AG Session… wants a CHILD to suffer with epilepsy rather than be able to use MMJ ?

Posted on January 18, 2018 by Pharmaciststeve

Jeff Sessions’s War on Pot Goes to Court, Attorney General Will Fight 12-Year-Old With Epilepsy

http://www.newsweek.com/jeff-sessions-war-pot-goes-court-attorney-general-will-fight-12-year-old-780749

A 12-year-old suing the federal government may have a whiff of adorableness. But for Alexis Bortell, who filed a lawsuit against Attorney General Jeff Sessions last fall, it’s a choice she had to make to save her life. Alexis has epilepsy, and Sessions has made it his mission to make it impossible for her to access the only drug that has kept her seizures at bay: cannabis. 

A Scream of Terror

Alexis doesn’t remember her first seizure. But her father, Dean Bortell, does. 

“We were literally folding clothes, and Alexis was sleeping on the couch,” Bortell told Newsweek. “All of a sudden, I heard her make this shriek—I mean, it was a scream of terror,” he said. “I look over, and Alexis is stiff as a board, on her back, spasming.” 

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At first, Bortell suspected his daughter had a brain-eating amoeba on account of headlines about them that summer and took her to the hospital. Within hours, it became clear something else was wrong. Alexis was diagnosed with epilepsy in 2013.

Three years ago, Alexis began taking medical marijuana, and her seizures disappeared. But that treatment option is threatened by an aggressive federal crackdown on medicinal cannabis led by Sessions, who is also the acting director of the Drug Enforcement Administration. 

Her day in court—February 14, at a New York City federal courthouse—is fast approaching. Alexis won’t be there in person, but her lawyer, Michael Hiller, thinks the ruling will go their way. 

“We are very optimistic that the case is going to come out the way it should, which is that the Controlled Substances Act is going to be found unconstitutional,” Hiller said. Several other plaintiffs—a former professional football player, a veteran and another child—are also included.

AlexisInThePatchesOfHopeGardenBeforeGroundBreaking Alexis Bortell stands in a field in this undated photo. Courtesy of the Bortell Family

Out of Options

The basic outline of Alexis’s story has been well reported: Horrible seizures forced her family to move to Colorado from Texas, where she could use products with compounds derived from marijuana. But due to the concentration of THC, also known as tetrahydrocannabinol, in one of the products she uses, Alexis is unable to cross state lines, board an airplane or set foot on a military base or in other federal buildings and lands.

Biologically, Alexis’s problem begins in the left frontal lobe of her brain. Normally, brain cells communicate with one another using electrical and chemical signals. Epileptic seizures happen when those signals go haywire.

Anyone familiar with epilepsy knows that’s a fairly muted description. These rogue cells can create something terrifying to experience or watch, and you can’t know when the next seizure will strike. It can be “frustratingly random,” Bortell said.

These brain signals can also spark a long-term relationship with one’s local neurologist or hospital as patients and doctors figure out what is happening. But that’s only half the battle; controlling the seizures is the other. For many people with epilepsy, one of the various kinds of prescription drugs available will work. But finding the right one or the right combination can take time. “They try to go mild to wild,” Bortell said.

At home in Texas, none of the mild stuff worked for Alexis. Giving two medications a real shot and having them both fail is usually enough for doctors to call a person’s epilepsy intractable; in other words, unresponsive to drugs. Alexis tried at least 20 different doses or combinations, her father said. She also experienced some extreme side effects from conventional medications. 

She had two final options in Texas: See if she was a candidate for surgery to remove the brain tissue where the seizures began or try one last medication, Felbatol. This drug carries a “black box warning,” the most serious kind the U.S. Food and Drug Administration will put on a label to flag extremely dangerous side effects. In this case, Felbatol has been associated with a serious bone marrow disorder and liver failure.

The family decided on Felbatol. But on the way to fill the prescription, their pediatrician called them and suggested they try something else. Weeks later, the Bortells packed their bags and drove to Colorado, ready to try a different course of treatment: a tincture of cannabidiol (a compound found in marijuana that isn’t responsible for a high) and a spray with THC (the compound that is). The CBD tincture tastes “bad and earthy,” Alexis told Newsweek, but it’s been working. She still gets auras, the warning signs that a seizure is about to hit, but she hasn’t had a full-blown episode in the past three years. Her father says the only side effect is the constant threat of federal law enforcement.

AlexisandMomInHempGreenHouse Alexis Bortell, left, and her mother stand in a hemp greenhouse in this undated photo. Courtesy of the Bortell Family

Safer Than Seizures

Some science backs up Alexis’s treatment plan. Clinical trials have shown that CBD can be useful to treat seizure disorders, but we’re still learning why it works. CBD could be working along about a dozen different pathways and receptors, said Dr. Jerzy Szaflarski, the director of the epilepsy center at the University of Alabama at Birmingham. (Coincidentally, that’s the same state university system from which Sessions earned his law degree.) Exactly how many might be related to epilepsy isn’t entirely clear. “The evidence for each and every one of those pathways is there but it’s relatively weak,” Szaflarski said. “It’s going to take a while before we sort this out.”

The evidence is stronger for CBD as an anti-seizure medication than for THC, he noted. “It doesn’t mean that THC doesn’t work for seizures,” said Szaflarski. “It just means that we have much less data because we’ve been studying this much less.”

Despite their utility, these products aren’t without risk, Szaflarski noted. The concentration of CBD in some products available on store shelves can vary from batch to batch. These drugs may interact with traditional anti-seizure medications, changing the amount of the drug found in a person’s blood. And some studies have linked early THC exposure to lower IQs and behavioral problems.

But, Szaflarski noted, “the question is, Do these problems that we see that develop through the use of cannabis outweigh the risk of epilepsy?” For Alexis, the answer is clear: Her drugs are safer than having continued seizures.

A Violation of the Constitution

The government disagrees. It says marijuana has no medical applications whatsoever and is accordingly listed by the DEA as a Schedule 1 drug under the Controlled Substances Act, first passed in 1970. 

That entire act is what Alexis, her co-plaintiffs and Hiller, her lawyer, are challenging. Hiller took the case pro-bono and has written a brief that, at 98 pages, is the longest of his career. The document lays out the basic reasons why he believes the act is unconstitutional. Specifically, the case claims the act violates Americans’ fundamental right to travel, as well as the Commerce Clause of the Constitution and the First, Fifth, Ninth and 14th amendments.

Hiller believes the case could end up in the U.S. Supreme Court. It’s impossible to say what the outcome of the case will actually be until a judge hears the arguments and makes a ruling. But while Alexis and her family wait for that outcome, they are on increasingly uncertain ground.

On January 4, Sessions rescinded the Cole memorandum, an Obama-era directive to U.S. attorneys ordering them to focus on prosecuting major distributors and more serious marijuana-related offenses, such as selling to minors. The Rohrabacher-Blumenauer amendment, renewed in December, is also set to expire on January 19. That amendment prevents the Justice Department from using its funding to keep states from implementing medical marijuana laws.

That amendment is likely to be renewed, Hiller said. Senator Elizabeth Warren has also announced plans to introduce legislation that could have the same effect as the Cole memo. But that’s little comfort to the Bortells—a family that just wants to help their child use the one thing that’s worked for her epilepsy.

“No one else is living memo to memo or administration to administration,” Bortell said. “I don’t think asking for my daughter to have that long-term plan for her life—I don’t think that’s asking too much.”

This article has been updated to clarify the medical treatment Alexis received after her first seizure.

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Civil asset forfeiture is an unconstitutional practice whereby the government takes people’s property without due process

Posted on January 18, 2018 by Pharmaciststeve

Bill Introduced to Stop Civil Forfeiture Funding of DEA Marijuana Eradication Program

“DEA’s use of proceeds acquired through civil asset forfeiture to expand marijuana enforcement makes the already unacceptable practice even worse.”

http://reason.com/blog/2018/01/18/bill-introduced-to-stop-civil-forfeiture

Citing waste of taxpayer dollars, shifting public opinion, and constitutional concerns, Reps. Ted Lieu (D-Calif.) and Justin Amash (R-Mich.) have introduced a bill in Congress that would block funds from the federal government’s controversial asset forfeiture fund from being used for the Drug Enforcement Administration (DEA) marijuana eradication program.

The Stop Civil Asset Forfeiture Funding for Marijuana Suppression Act, first introduced in 2015, would use Congress’ power of the purse to block money from the Justice Department’s Asset Forfeiture Fund from being used to support the DEA’s Domestic Cannabis Suppression/Eradication Program.

According to the DEA, the program was responsible in 2016 for the eradication of more than 5 million marijuana plants, more than 5,000 arrests, and the seizure of more than of $51 million from marijuana cultivators.

For example, in 2009 federal prosecutors unsuccessfully fought to seize a farm from an Alabama woman after her husband was caught growing marijuana on the property. Her husband, who said he used the marijuana to manage chronic pain, committed suicide during his trial in a last-ditch attempt to keep the farm in family hands, as it had been for generations. His wife was never charged with a crime.

“Civil asset forfeiture is an unconstitutional practice whereby the government takes people’s property without due process,” Amash, one of the more libertarian members of Congress, said in a joint statement with Lieu. “The DEA’s use of proceeds acquired through civil asset forfeiture to expand marijuana enforcement—a state-level issue—makes the already unacceptable practice even worse.”

Lieu called the DEA eradication program “a waste of time and money and runs contrary to the will of the people.”

“The Federal Government has a responsibility to spend taxpayer money wisely,” he said. “Instead, A.G. Jeff Sessions would rather waste federal dollars by attacking marijuana, which has been legalized either for medical or recreational use in the majority of states in the U.S.”

Attorney General Jeff Sessions, a longtime supporter of the drug war, recently rescinded Obama-era guidance to U.S Attorneys on marijuana enforcement, sparking fears of a federal crackdown on the drug, which is now legal at the state level for recreational use in eight states and the District of Columbia.

A new poll conducted by Mason-Dixon Polling and Strategy and released by Smart Approaches to Marijuana (SAM), an anti-legalization group, found that only 16 percent of Americans support keeping the current federal policy on marijuana, while 49 percent favor full legalization for recreational use.

The bill also has the support of marijuana legalization groups.

“Never in modern history has there existed greater public support for ending the nation’s nearly century-long experiment with marijuana prohibition,” Justin Strekal, the political director of the National Organization for the Reform of Marijuana Laws, said in a statement. “With eight states and the District of Columbia now having legalized its personal use and 30 states having legalized medical marijuana, it is time that the DEA cease interfering with state-legal programs and stop wasting taxpayer dollars that would be better directed at going after the pill-mills contributing to the nations opioid crisis.”

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First it was tobacco, then the Pharmas and now oil.. alcohol can’t be far behind… then what legal industry is next ?

Posted on January 18, 2018 by Pharmaciststeve

https://youtu.be/6Pnq9FwFr_I

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Could put thousands of otherwise innocent Americans into locked treatment units

Posted on January 18, 2018 by Pharmaciststeve

New Laws Force Drug Users Into Rehab Against Their Will

https://www.thedailybeast.com/new-laws-force-drug-users-into-rehab-against-their-will

Involuntary commitment laws are being opened up to allow some people to be detained for overdosing or even having visible track marks—in some cases up to 90 days.

Debra Hicks went to work on Sept. 19, 2011, to teach California high school students about the Constitution. But that night she got a crash course on how easily her own civil rights could be violated, when she overdosed on her pain pills and a psychiatrist she’d never met involuntary committed her to Glendale Adventist Medical Center, near Los Angeles.

By the time she was released six days later, Hicks claims she had been placed in five-point restraints and “forcibly and unwillingly subjected to the use of strong antipsychotic medications”—according to an ongoing lawsuit against the facility.

Her only “crime,” she says, was having a bad reaction to her doctor-prescribed opioid medication.

Now lawmakers in at least eight states are considering bills that would make it even easier for drug users like Hicks to be forced into treatment against their will.

Proponents insist the bills are an unfortunate but necessary response to a troubling rise in the number of Americans dying from drugs like Oxycontin and heroin. But patients rights advocates say involuntary commitment is an overly extreme measure that will only make addicts’ lives worse.

Meanwhile, the private prison industry is waiting quietly in the wings, sensing an opportunity to get new business in the wake of declining prison populations.

 “The idea of using the criminal justice system or civil commitment to compel drug users to accept treatment is ridiculous,” said Dr. Mark Willenbring, an internationally recognized addiction psychiatrist and founder of the Alltyr clinic in Minnesota. “Why aren’t we incarcerating people with heart disease who continue to smoke or people with diabetes who don’t manage their diet?”

According to the National Alliance for Model State Drug Laws, 37 states already have statutes that allow substance abusers who have not committed a crime to be briefly detained against their will. In most cases the legal bar is high—often requiring a finding that the person being committed has threatened to harm themselves or another person.

Over the past several years, however, states have been quietly revising their laws to allow for longer periods of commitment with fewer legal hurdles.

Kentucky and Ohio led the push. And in 2015 Mike Pence signed a law permitting involuntary commitment for drug users in Indiana.

Last year, Florida followed suit, passing a new measure that allows individuals with substance abuse problems to be held up to 90 days against their will. A petition can be filed by “any adult with direct personal observed knowledge of the respondent’s impairment,” and must only show probable cause that the individual has “lost the power of self-control with respect to substance abuse” and are “incapable of making a rational decision regarding his or her need for care.”

Lawmakers in New Jersey have been trying for the past two years to get a similar measure on the books there. The latest iteration of the bill, introduced by Democratic Assemblyman Joseph Lagana (Paramus), would allow a police officer with no addiction training to detain a person if they have “reasonable cause” to believe that the person is in need of involuntary treatment.

 A bill proposed this session in the Washington Senate would expand civil commitment to include individuals who have had three or more arrests “related to activities connected to substance abuse,” who have ever been in rehab or detox, or who have three or more visible track marks (PDF).

Three such bills are currently being considered in Pennsylvania, including one that would permit forced treatment for any individual who “has ingested an amount of drugs as to render himself unconscious or in need of medical treatment to prevent imminent death or serious bodily harm.”

Like many of the new measures, the bill would authorize up to 90 days of involuntary inpatient drug treatment.

Since most addicts are not “severely mentally impaired,” legal experts say that once they are detoxed it will become increasingly difficult to justify involuntary detention. That means that, in practice, the period of commitment is likely to be much shorter.

Addiction experts say that could actually lead to an increased risk of overdose, as drug users return to the community without the physical tolerance they had only days or weeks earlier.

“Often what will happen is that people will remain sober through treatment but then rapidly return to use as soon as they are out,” said Kirk Bowden, a certified addiction clinician and the former president of the Association for Addiction Professionals.

Lawmakers in New Hampshire, Alabama, Maryland, Michigan, and Mississippi are also considering broad civil commitment measures this session.

David Freed, district attorney for Cumberland County, Pennsylvania—where overdose fatalities doubled in 2016—supports the measure, and says states have a “moral obligation” to help drug addicts who he says won’t help themselves.

“The process should be seamless. It should be standard, and frankly, it should not be optional,” he testified last year.

But morality and medicine are frequently at odds, as Hicks’ case shows.

Like millions of other Americans, Hicks suffers from chronic pain issues, including fibromyalgia—a painful nerve condition—three herniated disks and two pinched nerves.

Her treatment includes seeing a pain management specialist, and taking prescribed medications that include opioid painkillers.

According to a lawsuit she filed in Los Angeles Superior Court, on the day her ordeal began Hicks had forgotten to take her morning dose of painkillers. As the hours wore on she found herself in increasing physical distress. By the time she got home that evening she says she was experiencing severe pain, and erroneously believed she needed to take more than her prescribed dose to make up for the missed one.

Hicks’ roommate found her passed out on the floor of the apartment they shared and called 911.

Though she managed to walk to the ambulance that would take her to the emergency room, doctors there told Hicks that, as a matter of protocol, patients who have suffered a drug overdose must speak to a psychiatrist before being released.  

According to her lawsuit, Hicks waited nine hours after she was discharged from the emergency room before a nurse informed her she was being detained under a 1967 law that  gives psychiatrists in California limited powers to hold a person who is dangerous to themselves or others due to mental illness against their will for up to 14 days.

Hospital records attached to Hicks’ lawsuit say her only formal diagnosis was “depression.” When Hicks attempted to leave the hospital—a full 24 hours after being released from the ER—she was chased down and brought back by local police and hospital security guards, she asserts in her complaint.

“The Hicks case is a dramatic example of how a person can be captured into a system by people who pretend to be trained to help but actually completely misunderstand the process,” said Hicks’ attorney, Gary S. Brown, in an email to The Daily Beast.

In court filings, the hospital does not dispute the facts of the case, but argues that it is immune from civil action under California’s civil commitment law—which requires only a finding of probable cause that an individual is a danger to themselves.

Brown, who has spent the better part of three decades defending clients who’ve been involuntarily committed, says that while patients can challenge that finding in court after a few days of confinement, the odds are often stacked against them.

While forcing substance abusers into treatment may provide temporary relief for family members who are dealing with an addicted loved one, experts say it offers little help for the person actually suffering from addiction.

A recent study published by the medical journal the Lancet found that heroin users forced into treatment “had significantly more rapid relapse to opioid use post-release” compared with those who voluntarily sought help.

Involuntary commitment also violates the ethics codes of some treatment organizations, such as the Association for Addiction Professionals (PDF).Meanwhile, detaining a person who has committed no crime based on what they might do in the future has potentially severe long-term repercussions.

“Involuntary commitment gives someone a lifelong marker that interferes with their ability to get health care coverage or own a firearm, and it could prevent them from getting certain jobs, like federal employment,” said Mary Catherine Roper, of the the American Civil Liberties Union of Pennsylvania.

Once a civil commitment is on a person’s record, Roper says, it’s nearly impossible to get it expunged.

But there’s another, more pressing problem with involuntary commitment for substance abuse: Most states don’t have enough treatment beds even for the people who want them.

Massachusetts—which has permitted courts to force drug users into treatment for more than two decades—has so little bed space for drug addicts seeking help that those compelled into treatment are often sent to one of two state correctional facilities instead. Last year, the state actually had to pass a law to ensure that women who are involuntarily detained for drug abuse go to an actual treatment facility instead of jail.

Doctors say giving precedence to drug addicts who don’t want treatment will almost certainly make it harder for those who do want treatment to access it.

“There are waiting lists for treatment right now,” said Dr. Raymond Bobb, an addiction doctor in Philadelphia who treats patients with methadone and Suboxone. “Plenty of people are seeking treatment and waiting for spots to open up, do these people supersede them?”

That has caught the attention of the private prison industry—which has been refocusing its efforts on treatment and reentry services as states have moved to reduce the number of inmates in their correctional systems.ennsylvania lacks any secure drug treatment facilities—with the exception of those currently contracted by the Department of Corrections. In February, Gov. Tom Wolf announced the state would cut $40 million from its community corrections budget and plans to eliminate 1,500 halfway house beds.  

Weeks later private prison firm The GEO Group completed its $360 million acquisition of Community Education Centers, which operates five residential reentry facilities in Pennsylvania. The GEO Group spent more than $112,000 lobbying lawmakers in Harrisburg over the past 12 months.

Correct Care Recovery Solutions (CCRS), a subsidiary spun off by GEO Group in 2013, also operates residential psychiatric treatment hospitals, as well as the only privatized civil commitment facility in the country (in Florida). In addition to Pennsylvania, the company manages facilities in several states where civil commitment measures are being considered.

New laws that would put thousands of otherwise innocent Americans into locked treatment units could potentially be a windfall for the company and others like it. But like so many other failed policies in the War on Drugs, it will be the most desperate and marginalized Americans who will pay the price.

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Ravenna eyes fees for marijuana businesses

Posted on January 17, 2018 by Pharmaciststeve

http://www.record-courier.com/news/20180117/ravenna-eyes-fees-for-marijuana-businesses

Ravenna City Council is considering imposing a $25,000 licensing fee for any medical marijuana-related businesses that might operate in the city after learning that all taxes from such a business would go to the state.

Council’s Community and Economic Development committee recently discussed the potential fee. Councilman Andrew Kluge said Lakewood implemented an identical fee for such businesses. Akron, he said, implemented a fee of $60,000 for businesses related to the new medical marijuana program in the city limits.

Under the state program, the Ohio Board of Pharmacy is issuing licenses to cultivators, processing plants and dispensaries throughout the state.

Geauga County businessman Tom Hobson recently got the green light from the state to open a cultivation business at 4000 Lake Rockwell Road in Ravenna Township. FN Group Holdings, LLC, which is doing business as Wellspring Fields, will be owned by Hobson’s daughter, Claire, and his son, Spencer. The group holds the only cultivation license issued in Portage County, and reportedly applied for a processing license, an application that is pending.

Groups have approached Ravenna City Engineer Bob Finney about operating dispensaries in city limits. Council members implemented legislation to pave the way for such businesses, and some council members expressed hope that the city would benefit from the taxes generated by the new enterprises.

However, officials later learned that the taxes would go back to the state, and the city would have little to gain from such a business locating in the city.

That’s why some cities are implementing licensing fees, reasoning that most medical marijuana businesses have already paid much higher fees at the state level to obtain their licenses. Under Ravenna’s plan, the fee would be charged annually for five years, and could possibly drop in the years after that.

Kluge said the money would go into the city’s general fund. From there, the money can be used toward other purposes, such as drug education.

Councilman Rob Kairis said he doesn’t object to the fee, but thinks talk about drug education misses the point.

 “This is something that is meant for medical purposes for specific conditions,” he said. He suggested directing the fees toward the city’s safety forces instead.

He pointed out that Kent is looking at ending its moratorium, and Streetsboro seems to be reversing its proposed ban on the program.

“There is competition out there,” he said.

Councilman Scott Rainone said he read about a similar enterprise out of state that paid a $25,000 fee, but sued when that city raised its fee by $100,000.

“If it’s low enough, they see that fee as the cost of doing business,” he said.

Council President Joseph Bica pointed out that a fee of $50,000 is roughly equivalent to the entry-level salary of a police officer.

Councilwoman Amy Michael said the city should think carefully before deciding how much the fee should be.

“Whatever we go in at, we’re going to be there for a very long time,” she said.

All these bureaucrats can see is a “cash cow”… they are too myopic to see that taxing the crap out of a legit MMJ business will just allow those selling MJ on the street to be able to UNDER CUT the price of the product from the legal distributor… because they have no legal taxes and the cost of permits to the state and any other middleman bureaucracy  to pay…  Remember there is no education required or previous experience to be an elected or appointed bureaucrat and these bureaucrats in Ohio seem to be clearly demonstrating why there should be.

 

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Survey: 42% of Physicians Report Burnout, Some Cite Depression

Posted on January 17, 2018 by Pharmaciststeve

https://www.medscape.com/viewarticle/891411

Forty-two percent of physicians said they feel burned out, while 15% reported feeling depressed, according to a new Medscape survey.

Half of those who reported burnout experienced those feelings on a regular basis. Of the smaller number of physicians who reported depression, 70% called it “colloquial,” while 19% said they had clinical depression.

Those reporting to be the happiest at work were ophthalmologists, orthopedists, plastic surgeons, and pathologists. Those who were the least happy included clinicians in diabetes and endocrinology; family medicine; critical care; internal medicine; and, at the bottom, cardiology. Some 15,000 physicians from 29 specialties participated in the Medscape survey.

Burnout was reported at the highest rates by critical care physicians (48%), neurologists (48%), and family medicine doctors (47%). In a large number of specialties, 40% or more of the respondents said they felt burned out. Among oncologists, 39% reported burnout. Lower numbers — but still somewhat large — of orthopedic physicians (34%), ophthalmologists (33%), pathologists (32%), and dermatologists (32%) said they were burned out.

 The smallest number of clinicians who said they were burned out were plastic surgeons, with just 23% reporting that feeling.

Medscape also asked whether physicians felt both burnout and depression. Ob/gyns were the leaders, with 20% saying they felt both. Specialists in public health and preventive medicine, urology, neurology, and family medicine followed. At the bottom, just 8% of psychiatrists said they were both burned out and depressed.

Women tended to report feeling burned out more than men. Mid-career physicians also seemed to be hit the hardest, with half of those aged 45 to 54 reporting burnout.

For those who said they felt depressed, the job was the biggest contributing factor, approaching a 6 on a 7-point scale used by Medscape. Finances followed, at around 4, with health considered the least important factor in depression.

Too much bureaucracy and paperwork was the main factor contributing to burnout, listed by 56% of respondents. Spending too much time at work, and lack of respect — from colleagues, administrators, or staff — took the second and third spots.

Government regulations, decreasing reimbursement, emphasis on profit over patients, and maintenance of certification requirements were all also listed as burnout factors, but were less important, with only about 15% to 16% of respondents citing those.

Disconnect on Perceived Impact on Care

Medscape asked physicians who reported feeling depressed whether their depression had any impact on patient care. Some 40% said it did not affect their interaction with patients.

However, about a third said they were less engaging, more exasperated, and less friendly with patients because of their depression. Fourteen percent of respondents said they make errors that might not otherwise occur.

A larger number seemed to recognize that their distress was affecting interactions with staff and colleagues. Forty-two percent admitted to being less engaged with or actively listening to staff and peers. An equal number acknowledged being more easily exasperated, and a slightly smaller percentage said they were less friendly and that they expressed frustration in front of colleagues and staff.

 Coping With Burnout

Survey respondents were also asked about what might reduce their burnout, what kinds of coping strategies they employ, including whether they might seek professional help, and whether their workplace offered any sort of assistance in dealing with burnout.

 The most popular coping mechanisms were exercise — cited by 50% overall, with slightly more men than women favoring that — and talking with family and friends. More women than men said they turned to friends or family. Sleeping and isolating themselves from others were also much employed, as was listening to music. A third said they would eat junk food, and a fifth turned to alcohol. Few clinicians — less than 3% — said they used prescription drugs or marijuana to cope.
 Similarly, a small number of survey respondents said they currently were receiving professional help or planned to do so. Sixty-six percent of men and 58% of women said they were not receiving counseling and had not done so in the past. Not surprisingly, the specialists most likely to seek help were psychiatrists, followed by plastic surgeons. At the bottom, 17% of cardiologists said they would be likely to do so.
 Nonhospital academic practices, healthcare organizations, and hospitals were most likely to offer a workplace program to help. Office-based single specialty and solo practices were least likely. Only 10% of respondents from single practices said that a program was place. Interestingly, the highest number of clinicians who said they had used such a program were in office-based solo practices.
 Some of the respondents had advice for colleagues on how to avoid burnout, including finding a way to make themselves happy on the job. Another suggested leaving the laptop at the office. “Stay at work until 6:00 pm if need be to finish your work, but when you go home, BE at home,” the respondent said.
 Said another respondent, “Count your blessings.”
 Respondents, who were recruited for the survey from July to October 2017, were required to be practicing medicine in the United States. The margin for error was ±0.79%, with a 95% confidence level using a point estimate of 50%.

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STUDY: Patients Who Receive Prescription Opioids Are More Satisfied with Their Care

Posted on January 17, 2018 by Pharmaciststeve

www.nationalpainreport.com/study-patients-who-receive-prescription-opioids-are-more-satisfied-with-their-care-8835295.html

Patients with musculoskeletal conditions who receive prescription opioids are more satisfied with their care than comparable patients who do not receive opioids.

“In the current payment paradigm, reimbursement is partially based on patient satisfaction scores. We sought to understand the relationship between prescription opioid use and satisfaction with care among adults who have musculoskeletal conditions,” lead author, Brian D. Sites, MD, MS, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, wrote.

In a study of nationally representative data, 13 percent (2,564) of more than 19,000 patients with musculoskeletal conditions used prescription opioids. Among those who used opioids over time, moderate and heavy use was associated with greater likelihood (55 percent and 43 percent, respectively) of being most satisfied, compared to single or no use of opioids.

Although opioids may be expected to offer patients with musculoskeletal conditions improved pain control, patients taking opioids in this study had more pain and worse health and disability than those taking limited or no opioids, suggesting a more complex picture.

As clinician compensation is increasingly linked to patient satisfaction, and as the United States struggles with an epidemic in opioid use, the authors suggest it is imperative to determine whether improved satisfaction with care is associated with demonstrable health benefits.

Dr. Sites’ study, Prescription Opioid Use and Satisfaction With Care Among Adults With Musculoskeletal Conditions, is published in the American Academy of Family Physicians’ journal, Annals of Family Medicine.

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Intractable Pain Treatment Report No.1 Dr Tennant

Posted on January 17, 2018 by Pharmaciststeve

Filed under: General Problems | 4 Comments »

Illinois Judge Orders State to Add Intractable Pain as Qualifying Medical Cannabis Condition

Posted on January 17, 2018 by Pharmaciststeve

www.thejointblog.com/illinois-judge-orders-state-add-intractable-pain-qualifying-medical-cannabis-condition/

In a decision that will significantly expand the pool of people eligible to use medical cannabis in Illinois, a judge has ruled that the state must add intractable pain as a qualifying medical cannabis condition.

In 2016 the Illinois Department of Public Health rejected a petition to add intractable pain to the state’s medical cannabis program. Now, two years later, Cook County Judge Raymond Mitchell has ordered the agency to add the condition. Intractable pain is defined as pain that’s resistant to standard treatment options.

The ruling comes from a lawsuit brought forth by Ann Mednick, who often experiences extreme pain associated with osteoarthritis; Mednick uses prescription opioids, but says they fail to control the pain and result in numerous side effects.

“Illinois is years behind the times,” says Mednick. “The state needs to get [it] together.” Mednick previously petitioned the now-disbanded Medical Cannabis Advisory Board to recommend the state add intractable pain as a medical cannabis condition; if you want to learn more about marijuana click here for weed online. The board voted unanimously to approve the petition, 10 to 0. However, this didn’t stop Department of Public Health Director Dr. Nirav Shah from rejecting the recommendation in January of 2016.

In his ruling Judge Mitchell stated that Dr. Shah’s decision was  “clearly erroneous”. He pointed to the fact that Dr. Mednick said intractable pain is not a condition listed in the International Statistical Classification of Diseases and Related Health Problems as a recognized unique medical condition, despite that not being true. The judge also said that; “The record shows that individuals with intractable pain would benefit from the medical use of cannabis”.

Unsurprisingly, the Department of Public Health says it plans to appeal the judge’s ruling.

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Computer crashed and burned

Posted on January 16, 2018 by Pharmaciststeve

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Yesterday… about mid afternoon… my computer just decided to self destruct… This is only the second time in all my decades of using computers that I had to seek “professional help” to put my computer back together… Off to Best Buy today and Geek Squad to the rescue… According to them .. .they have seen a “rash” of “C drives” just self destructing – at least the OS on the drive…they suspect that a update from Windows or Dell… has been sent out.. and they are not saying anything about how their little “bug” has trashed computer’s OS.

The good and bad of it for me… my computer has a solid state C DRIVE and all my data was on a old reliable typical hard drive labeled as “D”… but all the programs had to be downloaded and reinstalled and change their default configurations to my liking… – the ones that I could remember was on the system… I will probably be finding “missing” programs for weeks going forward.. when I need to do something.

If my blog seems rather “silent” over the next few days or I don’t get to your email for a few days… I am not intentionally ignoring anyone…

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