Next Available For Those Who Really Need It!

More elderly patients with substance abuse issues are using the emergency department for their only means of intervention.

Pay Attention to Heard Mentality- Don’t Believe Everything You Hear (or Read)

There is a voluminous amount of information describing the risks of vaccinations that really has no consistent evidence based support. There is a myriad of shock and awe anecdotal correlates of how lifelong debilitating disorders are connected to childhood vaccines.  The word is “heard.”  So and so heard it causes…, and they told two friends, who read and said and more and more heard that there is no need to vaccinate children or those at greatest risk of contracting some of the most deadly and communicable diseases.  Those are the diseases that killed millions, with real data supporting the prevention of spreading the same diseases and saving many more lives through vaccine programs.  Meanwhile, thousands of people are dying yearly who are not fortunate enough to receive vaccinations, but would line up with their families for the opportunity if available.  What a shame it is.

Hand in Hand

It is not getting any easier to adequately address the needs of patients with mental illness.  The challenge is exponentially heightened for those in acute need, who turn to community health centers or office based practices, only to be redirected to the ultimate repository for many more these days-- the emergency department.  In fact, the circumstances are getting murkier.  With the addiction epidemic remaining at full throttle, more patients are in need of timely resources suited to help on more than one front as the two frequently go hand in hand. 

Drug Money

There are several perplexing circumstances pushing the cost of healthcare further into the stratosphere.  However, one entity in particular has a notable historic record of being incredulously bold in taking advantage of the greatest number of those most in need, for decades.  Pharmaceutical manufacturers are taking liberties to make billions at the expense of creating outrageous financial hardship and jeopardizing the health of millions of people.  Following a blog of several weeks ago, I have continued to share in discussions, with many providers and patients, of how devastating the impact from price fixing by several pharmaceutical companies is.

Taking a Stand on Addiction – Changing Behaviors, Theirs, Ours and Yours

As the epidemic of over prescribing pain meds, drug addiction and associated overdoses rages on, there is evidence that efforts to universally direct and limit the prescribing of controlled substances has had a positive effect on one of the largest underpinnings of this public health crisis.  The Department of Health and Human Services has directed initiatives to help limit the prescribing practices for opioids. There has been: updated training and education guidelines, increased use of naloxone and an increase in medication-assisted treatment combining medication with counseling and behavioral therapies to treat substance abuse disorders. Refer to New weapons combat opioid addiction, ID tools, e-prescribing are key, by Mari Edlin; Managed Healthcare Executive, Vol. 25 No.

Coming soon to a roadway near you! HB 1360

Quite some time ago I spent countless hours behind the wheel of commercial vehicles, to the point that I have caught my wife in conversation with others quoting, “Don’t you know? He is a professional driver.”  This usually results in shared chuckles by others, as it is reportedly a commonly recurring outward expression of the Y chromosome, likely overlooked by the mapping of the human genome, and barring XX chromosome counterparts such as Danica Patrick hopefuls on public streets.

Holding the Cash Assets of Healthcare Provider Systems (HCAHPS)

There have been several memorable patient encounters that were anything but satisfying for me or the patients.  I can recall frustrating circumstances as a medical intern on the floors, tending to patients’ medical needs, but not really being aware of their expectations.  What I mean by this is that I wasn’t tuned into each individual patient as to how to maximize their satisfaction or to include some kind of loop closure regarding their impressions of their hospital admission.

Stigmatized and Left for Dead, Who Should Make the Call?

Over the past couple of weeks I have become more aware of opinions that could be unfortunate barriers to HB 271 being passed by the Senate.  While participating in an EMS continuing education presentation, the question was put forward as to who might not be in favor of having naloxone (Narcan) more readily available for addicts, their friends, family members and others to administer emergently to anyone whose life is threatened from an opioid overdose.  Surprisingly, there was more than one hand raised.  The supporting commentaries shared a similar concern, that it will only aid and abet abusing illicit drugs.  Others, who are not EMS providers or healthcare professionals, have also recently expressed their biases to not support easier access to Narcan, regardless of its lifesaving potential.  There have been deeper dives and hard looks at the risks and benefits for bystander Narcan to be more readily available.

Stop the Pain - Killers

So much time is spent on the astonishment of the opiate epidemic in the United States.  Where did it start?  How did it get to be so bad?  Who is the most responsible party?  Most importantly, who has the greatest likelihood of making the most timely impact in reducing the overprescribing, abuse and unnecessary deaths from opioids?  After all is said and done, there needs to be greater federal and state mandates to stop the incessant marketing and prescribing of opioids as first line analgesics for chronic pain.  It is clear that current practices and usage are directly correlated with killing the thousands of people using them as painkillers, as well as facilitating recreational use and abuse. That, too, stems from overprescribing, overabundance and greater availability to secondary markets.  Refer to the blog two weeks ago, noting predictable prescribing practices by zip code.

What's in a zip code?

As there are many more states and providers across the country focusing on the epidemic of opioid abuse and addiction concerns, there can be some utility in recognizing patterns that exist within your own zip code. “Each community chooses its opioid.  Within a 60-mile radius of where I have worked, patients have told me that ‘only idiots’ abuse any opioid other than ‘fill in the blank.’  Heroin, oxycodone, meperidine, hydromorphone, fentanyl, dextromethorphan- they all have been abused, but usually only one is abused in any given community. This is primarily due to control of the drug scene by one gang or another.  If opioids do have to be prescribed, limit dosing to three to four days maximum because follow-up for persistent pain is essential.”  ACEP Now, Feb 2015, Vol.34, Number 2, p.

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