KHN Morning Briefing

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Doctor’s Murder Raises Tough Questions About Battling Opioid Epidemic

Dr. Todd Graham refused to give a patient a pain killer prescription. The woman's husband returned with threats and a gun. Graham's death is serving as a stark reminder to the community that doctors are on the front lines of the crisis. Meanwhile, deaths from drug overdoses in the U.S. rose sharply in the first nine months of 2016.

Stat: A Doctor Was Murdered Over Opioids. His Town Is Left With No Easy Answers
Dr. Todd Graham wasn’t yet halfway through his workday at South Bend Orthopaedics when a new patient came into his office here complaining of chronic pain. Heeding the many warnings of health officials, he told her opioids weren’t the appropriate treatment. But she was accompanied by her husband, who insisted on a prescription. Graham held his ground. The husband grew irate. ...Then he pulled out a semiautomatic weapon and shot the doctor who wouldn’t give his wife pain pills. Days after the July 26 murder, STAT interviewed doctors, law enforcement officials, and local residents to piece together the full story — and to understand how the shouts in the office and the gunshots in the parking lot have reverberated through this small Midwestern town. (Thielking, 8/8)

Stat: 'Doctors Are Getting Shot': Navigating The Perils Of Pain Pill Prescribing In The Midst Of An Opioid Crisis
The recent murder of Dr. Todd Graham has shaken physicians across the U.S. Graham was shot by the husband of a new patient who had asked him earlier that day for opioids to control chronic pain. Graham, an orthopedist in Mishawaka, Ind., had refused to write the prescription, explaining that the powerful pain pills weren’t appropriate treatment. The patient’s husband tracked him down later in the parking lot and pulled out a gun. (Ross, 8/8)

Stat: Doctors Who Attend Lower-Tier Medical Schools Prescribe Far More Opioids
Aphysician’s propensity to prescribe opioids could be affected by a range of factors relating to background and clinical experiences. But new research shows one variable may be especially influential: where the doctor went to medical school. A paper published Monday by economics professors at Princeton University determined that physicians who studied at lower-ranked medical schools prescribe nearly three times as many opioids per year as those who attended top-tier institutions. (Ross, 8/7)

The Washington Post: Deaths From Drug Overdoses Soared In The First Nine Months Of 2016
Deaths from drug overdoses rose sharply in the first nine months of 2016, the government reported Tuesday, releasing data that confirm the widely held belief that the opioid epidemic worsened last year despite stepped-up efforts by public health authorities. The National Center for Health Statistics reported that overdose deaths reached a record 19.9 per 100,000 population in the third quarter, a big increase over the 16.7 recorded for the same three months in 2015. Similarly, the first two quarters of last year showed death rates of 18.9 and 19.3, far greater than the corresponding periods for 2015. Data for the fourth quarter of 2016 are not yet available. (Bernstein, 8/8)

And in other news on the crisis —

The Associated Press: Report Reveals Underground US Haven For Heroin, Drug Users
A safe haven where drug users inject themselves with heroin and other drugs has been quietly operating in the United States for the past three years, a report reveals. None were known to exist in the U.S. until the disclosure in a medical journal, although several states and cities are pushing to establish these so-called supervised injection sites where users can shoot up under the care of trained staff who can treat an overdose if necessary. (Stobbe, 8/8)

The Oregonian: Fed Up With Opioid Deaths, Multnomah County Sues Drug Makers For $250 Million
Multnomah County has joined a list of other counties, cities and states across the nation in filing a lawsuit against major U.S. pharmaceutical companies, accusing them of pushing doctors to overprescribe opioids such as OxyContin and Percocet despite the great risks of addiction. In the $250 million lawsuit, Multnomah County claims pharmaceutical makers and distributors have engaged in a nearly two-decades-long “campaign of lies and deceptions” to drive up profits by selling opioids to the masses. It’s now a $13-billion-a-year industry. (Green, 8/7)

New Hampshire Public Radio: In First Year, Childhood Trauma Response Team Refers More Than 250 For Services
Children in New Hampshire are finding themselves caught in the front lines of the state’s heroin and opioid crisis. ...Lara Quiroga is with the Manchester Community Health Center, and helped launch a program last summer that aims to ensure children who experience trauma, whether it's witnessing an overdose or being exposed to violence, get the services they need. (Ganley and Brindley, 8/7)

Cincinnati Enquirer: Drug Overdose Surge Hits Hamilton County
A surge in suspected overdoses in Hamilton County on Saturday prompted public health officials to issue an alert to the community. Twenty-two suspected overdose cases were logged at Hamilton County hospitals on Saturday alone, health department records show. (DeMio, 8/7)

Boston Globe: A Door Inches Open To Give Inmates Medication For Addiction
With grants announced Monday, the houses of correction in Franklin and Hampden counties will expand their ability to offer buprenorphine, a drug commonly known by the brand name Suboxone, to inmates with a diagnosed opioid use disorder, starting within a month of their release. Only a handful of prisons and jails nationwide dispense buprenorphine as treatment. (Freyer, 8/7)

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