Trump’s Wall and the Opioid Crisis

http://www.acsh.org/news/2016/11/22/trumps-wall-and-opioid-crisis-10450

Will Trump’s wall between the U.S. and Mexico ever be built? Who knows? What are the political and economic ramifications of the wall? I haven’t the wildest. Not my job. But, this is: the plague of opioid overdose deaths that we are now seeing, and our hopelessly misguided policy for dealing with it. (If you think “plague” is too strong a word, see my interview with DEA Special Agent Erin Mulvey, below.) 

If a wall were in place, would it help fight the plague? Not alone. It might slow down, but not stop the waves of deadly non-prescription narcotics, which are constantly pouring in from Mexico. To put a dent in narcotic drug trafficking, the U.S. would need to focus on interdiction by air, land, and sea, and even this would not keep out all the narcotics that are killing Americans.

Yet, a wall alone, even if ill-conceived and largely ineffective, would still be a better plan to address the narcotic overdose epidemic that our current focus—counting the number of Vicodin pills prescribed by your dentist or doctor. While people are dying by the thousands from illegal opioids, the CDC is more concerned with restricting access to legal ones.

It would be hard to find a better example of ‘unintended consequences’ than what is now taking shape in the US. Instead of helping, our recent policy of severely limiting patient access to opioid pain medications can only make things worse for almost everyone. Addicts will be much more likely to die, because the alternatives to pills are far more dangerous than the pills, or even heroin, which many turned to when pills became unavailable.

And, life will be worse for ordinary people, all of whom will certainly experience severe pain during their lives. No matter how responsibly they use the drug, or how bad their pain is, patients with legitimate need for strong pain medications are increasingly being treated like addicts, simply for having the unmitigated gall to want a drug that is strong enough to give them relief. Worse still, doctors are becoming increasingly fearful of writing opioid prescriptions, even for long-time patients. They are afraid of losing their licenses. 

This fiasco is brought to us courtesy of the CDC (mostly), as well as the DEA, and some medical associations, and arises from a distorted overreaction which made an already-bad problem worse. Lax opioid drug prescribing practices over the past two decades supposedly (1) caused many patients to became addicted, and died from overdoses of the pills, or from the heroin that replaced them. So the way to “correct” this was to push the pendulum so hard in the other direction that the chain snapped.

How well has this worked so far? Let’s go with “terribly.” First, the assumption that addiction arises primarily as a result of the legitimate use of legally prescribed opioids has been challenged. Second, since pills have been restricted, addicts are now using far more dangerous substitutes, such as fentanyl. If this trend continues, exactly two things will happen:

• There will be more deaths, not fewer.
• Patients who legitimately need the drugs will suffer.

The graphs below, one from Florida, and the other from Massachusetts, illustrate what is really killing opioid addicts.

Sources: Left, Source: Florida Department of Law Enforcement. Right, Massachusetts Department of Health

On the left, the causes of opioid overdose deaths in Florida between 2007-2015 are given. Deaths per capita from oxycodone were about the same during the first six months of 2007 and 2015. But deaths from injectable opioids are 15-times higher (2) during the same time periods. Between 2013-2014 in Massachusetts, only 9 percent of opioid overdose deaths we due to pills, while 85% were due to heroin/fentanyl. Are pill overdoses killing addicts now? No. They are being killed by whatever they switched to after pills.

Any lingering doubts the origin of these drugs can be quickly tossed out the window, thanks to Special Agent Erin Mulvey of the New York City division of the DEA. Agent Mulvey kindly provided some eye-opening information:

JB: News stories have indicated that fentanyl is being made in China and then transported into the US through Mexico. Is this consistent with the DEA is observing?

EM: Yes. The news stories about fentanyl pouring in from Mexico are consistent with what the DEA is seeing. This is being driven by the Mexican drug cartels. They receive their fentanyl from China, but also make their own in labs located in Mexico. It is difficult to put a number on the amount of fentanyl coming across the border but considering the significant increase in seizures and overdoses, we can determine it has increased. 

JB: What percent of the fentanyl that enters the US comes from Mexico?

EM: In NYC, kilos of fentanyl and fentanyl-heroin mixtures are being seized. The number of seizures of both (meaning both fentanyl alone plus mixtures of the two) in NYC has gone up by 2,000 percent compared to 4 years ago, with 95 percent of it coming through Mexico.

JB: What information do you have about fatal overdoses? What is responsible for the deaths?

EM: First, we know that about 80 percent of the people who recently started to use heroin had previously used prescription pain pills. According to the NYC Department of Health and Mental Hygiene, the number of overdose deaths in New York City went up 66 percent between 2010 and 2015. Of that number, 59 percent of the fatal overdoses involved heroin and 16 percent involved fentanyl.

JB: How do these data differ from what has been seen in the past in New York?

EM: Over the period 2005-2015, only 3 percent of all injectable overdose deaths involved fentanyl. Now it is 16 percent.

Since it could not be more than obvious what is really killing America’ addicts, it is reasonable to ask why we are on a path that will do little good (and substantial harm), rather than focusing the real causes of overdose deaths. 

In a sense, a wall is already in use, but it is a the wrong wall—one placed between patients and their doctors, thanks to misguided bureaucrats. And the 800-pound opioid molecule in the room keeps on killing.

What a mess.

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The question is, how do we get these people to listen and answer?  I’ve sent numerous letters and emails to my congressfolks.  They’re either ignored, or I get a bot-generated email that tells me they’re glad I wrote to them about the opioid epidemic and how they’re so proud of doing everything they can to reduce opioid prescribing!!!  A group of us even got together and met with a rep of Senator John McCain’s in his office, to ask for help with arachnoiditis awareness AND with the difficulty of being a pain patient in a country where the government is standing between us and our doctors/treatment.  So far, no one has returned any calls from that meeting.

So here we have a group of chronic painers that attempt to get their message across to  a EIGHTY y/o… FIVE TERM REPUBLICAN SENATOR… in a SOLID REPUBLICAN STATE…  Who just got re-elected for his SIXTH… 6 yr term.  BY a 12% margin…

Just another example of the LACK OF UNITY of the chronic pain community ???

I haven’t seen any stats… but… I wonder what per-cent of chronic painers DON’T VOTE…

I am sure that the bureaucrats have those numbers… and if there is a HIGH PER-CENT that don’t vote… why should an incumbent – in a state that there is little chance of not getting re-elected… listen to those people ?

In the politician’s world.. the only two things that they are interested in is donation to their re-election campaign and votes… and IN THAT ORDER !

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Drug side effects have led to increased ER visits in older Americans

www.statnews.com/pharmalot/2016/11/22/side-effects-emergency-room/

Side effects from medication are causing more older Americans to visit emergency rooms and leading to more hospitalizations, according to an analysis of ER data from 2005-2006 and 2013-2014. And across all age groups, the drugs most often causing side effects that sent people to an ER were the same ones identified a decade ago —anticoagulants, antibiotics, diabetes agents, and opioid analgesics.

These were among the findings in a study that examined emergency department visits for adverse reactions to medicines in 2013 and 2014, compared with 2005 and 2006. The goal was to determine the characteristics of side effects that lead to ER visits in hopes of identifying outpatient prescribing patterns that could mitigate adverse events.

The analysis, which was funded by the federal government and published on Tuesday in the Journal of the American Medical Association, examined nearly 42,600 cases from the National Electronic Injury Surveillance System — Cooperative Adverse Drug Event Surveillance project, which is a public health surveillance system based on a nationally representative sample of US hospitals.

Interestingly, the prevalence of potentially inappropriate medication use in adults aged 65 and up remained high and the study authors suggested that the Beers criteria, a widely used guideline to improve safe prescribing, had “limited utility in identifying patient populations who are at highest risk for adverse drug events.”

The study authors, several of whom work for the Centers for Disease Control and Prevention, also noted that three drug classes — anticoagulants, diabetes and opioid analgesics — that were recently targeted by federal patient safety initiatives were also implicated in nearly 60 percent emergency room visits due to side effects experienced among older adults.

The study has a lot of interesting information, and here are some highlights:

An estimated four ER visits for adverse drug events occurred per 1,000 individuals annually. The rate of ER visits among older adults, aged 65 years and older, was 9.7 visits per 1,000 individuals compared with 3.1 visits per 1,000 individuals for those younger than 65 years.

An estimated 35 percent of ER visits for adverse drug events occurred among adults aged 65 years or older in 2013 and 2014 compared with nearly 26 percent in 2005 and 2006.

Even after accounting for prescribing frequency, the authors found that the rate of ER visits for adverse drug events per prescription was previously significantly higher for anticoagulants and diabetes medicines than for most other drugs.

Prescribing more medicine than needed or taking excess dosages was the most common type of adverse drug event. Medication errors were documented in 1 of 10 ER visits for adverse drug events and an estimated 27 percent of visits hospitalization.

The proportion of ER visits due to side effects involving anticoagulants rose during the last decade along with increased use. From 2009 to 2014, oral anticoagulant use increased by approximately 38 percent, whereas the proportion of ER visits for anticoagulants increased by 57 percent.

Among children, aged 5 years and younger, antibiotics were most commonly implicated as well as among older children and adolescents, aged 6 to 19 years old. Among older adults — aged 65 and older — anticoagulants, diabetes drugs, and opioid analgesics were implicated in approximately 60 percent of ER visits for adverse drug events.

Among older children and adolescents, antipsychotics were the second most commonly implicated type of drug in ER visits for adverse drug events. This occurred, the authors noted, as antipsychotic prescribing increased sharply during the last two decades. “Up to 75 percent of antipsychotic use in children and adolescents is estimated to be for off-label indications and there is evidence of low adherence to recommendations for safety monitoring,” they wrote.

Compared with 2005 and 2006, the rates of ER visits increased among older adults — 5.2 visits per 1,000 individuals in 2005 and 2006 versus 9.7 visits per 1,000 individuals in 2013- 2014 — and among adults aged 50 years to 64 years — 2.5 visits per 1,000 individuals in 2005 and 2006 versus 4.3 visits per 1,000 individuals in 2013 and 2014. The rates for other age groups were similar for both periods.

The most common drug products implicated in ER visits for adverse drug events varied by patient age. Among children and adolescents aged 19 years or younger, the 15 most common drug products implicated were involved in an estimated 50 visits, excluding unsupervised ingestions by children. Eight of the 15 most common drug products implicated among children and adolescents aged 19 years or younger were antibiotics, and two were neuropsychiatric agents.

Among children aged 5 years or younger, antibiotics alone were the most common drug class implicated in 56.4 percent of visits for adverse drug events. Among children and adolescents aged 6 to 19 years, antibiotics were implicated in 32 percent of visits. And four of the 15 most common drug products implicated in ER visits for adverse drug events among older adults were anticoagulants and five were diabetes drugs.

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Oops! Target, Walmart and CVS may sell aloe vera gel that doesn’t contain aloe vera

http://wgno.com/2016/11/22/oops-target-walmart-and-cvs-may-sell-aloe-vera-gel-that-doesnt-contain-aloe-vera/

WGNO) – Even though it’s winter, that’s no excuse for not wearing sunblock. But for those of us who forget during these colder months, over the counter Aloe Vera gels can soothe those unwanted sunburns because, after all, they contain aloe vera.

Unfortunately, an in-depth report from Bloomberg suggests otherwise. Samples of aloe vera gel products purchased at Target, Walmart and CVS showed no traces of the plant in multiple lab tests.

“You have to be very careful when you select and use aloe products,” says Tod Cooperman, president of White Plains, New York-based ConsumerLab.com, which has done aloe testing.

According to the report, there’s no watchdog to assure consumers the aloe products are what they say they are. The Food and Drug Administration doesn’t approve cosmetics before they are sold and has never required companies to pay a fine for selling fake aloe.

The four gels Bloomberg analysed were Walmart’s Equate Aloe After Sun Gel with pure Aloe Vera, Target’s Up & Up Aloe Vera Gel with pure Aloe Vera and CVS’s Aftersun Aloe Vera Moisturizing Gel.

The three samples contained a cheaper element called Maltodextrin, a sugar sometimes used to imitate Aloe.

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https://www.facebook.com/Afightagainstneuroblastoma/posts/1752100481710384:0
As a photographer it is important to capture the truth and the reality of a situation, too easy it becomes to capture the joy of life whilst discarding the torture that we see.

This is the hardest photograph I have ever made, it is in fact my own four year old daughter. A few days ago she was given what is most likely only a few weeks to live after a battle against cancer that has been waged for over twelve months. This photograph was made in a moment that we as parents could offer her no comfort, her pushing us away whilst she rode out this searing pain in solitude. This sadly, for us as a family, is not a sight that we see rarely. This is now a familiar sight that we see regularly through each day and night, its frequency now more often. This is the true face of cancer, my baby girls blood vessels protruding from beneath her skin, a solitary tear running down her cheek, her body stiffened and her face contorted in pain.

I could try and use a thousand words to describe this image that we as parents are confronted with on a daily basis but these words would fall short of truly depicting the sight we see. With this photo I do not mean to offend or upset, I do mean however to educate and shock those that see it in it’s context. Perhaps by seeing this photo people not in our position will be made aware of the darkness that is childhood cancer, perhaps these same people may be able to do something about it so that in the future no child has to suffer this pain, so that no parent has to bear witness to their own flesh and blood deteriorating daily.

The only apologies I offer are to those that know Jessica, I understand that this photo is hard to see and even harder to absorb. To those that do not know Jessica I offer no apologies, this is what cancer does to a child in their final weeks and days!!! Before her diagnosis I was one of those ignorant to the darkness of childhood cancer, not truly appreciating the hell that it brings. It would never happen to us! Now I give childhood cancer the respect it deserves, seeing too many children suffering this same fate and watching families torn apart.

If this photograph only serves as a purpose to make people think twice about this evil and put into perspective what it does to a child then it has achieved its purpose. Research needs to be done, cures need to be found, too long now has this been allowed to happen.

Please I beg of you, as a heartbroken father, it is too late for my daughter, but childhood cancer needs to be cured. No family should have to go through this hell.

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Connecting to the Speaker

You can give the House Speaker your opinion on the Affordable Care Act — if you’re patient.

http://www.snopes.com/paul-ryan-conducting-obamacare-phone-survey/

Read this on Facebook from a friend – have not seen it elsewhere:

Paul Ryan is conducting a phone poll on the ACA (Obamacare), hoping to hear overwhelming popular opposition to it. If you would like to express your support for the Affordable Care Act, call (202) 225-3031.

Press 2 to weigh in on the issue. You’ll hear a brief recording about HR-3762, Paul Ryan’s proposal to gut the ACA, and President Obama’s use of his veto power to stop it. Then, you will have a chance to indicate your opinion with the press of a button. Press 1 if you support Obamacare, 2 if you oppose it.

Copy and paste this, don’t click share!
(The reason for cutting and pasting instead of sharing apparently has something to do with how FB does its algorithms.This is vital.)

Origin:As of November 2016, House Speaker Paul Ryan’s Washington D.C. office is allowing callers to express their opinion regarding the Affordable Care Act, often called the ACA or, more simply, Obamacare.

The survey can be accessed by calling either (202) 225-3031 or (202) 225-0600. In each case, there is a period of silence before callers are asked to press “2” if they want to “express [their] opinion on President [Barack] Obama’s healthcare law”; for example, it took two minutes and 30 seconds before being able to begin the process while calling the latter number.

At that point, a statement plays promoting not only Ryan’s opposition to the law, but also his support for House Resolution 3762, which House Republicans passed in October 2015 in an effort to repeal portions of the ACA:

Speaker Ryan has heard from many individuals who have serious concerns about what the implementation of the Affordable Care Act (ACA) will mean for them, their families, and their businesses. In an effort to clear the way for common-sense reform, the House has acted boldly. HR 3762 — the Restoring Americans’ Healthcare Freedom Reconciliation Act — dismantles the president’s health care law. It repeals the individual and employer mandates, the medical device tax, and the “Cadillac tax” on high-value insurance plans. This bill eliminates the most harmful pieces of the ACA and lays the foundation for a patient-centered system.

Not surprisingly, President Obama vetoed HR 3762. On February 2, in bipartisan fashion, the House voted 241-186 to override the president’s veto. While this bipartisan majority failed to meet the two-thirds threshold required by the Constitution to override a presidential veto, the House demonstrated its unwavering commitment to repealing the ACA by completing the entirety of the constitutional process.

If you support President Obama’s healthcare law, press 1. If you are opposed to President Obama’s healthcare law, press 2.

At that point, callers have the option of leaving a voicemail for Ryan. However, the recording does not mention that HR 3762 also called for a one-year freeze on federal funding for Planned Parenthood.

We attempted to contact Ryan’s office for comment. Ryan himself has not addressed the survey either on his website or on social media.

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5 dangerous mistakes you make with your over-the-counter painkillers

http://www.foxnews.com/health/2016/11/21/5-dangerous-mistakes-make-with-your-over-counter-painkillers.html

More than 9 out of every 10 Americans use over-the-counter meds to manage pain, a new survey from the U.S. Pain Foundation found. 

If you take them correctly, OTC painkillers are generally safe and effective, says Charles Vega, M.D., a clinical professor of health sciences at the University of California at Irvine.

But too many people don’t take the pills seriously—and skip the fine print on the bottle as a result, says Charles Vega, M.D., a clinical professor of health sciences at the University of California at Irvine. 

“These are real medicines with real consequences,” Dr. Vega says.

Related: The Better Man Project From Men’s Health—2,000+ Awesome Tips On How to Live Your Healthiest Life

Here are 5 common mistakes you might be making with your painkillers—and what might happen as a result.

PAINKILLER MISTAKE #1: YOU TAKE TOO MANY PILLS

A lot of people assume that by doubling the dosage, they’ll double the pill’s effectiveness.

But you’re probably just increasing your chances of side effects or even poisoning without getting any additional pain relief, Dr. Vega says.  

Related: Gambling Addictions, Purple Sweat, Driving While Asleep—the Scary Side Effects Of Popular Meds

Lots of people learn this lesson the hard way. For example, taking too much acetaminophen—the active ingredient in Tylenol and many other OTC meds—is one of the most common causes of poisoning worldwide, the National Institutes of Health says.

“These OTC painkillers are shown to be effective at the dosage listed on the label,” Dr. Vega says. 

For acetaminophen, that’s 4,000 milligrams (mg)—or 8 tablets of Tylenol Extra Strength—per day, max. 

Pop two or three times the dosage of any painkiller, and you run the risk of nausea or an upset stomach, heartburn, rashes, or even liver or kidney damage, he says. 

PAINKILLER MISTAKE #2: YOU TAKE PAIN MEDS TOO OFTEN

Unless you’re following a doctor’s instructions, you shouldn’t be taking OTC pain pills more than one or two days per month, Dr. Vega says. 

For example, taking acetaminophen on a daily or weekly basis could raise your risk of liver failure or even death, according to the U.S. Food and Drug Administration (FDA). 

And while A Daily Low-Dose Aspirin Can Help Your Heart if you’re already at risk of heart disease, it can also eat away at the lining of your stomach and gut.

In fact, daily aspirin may raise your risk of serious internal bleeding by 55 percent, a study in JAMA found.

Related: What You Should Do If You Pee Blood

So if you need painkillers on a daily or weekly basis—whether for joint pain, headaches, or something other chronic issue—see your doctor to identify your underlying problem and the best solution to actually treat it, Dr. Vega says. 

PAINKILLER MISTAKE #3: YOU ASSUME ALL OTC PAIN MEDS ARE THE SAME

The active ingredient in Tylenol is different from the active ingredient in Advil (or Aleve, or Bayer). You should take each painkiller’s specific method of action into account when choosing a pain reliever—rather than just popping whatever you have in your medicine cabinet, Dr. Vega says.

For example, ibuprofen—the active ingredient in Motrin IB or Advil—works by lowering your levels of certain inflammation-causing hormones. 

That makes it a great option for arthritis pain or swelling, but it might not be as effective at knocking out a headache. In that case, acetaminophen might be your best bet, since it works by interfering with your brain’s pain receptors. 

Related: 7 Highly Effective Ways to Prevent a Headache

What’s more, different painkillers have different side effects. Depending on your personal health history—like if you have high blood pressure or you’re a heavy drinker—you may want to avoid certain meds, Dr. Vega explains.

Heavy drinkers may want to steer clear of acetaminophen, which may raise their risk of kidney disease. And taking naproxen (like Aleve) or ibuprofen (like Motrin) if you have high BP may increase your risk for heart disease or stroke, Dr. Vega says.

Your best bet? Talk with your drugstore pharmacist before you check out. 

“They’re great sources of info on side effects and proper usage,” he adds.

PAINKILLER MISTAKE #4: YOU MIX OTC PAIN DRUGS WITH PRESCRIPTION MEDS

When shopping for pain relievers, 45 percent of people don’t consider the prescription meds they’re taking, the U.S. Pain Foundation survey found.

But many prescription medications—like Oxycodone, Vicodin, and Percocet—also include acetaminophen. 

“So if you’re not paying attention and you take Tylenol with those, you can get into trouble,” Dr. Vega says.

Too much acetaminophen can cause liver or kidney damage, Dr. Vega says. 

What’s more, mixing prescription drugs like blood thinners, beta-blockers, or antidepressants with ibuprofen or naproxen could raise your risk for kidney problems, heart attack, or other serious health complications.

PAINKILLER MISTAKE #5: YOU MIX DIFFERENT OTC MEDS

The majority of painkiller users—65 percent—don’t consider how their pain pills may interact with other OTC drugs, the survey shows.

But many over-the-counter meds contain the same active ingredients as pain relievers, even if they aren’t specifically marketed to ease your aches, Dr. Vega says. 

One common scenario: A guy’s taking a low-dose aspirin per his doctor’s instructions to lower his risk for heart trouble. 

He gets sick, and buys an OTC cold medicine without thinking to check if it also contains aspirin—many do.

All that aspirin could lead to stomach problems or even life-threatening gastrointestinal bleeding, Dr. Vega says. 

Related: 5 Over-the-Counter Medicines You Should Never Take Together

Similar double-dipping can occur if you’re taking Tylenol regularly, and then add in meds like Alka-Seltzer Plus or Mucinex Fast-Max for a cold or cough—both of which also contain acetaminophen. That can raise your risk of liver issues or kidney damage. 

This article originally appeared on MensHealth.com.

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Kratom Could Still Get Banned. Here’s What You Need To Know

http://www.forbes.com/sites/sarahhedgecock/2016/11/21/what-you-need-to-know-about-kratom-before-december-1/#62883823385e

You may never have heard of kratom before August 31 of this year. (I certainly hadn’t.) That was the day the U.S. Drug Enforcement Agency (DEA) announced that it planned to put the plant on Schedule 1 a month hence, to what turned out to be widespread outcry.

The reaction led to a withdrawal of that order and a reconsideration: The DEA is now giving the public until December 1 to send comments on whether or not the drug should be placed on Schedule 1. It has also asked the FDA for input. This is a major difference from the agency’s original position: Because Schedule 1 is for substances that have a high potential for abuse and also have no proven medical benefit, an FDA opinion that the plant could have a medical benefit could hugely influence the end decision.

Shutterstock

Technically it was mitragynine and 7-hydroxymitragynine, kratom’s main psychoactive components, that the DEA initially proposed to ban starting September 30, and the ban would have been temporary. But a temporary ban still means probably two and up to three years on Schedule 1 without input from the FDA or the public. It’s intended to cover drugs that are “imminent hazards to public safety” and requires no research or public comment period in advance. The problem: kratom is not infrequently used by people trying to wean themselves off of opioids, which by all accounts seem to be a much more dangerous drug.

“ We’re not sure if it’s helpful, harmful, addictive or any of these things yet,” explained Andrew Kruegel, one of the few researchers currently studying kratom, in a recent interview in his lab at Columbia University. “It does seem to be very helpful for some people in relieving chronic pain.”

The DEA named as a reason for banning kratom as soon as possible the fact that from 2010 to 2015, poison control centers received 660 calls related to the plant. Meanwhile, the American Association of Poison Control Centers counts calls for 55,622 opioid exposures between January and October of this year alone. The DEA itself counted 15 deaths involving kratom between 2014 and 2016–14 of which also involved other, more dangerous drugs. (In 2014, the most recent year for which numbers are available, opioids were responsible for over 29,000 deaths in the U.S.)

But opioids, at least the prescription ones, have a proven medical benefit, so though they are a growing hazard, they aren’t going to be placed on Schedule 1 any time soon. Kratom, on the other hand, hasn’t had much research done on it at all, and thus has no proven medical benefit. This doesn’t mean there is no benefit at all; it just means there’s more research that needs to be done before we can figure that out.

“It seems to have other pharmacological activities, which we’re still studying, but we don’t know much about those at this point,” said Kruegel. “We definitely think there may be medical potential there, but nothing has been shown in a controlled clinical trial.”

A ban could have a major negative impact on labs like Kruegal’s that are trying to decide what those benefits might be. “It’s basically left us in unknown territory,” he said of the in-between place kratom is in right now. Should a ban occur, Kruegal’s lab is prepared to carry on its work after getting the proper license–but putting the plant’s active components on Schedule 1 could seriously deter new labs from getting into kratom research. Kruegal’s lab actually did once apply for a schedule 1 license to study a different banned substance, but it ended up abandoning the project because obtaining the license was too onerous.

What we do know: The two compounds are opioid agonists of a type that activate one type of signaling in the brain, but not the other. Past research has shown that other drugs that use this pathway are, in fact, less dangerous than typical opioids and cause less respiratory depression. Kratom research could, in fact, lead to new, less dangerous painkillers–but it will happen a lot faster if the plant isn’t banned.

Another surprising finding from Kruegal’s lab? Kratom grown in the U.S., as opposed to its native southeast Asia, doesn’t appear to have mitragynine, one of the two compounds the DEA is proposing to ban.That means not only that people claiming a reaction from leaves grown in the U.S. might only be reporting a placebo effect, but also that just banning kratom the plant along with its active components might not be as easy as it sounds.

The DEA made the right decision in asking the FDA for more research before it commits to putting kratom on Schedule 1. Hopefully enough of that research can show the plant has medical potential before it gets banned entirely.

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Study indicates high rate of ‘intentional’ drug-related deaths among nurses

http://mobile.abc.net.au/news/2016-11-21/study-indicates-high-rate-of-drug-related-deaths-among-nurses/8038866?

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