Give The People What They Want?

On February 27, 2014, the Draft Patient Registry Rules for the Therapeutic Use of Cannabis Program (He-C 401) were posted by the N.H. Department of Health and Human Services for public comment and were posted in the Rulemaking Register.

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.

Generically Expen$ive

It can be a self-rationalizing moment to reconcile prices at the pumps when filling up these days.  If you are not driving an economy car, it can break the bank.  No need to even go near the social conscientious swirl of how big your carbon footprint is, essentially a personal decision of indiscretion.  If you do a bit of research, a graduate degree in economics is not requisite to understand how prices from the wellhead to the pump are influenced by supply and demand through embargos and OPEC controls.  However, it is not as easily understood regarding the rapid rise in costs for several generic medications over the past few years.  For many this can lead to a personal healthcare and financial crisis that is not based upon personal indiscretions, while the drug companies’ explanations just don’t make sense.

Forget Me Not

This past Mother’s Day, my father’s wife told my brother and me that our dad was forgetting her name as well as having some other short-term memory difficulties.  He is in his early 80s and for years has tried to put up a good front, telling anyone who asked that the weather was great and life was copasetic.  However, the truth was that he has been slowing down his activity over the past few years, decreasing his interactions with other people and never telling his doctors what was really going on.  The concern, of course, is whether this is an early Alzheimer’s presentation or just an older man being stubborn and perhaps in denial.  As we assessed all the clinical information from a thousand miles away, it made sense to review the current research and treatment options for Alzheimer’s disease.

For Subcutaneous Use Only

If you were asked to name the best-selling medication in the United States last year, what would your guess be?  Not the most prescribed drug, but the medication with the most revenue, mind you.  I know what you are thinking — it must be a cardiac drug, due to the prevalence of heart disease.  Lipitor?  Close, but that would be the lifetime sales king ($141 billion).  Maybe a diabetic drug?  There are obese people with diabetes everywhere.  No, wait, an opioid — that has been in the news all over the place in the last year.  Well, the answer is not exactly clear cut, depending on what source you quote.  However, it does appear that between July 2013 and June 2014 the best-selling medication in this country was aripiprazole (Abilify), with sales of $7.2 billion, and the most prescribed medication was levothyroxine (Synthroid), with 22.6 million prescriptions written.

First Step in Our Journey to Better Healthcare System in NH.

Elections bring out strong emotions in all of us.  There are winners and losers and we often feel very strongly about the candidates we supported.  Following the election, we are exhausted from the campaign.  We are left wondering what, if anything, are we to do next and how can we move our agenda forward.  The answer is rarely clear, however, regardless of how we feel about the results of the election, doing nothing is not an option.

The work of the NHMS is critically important to advancing our profession and the public's health. While we may not know how our agenda will be received by our elected officials, we must reach out in good faith to them because they are the ones with whom we will work with over the next few years. 

First (Worst) In the Nation?

Last week, the New Hampshire Department of Insurance presented information about worker’s compensation medical costs in the Granite State.  This information came from the National Council on Compensation Insurance, or NCCI, which gathers data, analyzes industry trends and prepares objective insurance rate and loss cost recommendations from 35 states.

Supporting Mental Health Crisis.

On Monday of this week, I joined representatives from a variety of health profession, law enforcement, and patient advocacy organizations to speak about the mental health crisis in New Hampshire.  The National Alliance on Mental Illness New Hampshire (NAMINH) organized the press conference to share new data on the excessive wait times for people in mental health crisis.  

At the time of Monday's press conference, 31 adults and five children sat languishing in hospital emergency rooms across the state waiting for a bed to open at the New Hampshire State Psychiatric Hospital.  Since July, there have been a minimum of 30 patients per week waiting for admission, with a maximum of 120.  You can read full  details here.

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.

The Fetus is the Parent of the Child

As summer winds down and the seasons begin to change again, a new child will enter this world in the next few weeks.  My office manager will give birth soon, and while we may consider the notion that knowledge and ideas begin the day we are born, research has proposed that even in the womb, a developing fetus is learning things that will affect his/her own future and parents as well.  Most healthcare clinicians, and even the general public, understand how prenatal exposure to chemicals such as alcohol, nicotine and drugs will negatively affect the developing fetus.  See the article in Pediatrics.

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