they should be able to withstand some drop in their potency without really losing their ability to guard people from getting sick.

“There is a very slight, modest diminution in the efficacy of a vaccine against it, but there’s enough cushion with the vaccines that we have that we still consider them to be effective,” Anthony Fauci, the top U.S. infectious diseases official, said Monday on the “Today” show.

The coronavirus has been evolving throughout the pandemic, and scientists had expected that eventually, the virus would change so much that vaccines would need to be upgraded to better match dominant variants. But the appearance in recent months of the variants, which picked up mutations at much higher rates than the coronavirus was adding at the beginning of the pandemic, has moved up the date at which that might need to occur.

Experts say they need to now figure out how much less effective the vaccines can get before upgrades are needed, and what the regulatory process for approving such tweaks would look like.

Pfizer and BioNTech scientists have already reported their vaccine holds up against B.1.1.7, though they have not reported data yet against B.1.351. But researchers have been more concerned about B.1.351 because it contains a different set of mutations that, at least in lab experiments, had already helped the virus evade some of the immune protection generated in people who had an initial Covid-19 case.

Some of those same mutations of concern also appear in a different variant first seen in Brazil, called P.1.

In the meantime, if mutations do arise that deliver a blow to the vaccines’ strength, experts still say people should get them. Having some immune memory to the virus (which vaccines provide, almost like a substitute for an initial infection) is better than being completely vulnerable. You might still be able to get infected, and maybe even get sick, but giving your immune system even a small edge can reduce the chances you’ll get seriously ill.

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Experts recently told Fox News there is little to no evidence behind ‘double masking

Posted on January 25, 2021 by Pharmaciststeve

Fauci backs ‘double-masking’ in coronavirus fight, says ‘likely more effective’

https://www.foxnews.com/health/fauci-backs-double-masking-in-coronavirus-fight-says-likely-more-effective

Dr. Anthony Fauci, President Biden’s chief medical adviser on COVID-19, said two face masks are likely more effective than one against the novel coronavirus, despite significant uncertainty on the subject.

“If you have a physical covering with one layer, you put another layer on it just makes common sense that it likely would be more effective,” Fauci told NBC News on Monday.

Infectious disease experts from Stanford Health Care, Mayo Clinic and Johns Hopkins University recently told Fox News there is little to no evidence on the issue.

Neysa Ernst from Johns Hopkins University, where she serves as nurse manager of the Biocontainment Unit, agreed, though she proposed that anecdotal evidence suggests additional layers could offer “psychological safety” to some. 

“In this pandemic psychological safety is important, it provides a sense of control in an unknown environment,” Ernst wrote.

According to the Centers for Disease Control and Prevention (CDC), masks should have two layers of breathable fabric, with a snug fit covering the nose and mouth.

There is some conflicting advice on double-masking, which suggests there isn’t enough research behind it yet. When worn correctly, a single face mask made of “appropriate material” typically offers enough protection, Paula Cannon, a distinguished professor of molecular microbiology and immunology at the Keck School of Medicine of University of Southern California (USC), previously said in an email. 

“However, wearing two can provide additional protection. A second mask can create a tighter seal around your face, and also help secure the masks so they don’t slip down,” she added. 

Another physician, Dr. Dave Hnida, previously told CBS that two masks can create more of an “obstacle course” for viral particles in an attempted route from the air, through the body and into the lungs.

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Even if you’re on the right track, you’ll get run over if you just sit there. Will Rogers

Posted on January 24, 2021 by Pharmaciststeve

The statistic gatherers have so much data against opioids its impossible to stop pain regulations

Law enforcement has stats

Brds have stats on opioids

Profess organization has stats on opioids

Cities have stats on opioids

Treatment centers have stats on opioids

All of them use stats to support funding to justify their activities

The pandemic situation has caused the statistic folks to have data going through the roof on ODs deaths and addiction related bad outcomes

I have yet to run across someone reporting the pandemic has caused them more pain, didn’t allow them to get an Rx for pain meds, was turned down by their pain team…..

Just no universal collection of data, just individual anecdotes = no triggering event to jell a pain lives matter organization to rise up and get a voice

With the stats on elderly deaths in folks in their 70s and 80s, I predict the nursing home residents will be the next area of required tapering, who knows maybe CMS will treat them as anti-psychotics, that is what my gut says

The above is from a email that I received from a pharmacist friend of mine in another state… we exchange one or more emails almost daily.    He knows where I stand in regards to abuse and denial of care of chronic pain pts. In a email I made my observation that there are a lot of similarities between the chronic pain community and the pharmacists community… Pharmacists especially those working for the chains are being abused – too much volume and not enough staffing.  Chronic pain pts are being abused by practitioners… denied opiates for their pain and/or bullying into being routinely subjected to ESI – many/most medically unnecessary.

Both groups are big on whining, bitching and moaning and damn little action.  We have a serious and growing surplus of pharmacists and if they stand up they know that there is someone waiting to take their job, but most have a six figure student loan to pay off and finding a new job… will be difficult at best and what Pharmacists are getting paid is dropping and most are only being offered 28-32 hrs/wk..  At best, they are making about HALF of what was being paid when they started pharmacy school 6 + yrs earlier.

Chronic painers are in a similar position, if they SPEAK UP… they fear being discharged from the practice and finding a new prescriber will be difficult … so they accept what the prescriber will give them and can’t/won’t SPEAK UP.

I found his observations quite interesting…  all of those entities that have some skin in the game… collecting data … so that they can get more grant money… to keep fighting the war on pts/drugs that no one – who would tell the truth – would state that they are not even holding their own over the last 50 yrs…since the Controlled Substance Act 1970 was signed into law.

IMO, the gist of all his comments have to do with optics, the lack of unity within the community and all the infighting …  This is from basically a state bureaucrat that has no attachment with the community and a lot of what he knows … he has got from reading my blog.

The conclusion that I come away with from his comments is that the conclusion from the optics that the community is displaying is that the community is NOT A THREAT to anyone and in all likelihood it will be a long time before – if at all  – becomes a threat to anyone who opposes opiate prescribing or has a interest in trying to make the opiate crisis go away.  The community knows that since the CDC opiate dosing guidelines came to be that we have more chronic painers being denied adequate pain management, we have untold number of have or are thinking about committing suicide and more uncountable number that are now suffering/dealing with PTSD from trying to deal with living/existing in a torturous level of pain.

There is no KNIGHT ON A WHITE HORSE coming over the horizon to save your ass, nor is there someone name “george” coming to save your ass.

My blog is in its 9th year and I could have written all of this in a post 9 yrs ago and it would have been current then as it is today.

 

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Military Intelligence Agency Says It Monitored U.S. Cellphone Movements Without Warrant

Posted on January 23, 2021 by Pharmaciststeve

Military Intelligence Agency Says It Monitored U.S. Cellphone Movements Without Warrant

https://www.wsj.com/articles/military-intelligence-agency-says-it-monitored-u-s-cellphone-movements-without-warrant-11611350374

WASHINGTON—In a new document made public Friday, the nation’s top military intelligence agency acknowledged monitoring the location of U.S.-based mobile devices without a warrant through location data drawn from ordinary smartphone apps.

The Defense Intelligence Agency told congressional investigators that the agency has access to “commercially available geolocation metadata aggregated from smartphones” from both the U.S. and abroad. It said it had queried its database to look at the location information of U.S.-based smartphones five times in the last 2½ years as part of authorized investigations.

Such data is typically drawn from smartphone apps such as weather, games and other apps that get user permission to access a phone’s GPS location. A robust commercial market exists for such data for advertising and other commercial purposes. The Wall Street Journal first revealed last year that numerous U.S. government agencies were also buying access to that data from commercial brokers without a warrant, raising questions about whether those agencies were adequately safeguarding the privacy and civil liberties of Americans.

The ability of U.S. intelligence agencies to access data on Americans for intelligence purposes is typically circumscribed. A warrant from the secretive Foreign Intelligence Surveillance Court is required for most kinds of surveillance. However, the Defense Intelligence Agency told Congress that it didn’t believe it needed any sort of court authorization to acquire commercial data for foreign intelligence or national security purposes.

That echoes a position taken by numerous other U.S. government agencies in recent years as the amount of data on individuals using computers, smartphones and tablets has exploded. The Department of Homeland Security is buying a similar data product and is using it for warrantless tracking as part of its border security and immigration mission. The Internal Revenue Service also purchased access to cellphone data as part of its law enforcement mission. All claim because the data is purchased on the open market, no court order is required.

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British PM Says New Variant May Carry Higher Risk of Death

Posted on January 22, 2021 by Pharmaciststeve

British PM Says New Variant May Carry Higher Risk of Death

https://www.medscape.com/viewarticle/944558

LONDON (Reuters) – British Prime Minister Boris Johnson said on Friday the new English variant of COVID-19 may be associated with a higher level of mortality although he said evidence showed that both vaccines being used in the country are effective against it.

Johnson said that the impact of the new variant, which is already known to be more transmissable, was putting the health service under “intense pressure”.

“We’ve been informed today that in addition to spreading more quickly, it also now appears that there is some evidence that the new variant – the variant that was first discovered in London and the southeast (of England) – may be associated with a higher degree of mortality,” he told a news briefing.

Johnson said however that all the current evidence showed both vaccines remained effective against old and new variants.

Chief Scientific Adviser Patrick Vallance said the evidence about mortality levels was “not yet strong”, and came from a “series of different bits of information”, stressing there was great uncertainty around the data.

He said that once people reached hospital, there was no greater risk, but there were signs that people who had the UK variant were at more risk overall.

“There’s no real evidence of an increase in mortality for those in hospital. However, when data are looked at in terms of those who’ve been tested positive… there is evidence that there’s an increased risk for those who have the new variant, compared to the old virus,” he said.

He said that for a man in his sixties, the average risk was that 10 in 1,000 people who got infected would be expected to die, but that this rose to roughly 13 or 14 people in 1,000 with the new variant.

“I want to stress that there’s a lot of uncertainty around these numbers and we need more work to get a precise handle on it,” he said.

“But it obviously is a concern that this has an increase in mortality as well as an increase in transmissibility.”

Caution

The warning about the higher risk of death from the new variant, which was identified in England late last year, came as a fresh blow after the country had earlier been buoyed by news the number of new COVID-19 infections was estimated to be shrinking by as much as 4% a day.

Data published earlier on Friday showed that 5.38 million people had been given their first dose of a vaccine, with 409,855 receiving it in the past 24 hours, a record high so far.

England and Scotland announced new restrictions on Jan. 4 to stem a surge in the disease fuelled by the highly transmissible new variant of the coronavirus, which has led to record numbers of daily deaths and infections this month.

The latest estimates from the health ministry suggest that the number of new infections was shrinking by between 1% and 4% a day. Last week, it was thought cases were growing by much as 5%, and the turnaround gave hope that the spread of the virus was being curbed, although the ministry urged caution.

But the Office for National Statistics estimated that the prevalence overall remained high, with about one in 55 people having the virus.

Britain has recorded more than 3.5 million infections and nearly 96,000 deaths – the world’s fifth-highest toll – while the economy has been hammered. Figures on Friday showed public debt at its highest level as a proportion of GDP since 1962, and retailers had their worst year on record.

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Amazon announced at noon on 01/20/2021 that they will be happy to help distribute COVID-19 vaccine

Posted on January 21, 2021 by Pharmaciststeve

See the source image

It was announced today that yesterday (01/20/2021) at abt 12 noon – 12 minutes after our new President was sworn in… that they would be willing/happy to help distribute the COVID-19 vaccine in our country. The same day Amazon also announced that they have BANNED ONE PRIVATE CITIZEN Donald Trump from their service https://www.twitch.tv/

After Amazon – thru their Amazon Web Service (AWS) was going to “pull the plug” on a new competitor of Twitter called www.Parler.com 

Basically “killing” a company that was worth a estimated ONE BILLION DOLLAR value. This was apparently done because both Face Book and Twitter terminated then President Trump’s accounts and many of his followers had opened accounts on Parler.

It has been reported that just about all ancillary internet services that Parler needed to function cancelled their service provided to Parler, supposedly including the law firm that they had engaged to work for the company.

While we do have a FIRST AMENDMENT and FREEDOM OF SPEECH but that only applies to our government restricting speech, but we do have a law Sherman Antitrust Act that makes collusion to harm another business – ILLEGAL.   So far, the DOJ that is in charge of enforcing that law seems to be AWOL.  Of course, it has been reported that 90% of all the political donation for the 2020 election went to the Biden campaign.  You can do the math and come to your own conclusion.

I don’t like businesses that will conclude against other businesses..  especially when a handful or two “gang up” on a particular business…  Those “little boys” in Silicon Valley are nothing more than “school yard bullies”.

Personally, I have cancelled our Amazon Prime account… we are exploring our options with Target and Walmart.  One very enlightening situation, we have a 95 y/o neighbor and Barb had been ordering some things she need thru our Amazon account.  So she order one product thru Walmart.com – same product, same size, same free delivery and it was SIX DOLLARS LESS than what she was being charged via Amazon Prime.

The more troublesome question is how many more people could have received their COVID-19 vaccination if Amazon had stepped up a month ago to help distribution ?  I suspect that no one will hold Amazon responsible.

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new administration: FCA settlements and cases.. recoveries expected to nearly TRIPLE over 2020

Posted on January 21, 2021 by Pharmaciststeve

Client Alert-Justice Department Releases Data on FY 2020 False Claims Act Recoveries: What to Expect in 2021 and Beyond

https://www.lexology.com/library/detail.aspx?g=33eabeba-d6cb-4633-9cae-1a537c82567b&utm_source=Lexology+Daily+Newsfeed&utm_medium=HTML+email+-+Body+-+General+section&utm_campaign=Lexology+subscriber+daily+feed&utm_content=Lexology+Daily+Newsfeed+2021-01-21&utm_term=

A copy of this Client Alert can be found HERE .

Late last week the U.S. Department of Justice (DOJ) released a summary of its False Claims Act (FCA) settlements and judgments recovered during fiscal year 2020 (which ended on September 30, 2020). All in all, DOJ reports that it obtained more than $2.2 billion in FCA matters related to the health care industry, procurement, bid-rigging, and other types of fraud in government programs. This figure represents a drop of over $850 million from the prior year and the least since 2008.

By far the lion’s share of recoveries occurred in the health care sector, with more than $1.8 billion of the total attributable to drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice care facilities, labs and physicians. Of these, the vast majority originated as qui tam (i.e. whistleblower) suits. DOJ initiated less than 2% of FCA suits in the health care sector.

With the advent of 2021 and a new administration, we think that the health care and pharmaceutical industries can expect renewed vigor in the pursuit of FCA settlements and cases, with the numbers heading back up to those seen during the Obama administration, where recoveries hit over $6 billion in 2014.

As some media pundits have pointed out, many expect that the Biden administration will look like Obama 2.0, and the announcement that Biden’s pick for Health and Human Services (HHS) secretary, Xavier Becerra, lends some validity to that argument. Becerra, California’s attorney general and a former Democratic congressman, is well known for his dogged pursuit of cases against the Trump administration (taking it to court over 105 times), and suits against pharmaceutical manufacturers for bad over-the-counter medications and oil company Valero. The overarching theme of Becerra’s tenure as Attorney General has been a focus on consumer protection.

Biden’s appointee for associate attorney general, and therefore the de-facto head of the Civil Division (which is responsible for matters arising under the FCA), Vanita Gupta, is a veteran of the Obama DOJ, formerly serving as Principal Deputy Assistant Attorney General and head of the Civil Rights Division. In her former tenure at DOJ, Gupta focused on criminal justice reform and the prosecution of hate crimes and human trafficking, promoting disability rights, and protecting the rights of LGBT persons and others against discrimination. Like Becerra, Gupta is known for her active and aggressive approach. Entities in the health care and pharmaceutical spaces should expect that approach will be applied to FCA enforcement.

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Getting the word out on the denial of care for pts with chronic health issues

Posted on January 21, 2021 by Pharmaciststeve

Top 8 healthy tips for the New Year

Here are some tips that will help you improve your health and reach your goal:

1. Kick start your exercise habits

Dr. Katy Milkman, a professor at the Wharton School, says one of the key findings in her research was about preventing missing more than one scheduled workout in a row. Check out the latest exipure reviews.

2. Plan to have one healthy goal

Milkman says sometimes it can be overwhelming to try to keep up with multiple goals at once, so it’s important to have a plan for your top healthy goal.

3. Spend some time outside

Spending more time outside seems refreshing. Each day, try to take a walk to your local park, go for a walk around the block, or sit in your backyard, and enjoy some fresh air.

4. Drink more water

Drinking water increases energy and relieves fatigue, promotes weight loss, flushes out toxins and improves skin complexion! Get a reusable cup, or bottle with markings so you know exactly when you should have your next drink. Health experts commonly recommend eight 8-ounce glasses, which equals about 2 liters, or half a gallon a day.

5. Maintain a healthy diet

You may be eating plenty of food, but your body may not be getting the nutrients it needs to be healthy. Nutrient-rich foods have minerals, protein, whole grains and other nutrients but are lower in calories. They may help you control your weight, cholesterol and blood pressure. Check out this list of what you should eat, and what you should avoid.
One of the diets that fits this pattern is the DASH (Dietary Approaches to Stop Hypertension) eating plan. Most healthy eating patterns can be adapted based on calorie requirements and personal and cultural food preferences. Here’s more info on this dietary plan. Check out these exipure articles.

6. Live tobacco free

Don’t smoke, vape or use tobacco or nicotine products — and avoid secondhand smoke or vapor.

7. Take care of your skin

As we enter the dead of winter, the cold, low humidity, mask wearing and handwashing can wreak havoc on our skin – which in turn may make you feel unhealthy. HERE are some winter skin care tips to help it stay healthy.

8. Boost your immune system

Your immune system can help defend you against disease-causing microorganisms! HERE is a list of healthy ways to strengthen your immune system.

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