The Addict is Not Our Enemy

www.painnewsnetwork.org/stories/2016/11/27/the-addict-is-not-our-enemy

By Fred Kaeser, Guest Columnist

A number of people in chronic pain support the plight of those with addiction. Yet, over the past year and a half, I have read any number of derogatory statements and comments here on Pain News Network and on its corresponding Facebook page about people who are dealing and struggling with addiction.

Even a cursory review of the comment section on different articles will reveal rather quickly any number of folks who are dismissive of those dealing with addiction. Some express a real hatred.

One person actually suggested letting “all the druggies overdose, one by one.”

Another laments that “addicts can’t die quick enough for me.”

Some express a sort of jealousy over addicts getting better treatment than they: “It’s good to be an addict” and “Maybe I’d be better off being an addict.”

And then there are those who got all shook up over Prince’s overdose, not so much from his death, but because it was linked to an opioid and that it might make it harder for them to obtain their own opioid medications.

And to think these comments come from the same people who beg others to better understand and accept their own need for better pain care!

It wasn’t very long ago that the “drug addict” was scorned and forgotten: the druggie on the dark-lit street corner or the drunk in the back-alley. Pretty much neglected and left to fend for themselves.

But that started to change in the ’70s and ’80s, and nowadays the person suffering from addiction is recognized as someone who suffers from a very complex disease, is quite sick, and struggles to access the necessary care in order to recover. Societal attitudes towards those with an addiction now reflect empathy and a desire to help, as opposed to denunciation and dismissiveness.

We chronic pain patients are looking for the same acceptance and understanding that addicts were desperately seeking just a few short years ago. And that struggle took many, many decades, one might say centuries, to achieve. Our struggle is similar, and my guess is if we keep our eyes and focus on reasonable and rational argument, we too will achieve success in our struggle to obtain acceptable pain care and understanding.

But if some of us continue to see the enemy as the person who has an addiction, our fight for justice will suffer and be delayed.

Why? Because the addict is not very different from us.  Irrespective of the reason why a drug or substance user becomes addicted, the addict just wants to feel better, just like us. The addict is sick, just like us. The addict wants relief from pain, just like us. Perhaps not from physical pain, but emotional and psychic pain. The addict wants proper medication, just like us. The addict needs help and assistance, just like us.

And sometimes the pain patient is the addict. Sometimes we are one in the same. A recent review of 38 research reports pegs the addiction rate among chronic pain patients at 10 percent. From a genetic predisposition standpoint, we must presume that some addicts have become addicted just because of their genes, just like some of us.

No one with an addiction started out wanting to become addicted, just like none of us wanted chronic pain. And while our government is trying to figure out how to minimize the spread of opioid addiction, it is not the addict’s fault as to how it has decided to that.

In many ways those suffering from addiction are not very different from us who suffer from chronic pain. We both struggle for acceptance, we both require empathy and understanding from the world around us, and we both require treatment and proper care to lead better and more productive lives.

But, I firmly believe that as long as there are those of us in chronic pain who feel compelled to ridicule and demean those who are addicted, that we will only delay our own quest to receive the empathy we so justly deserve in our journey towards adequate pain care.

Empathy breeds empathy, and if we expect it for ourselves, we must be willing to extend it to others. And that includes the addict. 

Filed under: General Problems | 15 Comments »

Filed under: General Problems | 10 Comments »

Surgeon General’s Report Mistakenly Treats All Drug Use As a Problem

Vivek Murthy does not acknowledge the possibility that nonmedical consumption of psychoactive substances could be beneficial.

http://reason.com/blog/2016/11/18/surgeon-generals-report-mistakenly-treat

You might think Surgeon General Vivek Murthy, who acknowledges marijuana’s medical utility, has relatively enlightened views on drug policy. But a report he released yesterday reveals that Murthy is utterly conventional in his attitude toward drinking and other kinds of recreational drug use, which he views as a problem to be minimized by the government. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health claims “addiction is a chronic brain disease” caused by exposure to psychoactive substances, even while acknowledging that the vast majority of people who consume those substances do not become addicted to them. The report describes even low-risk, harmless, and beneficial drug use as “misuse,” giving the government broad license to meddle with personal choices through policies aimed at making drugs more expensive and less accessible. Murthy argues that driving down total consumption, rather than focusing on problematic use, is the most effective way to reduce the harm caused by alcohol and other drugs. As he sees it, every drinker and drug user, no matter how careful, controlled, or responsible, is a legitimate target of government intervention.

Murthy’s report eschews the term substance abuse, explaining that the phrase “is increasingly avoided by professionals because it can be shaming.” Instead the report talks about “substance misuse,” which “is now the preferred term.” But substance misuse is just as judgmental, vague, and arbitrary as substance abuse. In fact, Murthy cannot quite decide what it means. On page 5 of the introduction, he says misuse occurs when people use drugs “in a manner that causes harm to the user or those around them.” But elsewhere (including the very next page), the report uses a much broader definition. “Although misuse is not a diagnostic term,” Murthy says, “it generally suggests use in a manner that could cause harm to the user or those around them.” Could cause harm? That definition is wide enough to cover all drug use.

Murthy does seem to think drug use is problematic even when it causes no problems. As an example of drug misuse, Murthy repeatedly cites a 2015 survey in which 25 percent of the respondents, representing 66.7 million Americans, reported that they had engaged in “binge drinking” during the previous month. “By definition,” Murthy says, “those episodes have the potential for producing harm to the user and/or to those around them, through increases in motor vehicle crashes, violence, and alcohol poisonings.” But the government’s definition of a binge—five or more drinks “on an occasion” for a man, four or more for a woman—encompasses patterns of consumption that do not harm anything except the sensibilities of public health officials. If a man at a dinner party drinks a cocktail before the meal, a few glasses of wine during it, and a little bourbon afterward, he is drinking too much, according to Murthy, even if he takes a cab home. By that standard, at least 44 percent of past-month drinkers are misusing alcohol.

Murthy also counts all consumption of federally proscribed drugs as misuse, no matter the context or consequences. As far as he is concerned, all 36 million Americans who consumed cannabis last year misused it, even if they lived in states where the drug is legal for medical or recreational purposes (which is now most states). Unauthorized use of prescription drugs also counts as misuse, whether or not harm results. “In 2015,” Murthy says, “12.5 million individuals misused a pain reliever in the past year—setting the stage for a potential overdose.” That makes the risk sound much bigger than it is. According to the CDC, there were 18,893 deaths involving opioid analgesics in 2014, the most recent year for which data are available. That year, according to the National Survey on Drug Use and Health, 10.3 million Americans used prescription painkillers for nonmedical purposes. On average, they ran a 0.2 percent change of dying as a result. For those who avoided mixing narcotic painkillers with other depressants (a typical factor in opioid-related deaths), the risk was even smaller—on the order of 0.02 percent, judging from New York City data.

Murthy also seems confused when he talks about addiction. “We now know from solid data that substance abuse disorders don’t discriminate,” he recently told NPR. “They affect the rich and the poor, all socioeconomic groups and ethnic groups. They affect people in urban areas and rural ones.” But according to Murthy’s report, “Prevalence of substance misuse and substance use disorders differs by race and ethnicity and gender.” Furthermore, “genetic, social, and environmental risk factors” increase a person’s vulnerability to addiction, while “protective factors” reduce it. Risk factors include “low parental monitoring,” “high levels of family conflict or violence,” “current mental disorders,” “low involvement in school,” and “a history of abuse and neglect.” Protective factors include “involvement in school, engagement in healthy recreational and social activities, and good coping skills.” Pace Murthy, it sounds like substance abuse disorders do discriminate, since they are more common among troubled people in difficult circumstances.

The fact that everyone is not equally prone to addiction tells us that Murthy’s account, in which a “substance abuse disorder” is “a medical illness caused by repeated misuse of a substance or substances,” cannot be accurate. According to the report, “prolonged, repeated misuse of any of these substances can produce changes to the brain that can lead to a substance use disorder, an independent illness that significantly impairs health and function and may require specialty treatment” (emphasis added). Those cans are carrying a lot of weight. In fact, as Murthy concedes, drug use typically does not “lead to a substance use disorder”; controlled use is much more common. “For a wide range of reasons that remain only partially understood,” says the executive summary, “some individuals are able to use alcohol or drugs in moderation and not develop addiction or even milder substance use disorders, whereas others—between 4 and 23 percent depending on the substance—proceed readily from trying a substance to developing a substance use disorder.” By saying “some” and “others” instead of “most” and “a minority,” the report obfuscates the point that the vast majority of drinkers and drug users are not addicts.

Murthy’s equation of addiction with cancer and diabetes is also misleading. “Now we understand that these disorders actually change the circuitry in your brain,” he tells NPR. “They affect your ability to make decisions, and change your reward system and your stress response. That tells us that addiction is a chronic disease of the brain, and we need to treat it with the same urgency and compassion that we do with any other illness.” All experiences change the brain; that does not make them diseases. Although the medical terminology is supposed to reduce the stigma associated with drug addiction and encourage people to seek help, it is not clear that describing the problem as an illness rather than a habit makes it any easier to change. Arguably it does the opposite, by depicting harmful patterns of drug use as something that happens to people rather than something that they do.

Filed under: General Problems | 5 Comments »

Belladonna extract prompts recall of CVS homeopathic products

outbreaknewstoday.com/belladonna-extract-prompts-recall-cvs-homeopathic-products-35665/

Raritan Pharmaceuticals, a contract manufacturer for Homeolab USA, is voluntarily recalling homeopathic products containing belladonna extract (see products below) due to the potential for variation in the content of belladonna extract in the products. The U.S. FDA has tested some products and recovered varying levels of belladonna extract content from what is declared on the label. Raritan Pharmaceuticals is a contract manufacturer of these products for Homeolab USA that supplies the belladonna blends to Raritan Pharmaceuticals.

Image/The Global Dispatch

UPC: 050428424162
Product: CVS Homeopathic Infants’ Teething Tablet 135 tablets
(Please note that CVS has already taken a market action on this product as of September 30, 2016) Lots: 41116 and 43436

UPC: 778159090639
Product: Kids Relief Homeopathic Ear Relief Oral Liquid 0.85 fl. oz. Lot: 35254

UPC: 050428441633
Product: CVS Homeopathic Kids’ Ear Relief Liquid 0.85 fl. oz. Lot: 33149

The homeopathic products have a very small amount of belladonna, a substance that can cause harm at larger doses. The company is voluntarily recalling the product out of an abundance of caution.

These products were distributed Nationwide. Consumers with any product being recalled should stop using the product. Consumers with questions regarding this recall can contact Raritan Pharmaceuticals by phone at 1-866-467-2748 (Monday-Friday from 8am to 5:30pm EST).

No other Homeolab or Raritan products are affected.

Consumers should contact their physician or healthcare provider if they have experienced any problems that may be related to taking or using this drug product.

Filed under: General Problems | 1 Comment »

Jill Stein formally files for Wisconsin recount as fundraising effort passes $5m

http://www.msn.com/en-us/news/politics/jill-stein-to-formally-file-for-wisconsin-recount-as-fundraising-effort-nears-dollar5m/ar-AAkKPWV?

The Green Party’s candidate Jill Stein… got 0.36% of the national vote… yet she… and the GREEN PARTY.. are raising money to force a vote recount in 2-3 different states. The chronic pain community may need to pay attention… sending letters, making phone calls, putting forth petitions,  and all those other things that has proven to be synonymous with a dog chasing its tail…  It would appear that the only way to get things done within out system is using the laws within our system that are working against those who are suffering from subjective diseases and being denied appropriate therapy.. to raise money and hire a law firm(s) to challenge those decisions… if nothing else.. on a constitutionality basis… if not from the flat out denial of care and the intentional infliction of the “pain consequences” for denial of care.

Jill Stein, the Green party’s candidate in the US presidential election, formally filed a motion for a recount in Wisconsin on Friday as her funding effort for counting the votes again in three states passed $5m.

As more money flooded in for her effort – which aims to fund recounts in Michigan, Pennsylvania and Wisconsin, all states where Donald Trump narrowly beat Hillary Clinton – she admitted she had no hard evidence of fraud but said the systems were vulnerable.

Her campaign team said it would formally file in Wisconsin before the 5pm ET deadline to do so; the recount motion deadlines for the other two states are next week. Less than half an hour before the deadline, the Wisconsin elections commission confirmed it had received the recount petition.

Her move has split opinions, with some energized by the thought it has potential to show defeated Democrat Clinton is the rightful election winner, and those who see Stein’s intervention as an expensive gimmick to promote the Green party.

Related: Could Jill Stein’s vote recount change the outcome of the election?

The fundraising site explained that Stein’s campaign “could not guarantee” any of these states would have a recount. “We can only pledge we will demand recounts in those states,” the site said.

Amid questions from some quarters about how the money would be used, the site said: “If we raise more than what’s needed, the surplus will also go toward election integrity efforts and to promote voting system reform.”

On Friday, Stein said she was acting due to “compelling evidence of voting anomalies” and that data analysis had indicated “significant discrepancies in vote totals” that were released by state authorities.

“We do not have a smoking gun,” Stein told CNN. “On the other hand, we have a system that invites hacking, tampering and malfeasance.”

© REUTERS/Dominick Reuter Green Party presidential candidate Jill Stein, pictured July 26, 2016.

She said her campaign had no direct evidence voting systems had been hacked – something independent experts have also been skeptical about. And Stein insisted the recount was not meant to block Donald Trump, the surprise election winner, from becoming president.

Stein has frequently expressed disappointment in Clinton, and the day before the election described the Democratic nominee as a “warmonger” and said a victory for the former secretary of state would be “a mushroom cloud waiting to happen”. Those comments led to Stein being condemned by elected members of the Green party in Europe.

“Both of the candidates were at the highest level of distrust and dislike in our history and in my view, we as voters deserve a voting system that we can believe in,” Stein said on Friday. “And to my mind, having a verified vote is just a first step”.

Stein launched the campaign amid wider calls to recount or audit election results. Groups of academics and activists were concerned that foreign hackers may have interfered with voting systems, though none have provided evidence such hacking occurred.

These groups have called on Clinton to intervene. She is leading in the popular vote by more than 2.1m votes, a lead which is expected to grow. But Trump won narrow victories against Clinton in Pennsylvania and Wisconsin earlier this month and was declared the victor in Michigan on Thursday – sealing his electoral college win.

Stein’s effort, launched on Wednesday afternoon, is directed at funding recounts in those three states. Stein quickly surpassed the initial $2m fundraising goal by early Thursday morning, prompting her campaign to raise the goal to $4.5m. After crossing that threshold, the campaign increased the goal to $7m.

These funds will be used to file recount requests and for attorney’s fees, according to Stein’s campaign manager, David Cobb. He said $1m was needed for Wisconsin, $600,000 for Michigan and $500,000 for Pennsylvania. The rest of the money is expected to go to legal fees associated with the recount.

Adam Parkhomenko, national field director for the Democratic national convention and a longtime Clinton aide, said he did not support Jill Stein and “never will”, but: “I support democracy and the right to count every vote. And kudos to her for leading on this.”

US elections are so dominated by Democratic and Republican candidates that third-party candidates like Stein are more often seen as representing protest votes than a person with a legitimate shot at the White House. But these votes can greatly affect the race. For instance, Stein’s total votes in Michigan and Wisconsin were greater than the gap between Clinton and Trump, as were votes for the other major third-party candidate, Libertarian Gary Johnson.

And while it cannot be assumed that Stein voters would have voted for Clinton if Stein had not been on the ballot, it is a sensitive issue in such a tight race.

“I really wish Jill Stein had not waited until after the election to be so concerned about a few thousand votes tipping the election to Trump,” said Dan Pfeiffer, a former senior policy adviser to Barack Obama.

He criticized the fundraising campaign as a “wasted” effort and said funds could be better used to help Democrats in smaller, local races.

There was more energy around third-party candidates in 2016 because of the unpopularity of the main party candidates. Yet in the past two days, Stein’s recount campaign has raised more money than she did in the entirety of the presidential campaign. As of 19 October, Stein had raised $3.5m for her presidential race, according to the Center for Responsive Politics. As of 10am ET on Friday, the recount campaign had raised $4.8m.

Filed under: General Problems | 1 Comment »

The NonWorking Disabled Aren’t “Retired”, They Can’t Work; Depression And Self-Esteem Issues Are Common.

https://www.linkedin.com/pulse/nonworking-disabled-arent-retired-cant-work-depression-jane-l-brown?

Filed under: General Problems | 3 Comments »

A Battle to Change Medicare Is Brewing, Whether Trump Wants It or Not

http://www.msn.com/en-us/news/politics/a-battle-to-change-medicare-is-brewing-whether-trump-wants-it-or-not/ar-AAkIRb2?

WASHINGTON — Donald J. Trump once declared that campaigning for “substantial” changes to Medicare would be a political death wish.

But with Election Day behind them, emboldened House Republicans say they will move forward on a years-old effort to shift Medicare away from its open-ended commitment to pay for medical services and toward a fixed government contribution for each beneficiary.

The idea rarely came up during Mr. Trump’s march toward the White House, but a battle over the future of Medicare could roil Washington during his first year in office, whether he wants it or not.

“Let me say unequivocally to you now: I have fought to protect Medicare for this generation and for future generations,” Senator Joe Donnelly of Indiana, a Democrat running for re-election in 2018, said this week in a video message to constituents. “I have opposed efforts to privatize Medicare in the past, and I will oppose any effort to privatize Medicare or turn it into a voucher program in the future.”

For nearly six years, Speaker Paul D. Ryan has championed the new approach, denounced by Democrats as “voucherizing” Medicare. Representative Tom Price of Georgia, the House Budget Committee chairman and a leading candidate to be Mr. Trump’s secretary of health and human services, has also embraced the idea, known as premium support.

And Democrats are relishing the fight and preparing to defend the program, which was created in 1965 as part of Lyndon B. Johnson’s Great Society. They believe that if Mr. Trump chooses to do battle over Medicare, he would squander political capital, as President George W. Bush did with an effort to add private investment accounts to Social Security after his re-election in 2004.

© Stephen Crowley/The New York Times Representative Nancy Pelosi of California, the minority leader, said Democrats would “stand firmly and unified” against Mr. Ryan if he tried to privatize Medicare. Democrats will “stand firmly and unified” against Mr. Ryan if he tries to “shatter the sacred guarantee that has protected generations of seniors,” said Representative Nancy Pelosi of California, the Democratic leader.

Republicans have pressed for premium support since Mr. Ryan first included it in a budget blueprint in 2011. As he envisions it, Medicare beneficiaries would buy health insurance from one of a number of competing plans. The traditional fee-for-service Medicare program would compete directly with plans offered by private insurers like Humana, UnitedHealth Group and Blue Cross Blue Shield.

The federal government would contribute the same basic amount toward coverage of each beneficiary in a region. Those who choose more costly options would generally have to pay higher premiums; those who choose plans that cost less than the federal contribution could receive rebates or extra benefits.

Supporters say this approach could save money by stimulating greater price competition among insurers, who would offer plans with lower premiums to attract customers.

Democrats say that premium support would privatize Medicare, replacing the current government guarantee with skimpy vouchers — “coupon care for seniors.” The fear is that the healthiest seniors would opt for private insurance, lured by offers of free health club memberships and other wellness programs, leaving traditional Medicare with sicker, more expensive patients and higher premiums.

“Beneficiaries would have to pay much more to stay in traditional fee-for-service Medicare,” said John K. Gorman, a former Medicare official who is now a consultant to many insurers. “Regular Medicare would become the province of affluent beneficiaries who can buy their way out of” private plans.

Republicans say their proposal would apply to future beneficiaries, not to those in or near retirement. But the mere possibility of big changes is causing trepidation among some older Americans.

“I am terrified of vouchers,” said Kim Ebb, 92, who lives in a retirement community in Bethesda, Md., and has diabetes, atrial fibrillation and irritable bowel syndrome. “You get a fixed amount of money to draw on for your expenses. Then you are on your own.”

Charles R. Drapeau, 64, of East Waterboro, Me., said he was rattled by the Republican plans.

“I’m scared to death,” said Mr. Drapeau, who has multiple myeloma, a type of blood cancer, and takes a drug that costs more than $10,000 a month. “We don’t know exactly how it will work, but just the fact that they are talking about messing with Medicare, it’s frightening to me.”

Senator Richard M. Burr, Republican of North Carolina, has proposed a version of premium support, and other Republican senators have expressed interest, but the idea has not gained as much traction in the Senate as in the House.

The impact of premium support on Medicare beneficiaries depends on details of the plan to be specified by Congress. A crucial question is how the federal payment would be set. The effects would almost surely vary from one market to another, depending on whether private plans cost more or less than the traditional fee-for-service Medicare program.

Mr. Gorman said that premium support would be “a seismic change” in Medicare and could increase costs for many people in the traditional fee-for-service program, fueling a big increase in enrollment in private Medicare Advantage plans.

Enrollment in private plans is already on the rise, having increased more than 55 percent since adoption of the Affordable Care Act in 2010.

It is not just Republicans who have expressed interest in the idea. Alice M. Rivlin, who was the director of the White House Office of Management and Budget under President Bill Clinton, told Congress in 2012 that she favored a bipartisan proposal for premium support because health plans and providers would then “seek every possible way to provide higher-quality care at a lower cost.”

The nonpartisan Medicare Payment Advisory Commission, which advises Congress, has explored the idea of premium support and endorsed the principle that Medicare payments should be financially neutral — “that is, equal for fee-for-service and Medicare Advantage in each market.”

The Congressional Budget Office analyzed two of the leading options and found that “most beneficiaries who wished to remain in the fee-for-service program would pay much higher premiums, on average, under either alternative.” At the same time, the budget office said the proposal could slow the growth of Medicare spending if more beneficiaries enrolled in lower-cost private plans.

Nearly a third of the 57 million Medicare beneficiaries are already in private Medicare Advantage plans, and the government pays a monthly rate for each of those beneficiaries.

But, the budget office notes, several features of current law limit the degree of competition among insurers, and the traditional Medicare program does not bid against the private plans.

In a premium support system, each insurer would submit a bid showing the amount of money it was willing to accept to provide care for a typical Medicare beneficiary. Congress would need to define the bid for traditional Medicare. It could, for example, be the expected cost of providing care for a typical beneficiary in the fee-for-service program.

Medicare would pay the same basic amount on behalf of all beneficiaries in a region, regardless of whether they chose a private plan or traditional Medicare.

Nationwide, on average, Medicare spends about 2 percent more for a beneficiary in a private plan than it would for the same person in the fee-for-service program, according to the Medicare Payment Advisory Commission. But in some large urban areas with many competing private plans, those are less expensive than traditional Medicare.

Consumer advocates express several concerns about premium support. Private plans, under pressure to rein in costs, could respond by creating smaller networks of doctors and hospitals. Such plans would then be less attractive to sicker patients who need more health care services.

“What happens if the voucher doesn’t grow with the cost of health care?” asked Leslie B. Fried, a health lawyer at the National Council on Aging, a service and advocacy group. “Will people have more and more out-of-pocket costs?”

Ms. Fried said that having a healthy fee-for-service Medicare program was important not just for the 38 million people who have such coverage but also for people with private plans. Sometimes, she said, people switch from private plans to traditional Medicare when they develop serious illnesses and want a broader array of doctors.

For their part, insurers say the government would have an unfair advantage in any system of premium support because it would be regulating health plans and competing with them at the same time. Medicare officials set detailed standards for private plans and can fine them or suspend their marketing and enrollment activities if they violate the rules.

Filed under: General Problems | Leave a Comment »

French pain patient associations and health professionals recall the urgency of new concrete measures

http://www.lemonde.fr/sciences/article/2016/10/31/il-faut-ecrire-un-nouveau-chapitre-de-la-lutte-contre-la-douleur_5023175_1650684.html

In an open letter, published in le Monde, to the next President of the French Republic, patient associations and health professionals recall the urgency of new concrete measures.

Roughly (google) translated the article can be summarized as:

We, the patient associations and health professionals, invite the future President of the Republic to put in place concrete measures at the beginning of his mandate that will enable him to respond to a number of needs, including:
1. Strengthen the role of specialized structures in the management of chronic pain by developing their accessibility throughout the country and strengthening the articulation of their missions with the health professionals of the city.
2. To better prevent chronic pain and its impact by proposing early detection and management of chronic factors, as well as prevention plans at work.
3. To sensitize health professionals to chronic postoperative pain so that they are able to detect patients who can develop them and accompany them over time.
4. Strengthen the training of health professionals (specialists or general practitioners) in the management of pain and suffering, with emphasis on the coordination of care.
5. Guarantee the management of pain when the patient is hospitalized at home.
6. Closer involvement of patients and their representatives in the evaluation of new therapies for the control of pain and suffering, and access to a diversified therapeutic arsenal in order to respond as closely as possible to the patient’s needs.
7. Improve the relief of acute pain when patients arrive in emergency rooms.
8. Develop pain assessment tools for patients with communication difficulties (infants, people with psychiatric disorders, people with disabilities, etc.).

Filed under: General Problems | 3 Comments »

Westchester dentist denied HIV-positive sanitation worker treatment, suit says

http://www.nydailynews.com/new-york/westchester-dentist-denied-hiv-positive-woman-treatment-suit-article-1.2885184

A Westchester dentist denied an New York sanitation worker treatment because she is HIV-positive, according to a lawsuit filed Wednesday. Visit and check out Pacific Dental & Implant Solutions website to schedule your appointments, whose service is affordable for all kinds of people and assures that they get rid of all your dental issues permanently.

City sanitation worker Yvette Brown, 48, says Dr. Benjamin Kur canceled her painkiller prescription after pulling two teeth in May — because he found out about her HIV status, she alleged in papers filed in Manhattan Federal Court.

Brown, who thinks the pharmacist told Kur about her anti-retroviral regimen when he contacted the pharmacy, claims the dentist then “confronted” her about being HIV-positive.

Kur “screamed at her and called her ‘disgusting’ and a ‘criminal,’” according to Lambda Legal, a legal advocacy group for LGBT persons and HIV patients.

Kur threatened to tell “her insurance company to have her coverage dropped,” the lawsuit said.

He also told her “to leave the office and for her not to come back” and didn’t give her any follow up treatment, the civil complaint claims.

“Because I am black, because I am a woman, because I am HIV-positive, Dr. Kur treated me as less than a person. I was humiliated when he called me disgusting and kicked me out of his office,” said Brown, a wife and mother of five.

“I never thought that a medical professional — a person who is trained to care for you — would be so cruel,” the sanitation worker said.

“I am a private person and there were only a handful of people who knew I was HIV-positive before this happened to me, but I’m standing up today because I don’t want this to happen to anyone else,” Brown said in a statement.

Reached by phone, Kur emphatically denied the allegations.

Kur said Brown never disclosed her status despite being asked about her medical history at least four times.

“HIV status is a key piece of medical history and it’s important to ensure proper treatment,” the dentist said.

“Not being told about an illness such as HIV is dangerous not only to me but the staff and to everybody who works in the office — as well as the patient,” Kur said.

“HIV patients have a higher risk of developing infection and other comorbidities due to the immunosupressants and due to the actions of the virus,” he added.

Kur also denied the allegation that he refused to prescribe Brown a painkiller.

But he did say that after he learned of her HIV-positive status, he found out there might be a dangerous interaction with his original choice of Percocet for her.

“It wasn’t us denying the prescription — it was the pharmacist telling us there was an adverse reaction,” he told the Daily News.

“Given what we had just found out, we certainly didn’t want to put the patient at greater risk,” he said.

He gave Brown a prescription-strength ibuprofen instead, he said.

“Ms. Brown was treated in the office very well — there was nothing withheld from her,” the dentist said.

Filed under: General Problems | 3 Comments »

Highland pharmacist saves drug overdose victim

http://www.poughkeepsiejournal.com/story/news/2016/11/22/local-pharmacist-saves-drug-overdose-victim/94285154/

https://medlineplus.gov/druginfo/meds/a616003.html

She’s only been a pharmacist for a few months.

But when a woman overdosed in the City of Poughkeepsie Rite Aid parking lot, 23-year-old Sara Kissinger sprang into action, administering two doses of the opioid overdose reversal drug naloxone and reviving the unconscious woman.

“I’m still shaking a little bit,” said Kissinger, who spoke to the Journal about 20 minutes after she revived the woman on Tuesday afternoon. “It definitely was scary.”

It was unclear what drug the woman had taken.

Kissinger, a Highland resident, just graduated from the Albany College of Pharmacy and Health Sciences in May. She’s been a Rite Aid pharmacist since August.

And she never had to administer naloxone before Tuesday, after a man rushed into the pharmacy and told employees his friend had overdosed in the parking lot.

The man told staff the woman called him right before she overdosed — “he showed up and found her like that, unconscious in her car,” Kissinger said.

Rite Aid technician Erica Pinckney asked Kissinger if the pharmacy had a supply of naloxone.

The medication works by temporarily reversing the effects of illicit or prescription opioids. A person has the chance to regain consciousness and breathe normally.

But while Rite Aid pharmacies do distribute naloxone without a prescription in New York (among other states), Teleflex Medical just issued a recall on its intranasal atomizer device, which is used in the naloxone delivery system.

The naloxone medication “inside the kit is safe and can work to reverse an overdose,” said Dutchess County Deputy Medical Examiner Kia Newman, in a statement last week. “If the atomizer in your kit has a defect, it may stream the medication as opposed to spraying it as an atomized mist. Giving the naloxone with a possibly defective atomizer is still better than giving nothing at all.”

Approximately one-third of the kits distributed are estimated to be affected by the recall, the county announced.

So Kissinger was worried about the effectiveness of the pharmacy’s naloxone.

But she remembered she had some in her car.

Kissinger used to intern at a pharmacy that participated in a needle exchange program, “so I had kits that I keep in my glove box just in case,” she said. “I was trained about two years ago, so I’m thinking, ‘I hope I remember how to do this.'”

After grabbing the kits — two intranasal naloxone pens — “I went over and found the woman lying back in the car,” Kissinger said. “Her face was blue and she looked unconscious. We found that she was breathing and she still had a heart beat, but she was completely just unconscious.”

After Kissinger administered one dose of naloxone, “it seemed that she was breathing better… but she didn’t quite wake up. We were splashing water on her, we were trying to wake her up.”

So Kissinger administered the second dose.

“Her eyes opened and she sat up,” Kissinger said.

Emergency medical technicians arrived and Kissinger filled them in on the steps she had taken. The woman was taken to  MidHudson Regional Hospital.

“I believe everything turned out OK, fortunately,” Kissinger said. “I’m just happy that the day turned out the way it did and I hope she gets to spend Thanksgiving with her family. I hope this is a wake up call for her.”

Nina Schutzman: nschutzman@poughkeepsiejournal.com, 845-451-4518 Twitter: @pojonschutzman

Filed under: General Problems | Leave a Comment »