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Categories: Health, Opiates

If you or someone you care for is being treated for anxiety, depression or some other mental health disorder, and are taking opioids to treat a painful condition, it would be wise to seek alternative pain relief. People with emotional problems who use opioids are more at risk for dependence and…

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Physicians from lower-ranked medical schools prescribe nearly three times as many opioids per year as graduates from top-tier institutions, says a new study by two Princeton University economics professors. Clinical use of prescription opioids has quadrupled since 1999, almost exactly…

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study was published as a working paper for discussion by the National Bureau of Economic Research (NBER), the largest economics research organization in the country.

Striking relationship

“Using data on all opioid prescriptions written by physicians from 2006 to 2014, we uncover a striking relationship between opioid prescribing and medical school rank,” wrote the paper’s authors, Janet Currie, PhD, and Molly Schnell, a PhD candidate. “Even within the same specialty and county of practice, physicians who completed their initial training at top medical schools write significantly fewer opioid prescriptions annually than physicians from lower ranked schools.”

It’s unlikely that these differences in prescribing decisions were due to some sort of differences in the patients seen by doctors from higher- and lower-ranked schools. The study points out that the evidence was the same across geographic regions, across specialties, and even within the same hospitals.

“The relationship between medical school rank and propensity to prescribe opioids persists even among specialists who attended different medical schools but practice in the exact same hospital or clinic-where patients can be assumed to be relatively homogenous in their need for opioids,” the study said.

This additional evidence, they said, suggests “a causal effect of education rather than patient selection across physicians or physician selection across medical schools. Altering physician education may therefore be a useful policy tool in fighting the current epidemic.”

Overall, physicians from Harvard wrote fewer than 100 opioid prescriptions a year, compared to physicians from the lowest-ranked schools who wrote 300 a year. But the most striking differences were found among general practitioners, who accounted for nearly half of all opioids prescribed during the study period.

Harvard grad GPs wrote an average of 180 opioid prescriptions a year, while GPs from the lowest-ranked schools averaged 550 prescriptions a year.

Meanwhile at Harvard…

A year ago, the Obama White House asked medical schools “to sign a pledge” to require students to study new guidelines from the CDC for safe opioid prescribing before they graduate. According to a MedPage Today report, “of the nation’s 170-plus medical schools, 61 signed on.”

Harvard Med was one of those that refused to make the “pledge” to implement the CDC guidelines, saying that safe opioid prescribing is already part of the curriculum. But a group of Harvard med students said they weren’t satisfied with their education on opioids. So a group of them organized additional training on better opioid prescribing practices and how to more effectively treat addiction using the opioid overdose reversal drug naloxone (trade name Narcan).

MedPage said their efforts took place “amid a surge in deaths from opioid overdoses, which killed an estimated 28,000 people in the United States in 2014. And at least half of those deaths involved a drug prescribed by a doctor.”

Take it to the next step

The 61 schools that accepted the White House’s pledge to implement the CDC guidelines have begun enhancing their opioid training.

The NBER study’s Molly Schnell told MedPage that if the CDC training turns out to be effective, and if her medical education research gets “sufficient attention,” she and others could start to examine medical education and training “on a more granular level.”

“One thing we would love is to start working with medical schools to maybe know what they’ve been teaching and see if we can pinpoint which strategies are most effective,” Schnell said.

Meanwhile, here at Novus we help patients get their lives back from opioid dependence every day. Our development of innovative opioid detox protocols shows we’re on board with improving treatment methodologies. We congratulate those enterprising, proactive Harvard students, and all the med schools, seeking to find better ways to make a difference.

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Novus is the best way to get your life back as painlessly as possible.

Call to speak to one of our experienced & caring detox advisors today!

Categories: Get Help, Overdose

Let them die. Three strikes and you're out. This was the suggestion by Middletown, OH, Councilman Dan Picard recently for opioid overdose victims who've already been saved twice before by the city's overworked paramedics. A third overdose? Just refuse to send the ambulance and paramedics.…

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Let them die. Three strikes and you’re out.

This was the suggestion by Middletown, OH, Councilman Dan Picard recently for opioid overdose victims who’ve already been saved twice before by the city’s overworked paramedics.

A third overdose? Just refuse to send the ambulance and paramedics. Period.

Picard’s shocking idea was picked up by the news and went viral across America. It drew all kinds of fiery protests on social media from outraged people around the country.

But Picard says he’s desperate. He says the city just can’t afford to keep racing ambulances and teams of paramedics to the scenes of overdoses, and injecting expensive doses of Narcan into overdose victims who they’ve already saved multiple times before.

High cost with no apparent return

The cost to the small city of 50,000 souls for the first half of this year is already on track to exceed $100,000 – just on Narcan alone. The city’s costs treating overdoses and deaths are way over last year. By mid-June, the city had already responded to 100 more overdoses than it did in all of 2016. And there’s already been 51 overdose deaths this year in the city while there were only 74 all last year.

Not only that, only one of the hundreds of overdose victims treated repeatedly over the past year or two has agreed to seek drug treatment. Over and over again, victims wake up from the shot or two of Narcan that snaps them out of the opioid embrace of death, get up and just walk away.

From the news clips, it looks like the cops and paramedics know all the repeat heroin abusers in the city by now. And it’s not a friendly scene. It’s dark, it’s serious and it’s depressing as hell.

City Manager Doug Adkins says, “We can’t arrest our way out of this. I can’t keep it out of the city. It’s a Middletown problem. It’s a southwest Ohio problem. It’s an Ohio problem. It’s a national epidemic.”

Once, twice, goodbye? Not quite.

When Picard asked Adkins if there was a law that the city must respond to all calls for EMT, Adkins replied: “If we want to get out of the business, we have the right to get out of the business,” the suggestion being that the city could privatize emergency medical services and not be liable for the hundreds of rescues.

But Picard wasn’t proposing an “instant death sentence” for three-time losers. In fact, he suggested a program that would allow overdose victims a chance to extend the city’s expensive life-saving services.

Paramedics would respond only twice to the same overdose victim – a database would have to be built to ID and track victims. But now, victims would receive a summons to appear in court, and would be required to do community service after being treated.

And if they don’t show up in court, or don’t complete the service, and then they overdose a third time? The hammer drops. Paramedics would not be dispatched.

Will it ever happen?

The fact is, even though Middletown may not be legally bound to respond to calls for emergency overdose treatments, it’s unlikely that such a rule will ever be adopted.

According to a report in the Cincinnati Enquirer, city manager Adkins has ruled out the idea, partly because of all the negative attention it’s received. “This isn’t going to go anywhere,” he said. “Even if it was, I’m not sure I would want to face the lawsuits that could come from it.”

As for Picard, his council term expires at the end of the year, so he’s not currying public favor for a re-election. After nearly eight years, and all the attacks he’s received in the social media, he’s had enough.

“During the last four or five days, life has not been good,” he told the Enquirer.

His Facebook page contains tons of comments “lambasting” him:

  • You are a disgrace to humanity! said one.
  • “Have fun in hell!” read another.
  • “It costs $0.00 to be a decent human being,” another post said.

“My goal was not to stop treating overdoses, it was to solve a financial problem – not to stop the drug problem,” Picard told the Enquirer. “If we dispatch, then we have to treat. I have no problem with that.”

Deserve every chance

Fortunately, the city of Middletown, OH, has abandoned the 3-strikes idea. Perhaps the court intervention might be a workable idea, especially along with specific attention on helping victims coax their need to get clean into action for treatment and recovery.

It’s been our experience here at Novus that people with addiction problems do possess the desire to recapture sobriety and get their lives back. It can be deeply buried, but with the right help, it finds its way from darkness into light.

The secret, of course, is “the right help.”

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Conventional medical practice generally holds that bringing up the subject of dependence and addiction can alienate patients - especially those already dependent and needing more pills. In fact, many doctors, if not most, tend to refill such patients' opioid painkiller prescriptions to avoid…

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A 53-year-old car crash victim, suffering unimaginably intense pain from a thigh so badly shattered that pieces of bone were sticking out, begged doctors at a Baltimore, MD, trauma center recently to not give him opioid painkillers. The patient's surprising refusal to accept the standard treatment…

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Novus is the best way to get your life back as painlessly as possible.

Call to speak to one of our experienced & caring detox advisors today!

After six months of serious negotiations, China has agreed to a fentanyl ban of the production and sale of four variations of the synthetic opioid fentanyl. The killer drug has been pouring into the U.S. illegally from China for years and has been implicated directly in countless overdose…

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Developer says the new drug reduces pain without creating the euphoria that led to the opioid epidemic Drug developer Nektar Therapeutics has announced positive results from a phase III trial of its experimental opioid painkiller called NKTR-181. The drug “significantly reduced pain in patients…

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A recent study of the prescribing practices of emergency room physicians clearly shows that the more opioids you prescribe, the more long-term use and abuse will result - especially among the elderly. The study, published in New England Journal of Medicine, analyzed opioid prescriptions among…

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Novus is the best way to get your life back as painlessly as possible.

Call to speak to one of our experienced & caring detox advisors today!

Are America's physicians responsible for the soaring rate of opioid abuse and overdose deaths across the country? "Not exclusively," says Dr. F. Perry Wilson. "But we can't deny that somewhere in the chain of events that leads to opioid abuse lies a prescription pad." Wilson, a MedPage Today…

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‘The poor man’s methadone’ More and more opioid addicts these days are turning to a common type of over-the-counter (OTC) anti-diarrhea drug to help stave off withdrawal symptoms, or just to get high. Why anti-diarrhea drugs? The common active ingredient in Imodium A-D, Ultra A-D oral,…

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