CDC Reports Look at Prescription Painkiller Use

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Two new reports from the CDC regarding prescription painkillers received extensive coverage in several major US newspapers and websites. Most articles discuss both reports, and nearly all of the articles quote CDC director Tom Frieden. USA Today reports that a report from the CDC indicates that “prescribing rates” for opioid painkillers “vary widely by state.” Researchers found that “providers in” Alabama, the state with the highest rate, “wrote 143 prescriptions for every 100 residents, while providers in Hawaii, the state with the lowest rate, wrote 52 for every 100 people, nearly three times fewer.” Frieden said, “Overdoses from opioid narcotics are a serious problem across the country and we know opioid overdoses tend to be highest where opioids get the highest use.” Frieden “says the medications ‘can be an important tool for doctors to use … but they are not the answer every time someone has pain.’”

The New York Times reports that a separate CDC report indicated that “prescription drug overdose deaths in Florida fell sharply after the state began strengthening its prescribing laws and stepping up enforcement.” The study’s investigators found that “the death rate from prescription drug overdoses in Florida fell by 23 percent from 2010 to 2012, according to a report by the Centers for Disease Control and Prevention, and by more than half in the same period for oxycodone, one of the most widely abused drugs and one that has been at the heart of the health crisis.” Dr. Frieden said, “This tells us that policies and enforcement work.”

The Los Angeles Times reports that the drop “in painkiller deaths in Florida is one of the first signs that efforts to address the crisis may be gaining ground, Frieden said.” In an email to Michael Botticelli, acting head of the White House Office of National Drug Control Policy, Frieden wrote, “The results from Florida show that state action can make a difference, and confirms the tight correlation between prescribing and deaths.” Bloomberg BusinessWeek reports, however, that “Frieden called it ‘unlikely’ that other states mirrored Florida’s decline.” He said, “In at least one other state, we saw a decrease, but it was counterbalanced by an increase in heroin deaths, almost completely.”

TIME reports, “The CDC says states should increase use of prescription drug monitoring programs that track painkiller prescriptions by state.”

From the news release of the American Association for Justice.

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Ambien Linked to Doubling of Emergency Department Visits

Forbes contributor Robert Glatter, MD, writes about a study by the Substance Abuse and Mental Health Services Administration (SAMHSA) suggesting that overmedication involving zolpidem (commonly known as Ambien) has almost doubled in recent years, causing manufacturers to reduce dosing recommendations for both men and women by as much as half. Glatter points out that “The FDA is particularly concerned about the phenomenon known as ‘next morning impairment,’ whereby drug levels could remain elevated for persons who must perform tasks such as driving which require a high level of alertness.”

From the news release of the American Association for Justice.

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Clearing the Confusion: The Power of Attorney Explained

Clearing the Confusion The Power of Attorney Explained

The choice of creating a power of attorney is a critical decision. This can be difficult because there is much confusion as to what power of attorney truly means. It is important that one understands the definition, legal rights, and expectations before it becomes too late. Once properly educated on the subject, a person will be able to make the correct choice in appointing a power of attorney.

Defining Power of Attorney

Power of attorney is defined as a written authorization to act on one’s behalf in terms of legal decisions, both in private and business matters. The person who authorizes another to act is known as the principal or grantor. There are variations of the definition from state to state, though the main objective is all the same: Appointing a person who will make decisions for you when you are unable to. Sometimes the power of attorney is paid to make these decisions. The person appointed can be anybody that the principal sees fit to perform the actions.

What’s Legal

There are many different decisions that a power of attorney may make on behalf of the principal. These include but are not limited to:

  • Making health care decisions in which the power of attorney can grant permission to continue, begin, or terminate treatment of the principal.
  • The ability to give gifts or money to others from the estate of the principal.
  • The power to appoint a guardian for the principal.
  • The ability to make both personal and business financial decisions in regards to the principal.

Expectations When Choosing a Power of Attorney

Due to the nature of the results that may come, it is important to choose someone who is trustworthy and will be assumed to act in good faith when considering a power of attorney. Since every action they make on your behalf is legally binding, there is little to no room for misunderstandings. Going over and stating every little detail is absolutely necessary when preparing the contract. For instance, the principal may only want the power of attorney to give a certain amount of money or gifts to others. This issue should be outlined and defined in the contract.

Granting the power of attorney is an extremely sensitive issue. But it’s an issue that must be made with the utmost discretion, due to the repercussions that may ensue if handled incorrectly. Firms like Gittens & Associates, are dedicated in helping clients define and outline their wishes when the time comes where they are in need of someone to make those delicate decisions for themselves.

This article is from Karleia Steiner, who works as a freelance blogger and consultant. You can follow her on Google+.

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All Families Need to Have the Financial “Talk”

ID-100196770If you have an older loved-one, please read this article in the Dallas Morning News about having a frank financial talk with that person. This is something that must be done before any form or senility sets in.

I encourage you to read the entire article. Here are the opening paragraphs:

It’s the conversation that many families put off. And then put off some more.

It’s the talk between elderly parents and their adult children about the parents’ finances. It’s a conversation that every family eventually must have — and it’s best to do it before a crisis hits.

“Money is a taboo subject for families, but we do find that silence can be costly,” said Lauren Brouhard, a senior vice president at Fidelity Investments.

The company recently released a study that found that when it comes to important but difficult conversations about finances, many families struggle with the timing.

The Intra-Family Generational Finance study showed that 64 percent of parents and their adult children differ as to when detailed conversations on key financial topics, including retirement preparedness, elder care and estate planning, should take place.

“While parents would prefer to wait until after retirement, their children want the conversations to take place well before their parents retire or experience health issues,” Brouhard said.

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Hospice Industry Under Fire For Enrolling Patients Who Are Not Near Death

The Washington Post reports, in a 2043-word piece that is part of an ongoing series on the hospice industry in America, the “booming” hospice industry is coming under fire due to “what appears to be a surge in hospices enrolling patients who aren’t close to death.” Hospice facilities are able to receive higher revenues when recruiting new patients, particularly those who are not near death, and this practice can expose patients to “the more powerful pain-killers” that are routinely used as part of hospice care. Several lawsuits against hospice facilities have resulted from such practices, many of which have led to patients with morphine addictions or overdose deaths. Other lawsuits have attempted to recover “more than $1 billion in federal money from hospices that have billed for patients who were admitted but not near death, attorneys said. Medicare rules require that doctors certify that hospice patients are likely to die within six months”

From the news release of the American Association for Justice.

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Federal Government Tightens Restrictions on Hydrocodone Combination Products

News that the Federal government is tightening restrictions on hydrocodone combination painkillers in an effort to curb widespread abuse received wide coverage, with several major newspapers and news agencies reporting. Some news outlets noted that the rule change was welcomed by many, including lawmakers from states that have been plagued by opioid abuse. Others quoted sources who were skeptical whether the rule change would help curb abuse of the painkillers.

        USA Today reports the change, for instance, will “sharply reduce how many pills a doctor can prescribe for them at one time.” Also, manufacturers and pharmacies will now have to keep hydrocodone combination products such as Vicodin (acetaminophen and hydrocodone) under tighter security, along with “more extensive records.” The new rule, which takes effect from mid-October, elevates the painkillers to Schedule II from Schedule III under the Controlled Substances Act.

        Highlighting the importance of the rule change, the New York Times notes that it is “one of the most far-reaching efforts to stop the growing epidemic of prescription drug abuse.” The paper points to a grim statistic, noting that “more than 20,000 Americans die every year because of prescription drug abuse,” citing Federal data. Still, the Times notes, the change is expected to “draw strong criticism from some pain management experts,” who argue that the new restrictions impose “unfair obstacles for patients in chronic pain, making it harder, for example, on those who cannot easily make a trip to the doctor.”

        The Wall Street Journal examines both sides of the debate, citing sources who are against tighter restrictions and those who seek tougher rules. The paper notes that Linden Barber, a former DEA attorney, who now works with the law firm Quarles & Brady LLP in Indianapolis, pointed out the rule change may not have a major impact because painkillers such as OxyContin (oxycodone), which already have tough safeguards in place, continue to be abused.

        The AP provides background information, noting that the move, disclosed in a Federal notice, “comes more than a decade after” the DEA “first recommended reclassifying hydrocodone due to its risks for abuse and addiction.” The AP notes that for years, physician groups and the FDA “opposed the move, saying it would burden health care providers and patients while driving up costs.” However, FDA changed its stance last year, “citing the national epidemic of overdoses and deaths tied to prescription painkillers known as opioids.”

From the news release of the American Association for Justice.

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No Way to Run a Disability Program

Tom Margenau

Tom Margenau

The long-time Social Security Administration employee Tom Margenau has written another thought-provoking article about the Social Security disability system.

I encourage you to read the entire article, but these two paragraphs will give you a taste of his opinion:

When you file a claim for Social Security or Supplemental Security Income disability benefits, whether it is at your local Social Security Administration office, or via one of their call centers, or even using their online system at www.socialsecurity.gov, that claim is immediately shuffled off to a state government agency for processing. These agencies are usually called Disability Determination Service offices, although some states use slightly different names. The DDS office is usually part of a larger agency within the state. Sometimes it is part of a state’s social services bureaucracy or it might be connected to a state’s department of vocational rehabilitation.

So why aren’t all these state DDS agencies federalized, with one national bureaucracy and one national computer system? Well, that gets to the political reason. There simply is little support in Congress, and there certainly is no support in governor’s offices, to expand a federal agency (the Social Security Administration) at the expense of so many state bureaucracies — even though it might make perfect sense to do so. So we are stuck with a 60-year-old hodgepodge structure of disability decision making that we are now trying to patch together with an expensive new computer system. Like military service members and air traffic controllers, I think those people who make decisions for a national disability program should be federal employees. This would be one important step in speeding up the disability claims process.

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Many Wikipedia Entries On Prescription Meds May Not Be Accurate Or Up-To-Date

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HealthDay reports that according to a perspective piece published June 26 in the New England Journal of Medicine, “many Wikipedia entries about prescription medications aren’t up-to-date and accurate.” Researchers arrived at this conclusion after exploring “to what degree Wikipedia entries reflected US Food and Drug Administration drug-safety communications in an accurate and timely manner.” In particular, investigators focused on “22 drug safety warnings regarding prescription medications that the FDA issued over a two-year period between 2011 and 2012.”

From the news release of the American Association for Justice.

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Pediatricians Support Bill to Require Childproof Nicotine Refills

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The Hill reports that “a group of pediatricians and other health officials are calling for childproof packaging on liquid nicotine containers used to refill electronic cigarettes,” and have written to Florida Sen. Bill Nelson (D) in support of legislation he introduced last month “which would allow the Consumer Products Safety Commission (CPSC) to issue new childproof requirements for liquid nicotine containers.” The letter stated that “with the recent spike in calls to poison control centers related to e-cigarette exposure, pediatricians recognize an urgent need to protect young people from these dangerous, highly-concentrated products.”

From the news release of the American Association for Justice.

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FDA Warns Against Use of Laminated Surfaces During Medicine Preparation

Regulatory Focus reports the FDA’s recent warning to a Texas-based compounding pharmacy to “stop using laminated particleboard” in “aseptic processing areas” should serve as a warning to all pharmaceutical compounders. The warning letter to Home Intensive Care Pharmacy was unveiled to the public recently. In the letter, the agency warned the use of particleboard topped with a “laminated surface” in the cleanroom was unhygienic because it “is porous and difficult to clean, and can harbor contamination.”

From the news release of the American Association for Justice.

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