Viewpoints: The DEA’s Role In The Opioid Epidemic; What About ‘Patient Zero’?
A selection of opinions and editorials from around the country.
The Washington Post:
Is The DEA Partly To Blame For The Opioid Epidemic?
Destructive and persistent, the epidemic of opioid addiction is also deeply ironic: Unlike previous drug scourges in U.S. history, this one spread via perfectly legal channels. Millions of people were introduced to addictive pain-killing medications by doctors’ prescriptions, filled at pharmacies, ultimately supplied by pharmaceutical manufacturers. All of this went on in one of the most heavily regulated sectors of the U.S. economy — health care — which is supervised by a veritable army of officials working for dozens of agencies, state and federal. (10/30)
The New York Times:
The Ethics Of Hunting Down ‘Patient Zero’
The alleged “Patient Zero” of the American AIDS epidemic — a French Canadian flight attendant named Gaétan Dugas, who died of AIDS in 1984 — was exonerated last week. Genetic sequencing of blood samples stored since the 1970s showed that the strain infecting him had circulated among gay men in New York for several years before he arrived here in 1974. Therefore, although he had hundreds of sexual partners in several cities, he did not introduce the virus to North America; he was a victim before he was a vector. (Donald G. McNeil, 10/29)
“Patient Zero” Didn’t Exist, But AIDS Is Still An Epidemic
Thanks to some scientific sleuthing, that rap has been laid to rest. Patient Zero never existed. In fact, Dugas’ “zero” designation in popular culture was a solecism propagated in no small part by the author Randy Shilts in “And the Band Played On,” his book about the AIDS crisis. In fact, Dugas had been assigned the letter O, not a number, by a scientist at the Centers for Disease Control and Prevention (CDC). The letter denoted that Dugas was from “outside Southern California,” nothing more. (Mary Sanchez, 10/30)
It’s Time For Primary Care Providers To Embrace Treating Addiction
Many primary care practitioners have been avoiding the battle against opioid addiction and opioid overdoses. But they shouldn’t. Embedded in their communities, primary care doctors and nurses are perfectly positioned to treat addiction and champion care for those struggling with the use of opioid pills or heroin. Our expertise is in getting to know our patients and providing longitudinal care for those with chronic conditions like heart disease and diabetes — and addiction. (Julian A. Mitton, 10/28)
Los Angeles Times:
To Appease A Patient Lobby, Did The FDA Approve A $300,000 Drug That Doesn't Work?
A couple of weeks ago, the big insurance company Anthem decided that it wouldn’t pay for Exondys 51, a drug that already had been approved by the Food and Drug Administration to treat Duchenne muscular dystrophy. Anthem’s decision was controversial, because two other insurers had said they’d cover the treatment for their patients. But it was less controversial than it could have been for two reasons: The drug costs $300,000 a year, and the evidence that it works is almost laughably thin. To put it another way, Anthem’s decision undoubtedly infuriated advocates for DMD patients, but it may well have been the right call. (Michael Hiltzik, 10/28)
Is It A Sinus Infection Or A Cold?
It’s that time of year when many people experience cold and sinus infections. Telling them part determines how each illnesses is treated. Each year, about 31 million people experience sinus infections, usually caused by bacteria growing in the sinuses, the bony cavities found behind the nose, eyes, brows, and cheekbones. Typically, a cold or allergy attack causes mucous membranes in the sinuses to swell and block the tiny openings into the sinuses, which interferes with their ability to drain. (Nathan Deckard, 10/28)
Doctors' Group: Neither Candidate Should Have Finger On Hair-Trigger Nukes
Presidents George W. Bush and Obama have warned that keeping nuclear missiles on hair-trigger alert is reckless. There have been multiple near-misses and near-launches — cases where confusion or computer glitches forced leaders to make decisions in just a few sweaty, terrifying minutes about whether to Release the Kraken. And yet, in a failure of imagination and leadership, nothing has been done. Control of this God-like power will soon be transferred to a new president. But do we really want to trust anyone with this situation? (Matt Bivens, 10/28)
Emergency Medicine: Patient’s Heart Trouble Points To Greater Worry
There are so many times that we have to count on indirect methods to build evidence to make a diagnosis. For example, we count on an elevated white blood cell count to suggest infection or shadows on a chest X-ray to gauge the size of the cardiac silhouette. But we cannot differentiate between heart enlargement and fluid around the heart, and we read electrical impulses on an EKG and recognize a pattern that is suggestive of one diagnosis or another. This all changed with the addition of ultrasound. (Diane Gorgas, 10/30)
I Advise My Patients Against Marijuana, But Here’s Why I’ll Vote To Legalize It
If a patient came to my clinic and asked if it’s OK to smoke marijuana, I would explain why it’s a poor decision for their health. However, on Nov. 8, I will vote yes on Question 4 to legalize recreational marijuana in Massachusetts. This is because I have seen a much more frightening public health crisis up close: the devastating effects of mass incarceration for drug offenses. Rising prison populations constitute a major threat to public health and I believe the costs of incarceration for patients and communities simply outweigh the dangers of marijuana. (Akshar Rambachan, 10/28)
Some Hospital Systems Pioneer Transparent Pricing, But Industrywide Progress Is Slow
There are a small but growing number of health systems around the country that are thinking “more like retailers” and establishing clear pricing strategies to compete for consumers who face rising out-of-pocket costs under high-deductible health plans, according to a new report from the PwC Health Research Institute. ... Some policymakers believe new laws and regulations are needed to prod healthcare providers to move more rapidly on price transparency. If more consumers were demanding upfront price information to facilitate comparison shopping, that might do the trick. But so far, to the bewilderment of many experts, they are not. (Harris Meyer, 10/27)
Kansas City Star:
Myths About Quitting Smoking Harm Kansans With Mental Illness
Kansans in the mental health community are coming together to preserve our state’s mental health safety net in the face of a $30 million budget shortfall. Many Kansans — more than 126,000 — live with a serious mental illness. As policymakers, advocates and providers work to maintain core services and contain costs, it is important to consider a strategy for those with mental illness to live longer, healthier lives: helping them quit smoking. (Kimber Richter, 10/30)
St. Louis Post-Dispatch:
The Statistics Don't Lie. St. Louisans Need To Have The Condom Conversation.
An annual report from the Centers for Disease Control and Prevention put St. Louis at the top spot in the nation last year for spreading two pernicious, sexually transmitted diseases — diseases that should be easily preventable if the city promoted better sex education, more disease testing and increased public awareness about the importance of condoms. (10/30)