May 5th, 2011 by Steven Roy Daviss, M.D. in Health Policy, Opinion
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The White House released its plan last week entitled “Epidemic: Responding to America’s Prescription Drug Abuse Crisis” [LINK to pdf of this 10-page plan]. Below are some of the elements in this plan that is part of the National Drug Control Strategy (like that has worked so well :-/).
The areas of this plan involve education of prescribers and users, monitoring programs, making it easy to dispose of controlled dangerous substances (CDS for short), and enhancing enforcement. The plan establishes thirteen goals for the next five years, and also creates a coordinating body, the Federal Council on Prescription Drug Abuse, to oversee and coordinate it all.
If any of our readers have comments on specific items (I’ve numbered them for ease of reference), including unintended (or even intended) consequences, please chime in.
- EDUCATION
- require training on responsible opiate prescribing
- require Pharma to develop education materials for providers and patients
- require professional schools and organizations to include instruction on balancing use of opiates for pain while reducing abuse
- require state licensing boards to include relevant ongoing education in their licensure requirements
- help ACEP develop guidelines for opiate prescribing in the Emergency Department [this should be a big help]
- increased use of written patient-provider agreements
- facilitate public education campaigns, especially targeting parents
- encourage research on low-abuse potential treatments, epidemiology of substance abuse, and abuse-deterrent formulations Read more »
*This blog post was originally published at Shrink Rap*
April 30th, 2011 by StevenWilkinsMPH in Health Policy, Opinion
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Ok…here’s a brain teaser. What medical condition is the most costly to employers? I’ll give you a hint. It is also a medical condition that is likely to go unrecognized and undiagnosed by primary care physicians.
If you guessed depression you are correct. If you mentioned obesity you get a gold star since that comes in right behind depression for both criteria…at least in terms of cost and the undiagnosed part.
Four out of every ten people at work or sitting in the doctor’s waiting room suffer from moderate to severe depression. Prevalence rates for depression are highest among women and older patients with chronic conditions. Yet despite its high prevalence and costly nature, depression is significantly under-diagnosed (<50%) and under-treated by physicians.
For employers, the cost of depression cost far exceeds the direct costs associated with its diagnosis and treatment As the graphic above indicates, the cost of lost productivity for on the job depressed workers (Presenteeism) and lost time for depressed workers that are absent from the job (Absenteeism) far exceed the cost of cost of treatment (medical and medication cost).
Read more »
*This blog post was originally published at Mind The Gap*
April 27th, 2011 by Glenn Laffel, M.D., Ph.D. in Research
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Nowadays, a lot of folks pursue happiness as if it were their primary mission in life. But what is happiness?
Philosophers tell us there are at least 2 kinds. There is so-called “hedonic well-being” which is short-term pleasure derived from things like a tasty meal, great sex or a day in the amusement park. Then there’s “eudaimonic well-being” which comes from living with a sense of purpose, which is usually actualized by participating in meaningful activities like volunteering for a worthy cause, raising children or caring for others.
Scientists have recently joined their philosopher brethren in the analysis of happiness. Remarkably, they have produced evidence which suggests that people who are driven to achieve eudaimonic happiness actually have better health outcomes than those motivated to achieve hedonic happiness. They are more likely to remain intact cognitively, for example. They even tend to live longer.
For example, in a cohort study of 7,000 people known as MIDUS (the Mid-Life in the US National Study of Americans), Carol Ryff and colleagues at the University of Wisconsin have tried to identify social and behavioral factors that predict one’s ability to maintain good health into old age. The team has focused on sociocultural sub-populations known to be associated with poor health outcomes…things like low education level. Read more »
*This blog post was originally published at Pizaazz*
April 19th, 2011 by Jessie Gruman, Ph.D. in Opinion
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“Life gives you lemons and you make lemonade…your response to all those cancer diagnoses is so positive, such a contribution!” “Your work demonstrates that illness is a great teacher.” ”Your illness has been a blessing in disguise.”
Well-meaning, thoughtful people have said things like this to me since I started writing about the experience of being seriously ill and describing what I had to do to make my health care work for me. I generally hear in such comments polite appreciation of my efforts, which is nice because I know that people often struggle to know just what to say when confronted by others’ hardships.
But beneath that appreciation I detect a common belief about the nature of suffering from illness in particular, that in its inaccuracy can inadvertently hurt sick people and those who love them.
The belief is that sickness ennobles us; that there is good to be found in the experience of illness; while diseases are bad, they teach life lessons that are good. Read more »
*This blog post was originally published at CFAH PPF Blog*
April 9th, 2011 by Edwin Leap, M.D. in Opinion
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I sometimes see men and women who come to the emergency department and tell me about their PTSD, caused by service in Iraq or Afghanistan. I believe some of them; others I doubt, since their PTSD seems directly connected to a desire for Percocet, Lortab, MS-Contin or other prescriptions for back pain. Sadly, the VA system does not lend itself to inquiry by outside physicians, so in many instances I am treating them in an information vacuum.
However, as I contemplate their allegations of PTSD, I wonder how many physicians and nurses from emergency departments have the disorder. I’m no psychiatrist, but it just seems probable that the years of cummulative stress, the years of sleeplessness and snap decisions, the untold shifts filled with unpredictable chaos, pain, threats, death and anxiety would add up to significant emotional turmoil for providers who work in that environment.
It is appropriate that we are attentive to the needs of those who serve in combat zones. And yet, they may spend only spend one or two years there. Granted, that can be terrible enough. Read more »
*This blog post was originally published at edwinleap.com*
The White House released its plan last week entitled “Epidemic: Responding to America’s Prescription Drug Abuse Crisis” [LINK to pdf of this 10-page plan]. Below are some of the elements in this plan that is part of the National Drug Control Strategy (like that has worked so well :-/).
