“The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick and the needy, and the handicapped.” – Hubert Humphrey
passionate pachyderms
Pharmacist Steve steve@steveariens.com 502.938.2414
Spoon Drug, 540 Plaza Court, in Sand Springs. Spoon Drug received more than 8.5 million pain pills between 2006-2012 according to data released by the Washington Post. DYLAN GOFORTH/The Frontier
During a seven-year period, the pharmacy that received the highest-number of opioids in Oklahoma was a long-term care pharmacy in western Oklahoma City.
Coming in second was a southern Oklahoma City Walgreens.
The third was a small, independent pharmacy in Sand Springs, population 20,000. The pharmacy, Spoon Drug, sits in a small shopping center just off the Sand Springs Expressway next to a Taco Bueno and a nail salon. It is owned and operated by James “Jim” Spoon, a longtime member of the state’s pharmacy board and current Sand Springs mayor.
Last week the Washington Post released data that had previously only been available to the Drug Enforcement Administration that tracks every pain pill sold in the United States.
The Post said it “sifted through” nearly 380 million transactions between 2006 and 2012. The data came from the DEA’s ARCOS database, a drug reporting system the DEA says “monitors the flow of DEA controlled substances from their point of manufacture through commercial distribution channels to point of sale or distribution at the dispensing/retail level.”
“The Post is making this data available … in order to help the public understand the impact of years of prescription pill shipments on their communities.”
The release of the data by the Washington Post came just after Oklahoma wrapped up its seven-week trial against Johnson & Johnson for its alleged role in the state’s opioid crisis.
Data released by The Washington Post shows that more than 1.4 billion pain pills were received by pharmacies in Oklahoma between 2006 to 2012, a number that would account for more than 50 pills per resident per year.
The data showed that Walgreen Co. was the largest distributor of opioids from 2006-2012 in Tulsa County, while Actavis Pharma, Inc., a global pharmaceutical company and subsidiary of Teva Pharmaceutical Industries, was the largest manufacturer of pills that made their way to Tulsa County.
And Sand Springs’ Spoon Drug received the highest number of pills in the county.
There are actually two Spoon Drug locations in Sand Springs and both sites, situated only three miles from each other, were among the Oklahoma pharmacies that received the most pain pills, according to the data.
The first location, at 540 Plaza Court, received 7.8 million pain pills between 2006-2012. The second location, just three miles south off of Oklahoma 97 and 38th Street, received more than 1.5 million. Combined, that figure would rank Spoon Drug second only to Omnicare in Oklahoma City.
Most of the top locations on the list are large pharmacies in bigger cities across Oklahoma. For instance, Walgreens makes up more than half of the 25 pharmacies that received the most opioids. Of those 13 locations, five are in either Tulsa or Oklahoma City. Of the top 25 pharmacies on the list, only five are either not a Walgreens or not located in Oklahoma City or Tulsa.
There are other smaller pharmacies in smaller towns sprinkled among the list as well. Places like R and S Drug Stores in Duncan, City Drug Store in Hugo, or Beggs Pharmacy in Pryor.
Jim Spoon. Courtesy City of Sand Springs.
Spoon opened his first pharmacy 40 years ago. On the Spoon Drug “About Us” page, it states that the facility provides Sand Springs with “prescription delivery, nursing home service, a drive-thru window, and a great opportunity to get to know the pharmacists that serve you.
Spoon is listed as one of five pharmacists at Spoon Drug. He responded to an interview request by saying that while he appreciated the interest, “he had been advised not to comment on the situation since it involves ongoing litigation.”
Last year Spoon Drug was added as a defendant in the civil suit brought against opioid manufacturers by the Muscogee (Creek) Nation. The lawsuit originally targeted larger corporations such as Purdue Pharma, the McKesson Corporation, or Walgreens and CVS stores. Last July it was amended to add dozens of pharmacies, including Spoon Drug, as defendants.
Spoon has been on the Oklahoma State Board of Pharmacy Board for years. A spokeswoman at the Pharmacy Board said Spoon had served 20 years on the board and that his current term began in 2017 and expires in 2022.
For the past 20 years, both Democrats and Republicans have allowed, and actually supported, the attacks on doctors and pain patients, in spite of Supreme Court decisions and the fact that addiction is rising exponentially and drugs are not the cause. Why should you continue to support these status quo maintainers, when there are people running for local, state, and federal offices that know and understand the problem, and are willing to get in there and fight for decency and respect of the chronic pain patient and the doctors sticking their necks out to treat them? Stop supporting the establishment, and
GO LIBERTARIAN!!
On October 7th Cara Schulz, Burnsville, MN City Council member, the candidate recruiting specialist for The Libertarian party, and herself a cancer patient who has seen the denial of pain meds by even oncologists, was interviewed on the DoC Communication Campaign webinar. She gave us some insight into why we need to leave status quo politics behind, and move forward to a new force growing in America. She ended her discussion with the comment (paraphrased):
“Why should we continue to support political parties that have done nothing? That only permits them to continue to do nothing.”
Q: What is the Libertarian Party (LP) and what does it stand for? A: The basic premise of the party is: don’t hurt people, don’t steal their stuff. People should be able to have voluntary mutual beneficial relationships, acting like adults with one another.
The LP started in 1971. In the history of the LP, they pushed forward discussions, such as the medical use of marijuana, that weren’t popular at the time, but people are now coming around.
More libertarians are being elected into office. Starting with local offices, they then start to impact the wider arena. Local government impacts your day to day life. Local officials create their legislative agenda each year. Those agendas have a big impact on state legislatures. Some communities are starting to push back against the opioid war.
Q: What is the libertarian’s stance on the Controlled Substance Act? A: The government should not be interfering in the doctor/patient relationship.
One of the laws LP is fighting against is civil asset forfeiture. This law allows for the government to confiscate assets of doctors without even charging them with a crime, and it is ongoing in the War Against Doctors.
Q: How many health care practitioners are in the LP? A: They don’t know because they don’t invade privacy.
However, there is one doctor, Kyle Varner, MD, an internist in Toppenish, WA who is an active Libertarian. His website is http://www.DrVarner.com.
Q: What needs to be done to get candidates we want elected? A: Ally with the Libertarian Party
1. Join the LP. There is strength in numbers.
2. Donate even if you aren’t a member.
3. Support the candidates:
o Ask them the tough questions.
o Attend events, attend rallies.
o Speak up about issues.
o Go to the media.
A person can possibly become a member of the LP without giving up their registration with one of the other main parties. Check with your registration requirements in your state.
Q: Who are the current candidates running for 2019? A: Current candidates are listed HERE.
Q: If any of us want to campaign, how do we get connected? A: Go HERE, fill out the form and submit.
FYI: The Libertarian convention for the 2020 election will be in Austin, Tx over memorial weekend. (May 21-25, 2020) The website is HERE.
Contact your state party to learn how to be appointed as an official voting delegate from your state. Family, friends, and observers who aren’t ticketed convention attendees are most welcome to watch the non-ticketed events in the main hall, take in the exhibits, and enjoy family-friendly attractions, shopping and recreational opportunities. https://www.lp.org/state-affiliates
An attack on the World Health Organization (WHO) by US politicians accusing it of being corrupted by drug companies is making it even more difficult to get morphine to millions of people dying in acute pain in poor countries, say experts in the field.
Representatives of the hospice and palliative care community said they were stunned by the Congress members’ report, which they said made false accusations and would affect people suffering in countries where almost no opioids were available.
“At least 5 billion people live in countries where there is limited or no availability of opioids for pain treatment,” according to the International Association for Hospice and Palliative Care (IAHCP). More than 18 million people a year worldwide die with “untreated, excruciating pain”, the organisation says.
The report by the Democratic congresswoman Katherine Clark and the Republican congressman Hal Rogers, published in May, has undermined efforts to encourage governments to buy generic morphine or other appropriate opioids and doctors to prescribe them, dealing a severe blow to the struggle to help people dying in acute pain from cancer, Aids, injuries and other conditions, the IAHPC says.
The palliative care experts say low- and middle-income countries need cheap morphine, not patented opioid drugs such as OxyContin, at the centre of the US opioids crisis.
According to the UN’s International Narcotics Control Board (INCB), only 10% of the world’s morphine is used for palliative care. Almost all of the remainder is converted into codeine and used in cough medicine for sale in wealthy nations. “That makes it difficult for countries with fewer resources to procure any of the limited amount of morphine available for palliative care,” said a 2018 INCB report on access to controlled drugs for medical use.
There is anxiety in many countries about the potential for opioid addiction, which has been heightened by events in the US.
The Congress members accused WHO and the palliative care community of being influenced by funding from Purdue Pharma, the company accused of precipitating the disaster in the US. Two sets of WHO guidelines on the prescribing of opioids wrongly claim the drugs are safe, says the report, supporting Purdue’s claim that dependence occurs in less than 1% of patients and talking of the need to tackle “opiophobia”, which stops doctors prescribing the medications.
Congresswomen Katherine Clark. Photograph: Joseph Prezioso/AFP/Getty Images
“The web of influence we uncovered, combined with the WHO’s recommendations, paints a picture of a public health organisation that has been manipulated by the opioid industry,” says the Congress members’ report.
WHO and palliative care organisations have denied taking money or being influenced by Purdue Pharma’s global offshoot, Mundipharma. But the decision of WHO to withdraw the guidelines immediately after the criticism dismayed the palliative care community. The move will further discourage countries from trying to buy the drugs, they say.
Dr Lukas Radbruch, the chair of the IAHPC, said the opioid crisis in the US had caused global alarm before the attack on WHO. “Stakeholders are getting more reluctant to advocate for easy access to opioids,” he said, citing India as one of the countries that had slowed down. He said he had seen morphine locked in a small safe labelled “poisonous drugs cupboard” in one of the largest hospitals in the world, in Johannesburg. In sub-Saharan Africa, people still die in agony as a result of Aids.
“We were really shocked about the withdrawal of the guidelines from WHO in response to that report,” said Radbruch, a professor of palliative medicine at the University of Bonn. The two sets of guidelines, from 2011 and 2012 – Ensuring Balance in National Policies on Controlled Substances, and Guidelines on the Pharmacological Treatment of Persisting Pain in Children with Medical Illnesses – provided vital information and guidance to governments and doctors on what was safe and necessary for pain relief.
“This wasn’t influenced by any of the pharmaceutical companies,” said Radbruch, who was involved in drawing up the guidelines. The IAHPC, which was also attacked in the report, has published a detailed refutation of the allegations, saying claims it took pharma money are false. “The IAHPC has never served the interests of Purdue or any other pharmaceutical company to influence WHO or any other agency, government, institution or entity,” it says.
Prof Felicia Knaul of the University of Miami, chair of a recent Lancet commission on palliative care, said the Congress members’ report was not evidence-based. “Actions that are not based in evidence will do harm,” she said.
The stakes were high, she said. “I believe that policies that work to deny access to necessary pain relief medication in low- and middle-income countries because of the situation in the United States are akin to denying food to people suffering from malnutrition because there is an obesity epidemic in the United States.
“More than 60 million people every year require pain relief and palliative care and we know that more than 80% get virtually nothing. The vast majority of those individuals live in low- and middle-income countries. I consider it despicable from an ethical point of view and completely antithetical to the goals of global health and sustainable development to have children and adults living and dying in extreme pain when we have very inexpensive safe medications that we could offer them. Poor policies in the United States are not an excuse for allowing that to continue to happen.”
Clark said in a statement that “all patients deserve access to the medical care they need to live with dignity and without pain, and that includes access to medically appropriate pain medication”. But opioid manufacturers including Purdue Pharma had lied about the risk of substance use disorder and their claims made their way into the WHO guidelines, she said.
“Some critics, including those financed by the opioid industry, would have you believe that we face a choice between irresponsibly flooding countries with powerful opioids or leaving patients to suffer without any pain relief at all. This is simply not true,” said Clark.
An electric syringe pump administering morphine in Congo-Brazzaville. Photograph: Alamy
“No one disagrees that patients deserve access to medically appropriate treatment, but they also deserve factually accurate information about the care they receive and the risks that they might face. In addition, respected health authorities have a responsibility to promote appropriate access to palliative care while at the same time working to prevent the opioid crisis that we are experiencing in the United States from being replicated across the globe.”
A spokesperson for Rogers said he and Clark had raised legitimate concerns with WHO in 2017 that Purdue Pharma’s “reckless and unsavoury marketing strategies” would be employed internationally and lead to a global crisis.
“Their goal has never been to restrict access to therapies for patients truly in need of palliative or other care,” the spokesperson said of the Congress members. “In fact, he [Rogers] agrees that WHO ought to ‘ensure adequate access to internationally controlled essential medicines necessary for the relief of suffering, while preventing diversion and non-medical use’.
“However, it is clear that in the United States, we have failed to prevent vulnerable patients from [unwittingly becoming addicted] to powerful pain medications – and that is due in large part to the influence of companies like Purdue Pharma that put profit above people.
“Unless and until organisations like the World Health Organization do more to ensure that the pharmaceutical industry does not unduly influence their policy-making, these patients remain at risk.”
Mariângela Simão, a WHO assistant director general in charge of access to medicines, said: “WHO pushes for a balanced approach – people suffering severe pain should get the medication they need. At the same time, some pain medication, specifically opioids, needs careful handling through sound prescription practices and regulations to reduce the risk of abuse and potential harm.
“WHO withdrew the 2011 and 2012 guidelines because new evidence on these risks has come out in recent years and, on examination, they were not fully aligned with revised internal procedures. We are now in the process of reviewing the guidelines for publication next year.”
The world population is abt 8 BILLION and if 65% of the world’s population has no access to pain management… it is little wonder that some anti-opiates can claim that the USA consumes the majority of the world’s opiate production. Because 65% of the world’s chronic pain pts are allowed to live – or die – in a torturous level of pain.
And according to this article our CONGRESS is not helping the problem at all… and .. apparently doing just the opposite…
SOUTHINGTON, CT (WFSB) — A Southington teen was hospitalized recently after she took the wrong prescription pills because of a medication mix-up by her local pharmacy.
Alyssa Watrous, 17, had recently felt strange after picking up her prescription for asthma medication at a CVS pharmacy in Southington.
“Just throughout the day on Friday I didn’t feel good because I was feeling all the side effects,” Alyssa Watrous said.
“She had side effects from it such as nausea weakness dizziness pounding headache,” her mom Jill Watrous said.
After taking the pills from CVS for two days, Alyssa realized there had been a terrible mix up.
“She called me, ‘mom, mom there’s somebody else’s name on my medicine’,” Jill Watrous said.
It turns out, Alyssa had been taking blood pressure medication instead of her asthma pills.
CVS had accidentally given Alyssa the wrong prescription and she had been taking a lot of it.
Commonly for the medication she had, you’d take one pill a day for an adult and she was taking three at a time, because she was following the directions for her medication.
Jill Watrous called CVS and poison control right away. They said Alyssa had technically overdosed on the blood pressure pills and should go to the emergency room.
Fortunately, doctors told Alyssa she had come in just in time to avoid serious problems.
“They said thank goodness, there wouldn’t be any long-term effects, that it’s something will leave your system,” Alyssa Watrous said.
In a statement, CVS admitted to the error saying “We sincerely apologize to Ms. Watrous and her family. Prescription errors are a very rare occurrence, but if one does happen, we do everything we can to learn from it in order to continuously improve quality and patient safety.”
Jill appreciates the apology but says the CVS’ mix-up has taught her family a valuable lesson.
“I just think it’s important for people not to take for granted that the pharmacies always doing the right thing and that they don’t make mistakes, because clearly it happens,” she said.
From now on, the Watrous family says they will be even more diligent by checking the information on the bottle is accurate and even looking up pictures of the correct pill to make sure they are taking the right medication.
A UC Davis research team, led by Vladimir Yarov-Yarovoy and Heike Wulff, will receive a $1.5 million grant from the National Institutes of Health (NIH) to develop a novel class of peptides that are better at treating pain and don’t have the side effects of opioids. The grant is part of the NIH initiative Helping to End Addiction Long-Term (HEAL Initiative).
“With the national opioid crisis, we more than ever need a safer, more effective and non-addictive class of medications to treat chronic pain,” said Vladimir Yarov-Yarovoy, associate professor of physiology and membrane biology at UC Davis School of Medicine and principal investigator of the study.
“Dr. Yarov-Yarovoy is leading the next wave of innovative and novel therapeutics for pain,” said David Copenhaver, associate professor and Chief of the Pain Medicine Division at UC Davis. “We are excited to collaborate on this journey of discovery to find novel, safe and effective agents to treat pain.”
Scott Fishman, professor and director of UC Davis Center for Advancing Pain Relief, agrees.
“Receiving this grant reflects the great potential for this work to help millions of people in pain,” Fishman said. “We look forward to bringing this exciting science to the front lines of patient care.”
Targeting specific sodium channels
Previous research has identified voltage-gated sodium ion channels, especially NaV1.7, NaV1.8 and NaV1.9, as critical elements in pain signaling and transmission.
Certain peptides, such as the tarantula-based toxin ProTx-II, are known to block specific sodium channels, preventing nerve cells from transmitting signals that trigger pain.
“We want to relieve pain without the side effect of addiction that occurs with opioids,” said Karen Wagner, a co-investigator who studies pain in animal models.
“By targeting the relevant sodium channels instead of the receptors usually targeted by opioids, we provide an alternative to the addictive and detrimental effects of opioid pain medications.”
Blocking sodium channels to control pain
To ultimately relieve chronic pain, the researchers want to identify the most effective peptide design that can block the relevant sodium channels without affecting the activity of other channels.
In January 2019, several high-resolution structures of human sodium channel were published, giving the researchers a better understanding of the interactions between peptides and the sodium channels. Using the computational power of Rosetta software, the UC Davis researchers will design and synthesize different versions of the ProTx-II-based peptide to identify those that best selectively and effectively block pain-associated channels.
“Starting from the naturally-occurring ProTx-II peptide, we can improve the design of these toxins by optimizing for potency and selectivity,” said Wulff, a professor of pharmacology and director of the Probe and Pharmaceutical Optimization core of the UC Davis CounterACT Center of Excellence. “We will trim ProTx-II down to its essential binding parts to enhance its targeting of specific pain-related channels.”
Designed peptides that are found to selectively block voltage-gated sodium ion channels will be sent to Jon Sack’s laboratory for testing on neurons. Based on this testing, the researchers will choose the peptides that would be used in animal models.
The NIH launched the HEAL Initiative in April 2018 to improve prevention and treatment strategies for opioid misuse and addiction and enhance pain management.
“It’s clear that a multipronged scientific approach is needed to reduce the risks of opioids, accelerate development of effective non-opioid therapies for pain and provide more flexible and effective options for treating addiction to opioids,” said NIH Director Francis Collins.
The Team
Yarov-Yarovoy is an expert in computational modeling of peptide toxin – ion channel interactions and peptide design targeting ion channels.
Heike Wulff specializes in preclinical therapeutics development targeting ion channels and has developed an ion channel-targeted peptide toxin variant currently in clinical trials.
Bruce Hammock, a distinguished professor of entomology and director of the NIEHS-UCD Superfund Research Program, conducts research to develop preclinical therapeutics to control acute and neuropathic pain.
Karen Wagner, a research scientist in the Department of Entomology, researches neurobiology of inflammation, pain and chronic neurodegenerative diseases.
Jon Sack, an associate professor of physiology and membrane biology, specializes in mechanisms of voltage-gated ion channel modulation by toxins, and the design of novel probes to monitor ion channel activity.
Daniel Tancredi is a biostatistician and associate professor of pediatrics at UC Davis School of Medicine.
Project title: Optimization of non-addictive biologics to target sodium channels involved in pain signaling.
The Pharmas generally spends upward to 500 million dollars on R&D to discover a new medication… and … The National Institute of Health is providing a 1.5 MILLION grant to fund a new pain medication discovery ?
We have already been down this path of a non-addicting pain medicine… one was Stadol and one was Talwin and both ended up being abused and being made a controlled substances.
Then we have the whole class of NSAID ( Aspirin, Motrin , Aleve ) and while they are now OTC… it is claimed that 15,000 people die every year from the use/abuse of this class of drug… mostly from intestinal bleeds.
I am neither going to hold my breath or bet the farm that this research will bring out a non-addicting pain medication
Just think about it… global warming is blamed on excessive CO2… along with other things like COW FARTS ( Methane )
Every time that one of us exhales… we expel CO2… fewer people would mean less CO2 and it would probably mean fewer cows… since fewer people would suggest fewer steak/hamburgers being consumed and thus less cow farts. Fewer people driving/traveling less miles in various means of transportation all contributing to increased CO2
Then we have all those disabled/handicapped/medically compromised pts that many refer to as “takers” because they take more from our society than they contribute…
We really can’t go out and “knock people off”, but if we limit or compromise their medical treatment so that their co-morbidity issues to escalate or worsen and they die of “natural causes”
The millions of dollars that our country could save from fewer Medicare/Medicaid pts that have to receive treatment could help address our 22 trillion national debt and extent the years of viability of the Medicare and SS trust funds could be substantial. Insurance companies could either become more profitable or reduce the premium costs .. since fewer people needing expensive medical care.
Could the chronic pain community be the “guinea pigs” to see if such a theory could work… since most chronic pain pts are having their therapy limited and many are choosing suicide as the final solution to end their pain and many are dying of “natural causes” because their untreated pain is causing their other health issues to worsen
It’s never an easy business to predict which flu viruses will make people sick the following winter. And there’s reason to believe two of the four choices made last winter for this upcoming season’s vaccine could be off the mark.
Twice a year influenza experts meet at the World Health Organization to pore over surveillance data provided by countries around the world to try to predict which strains are becoming the most dominant. The Northern Hemisphere strain selection meeting is held in late February; the Southern Hemisphere meeting occurs in late September.
The selections that officials made last week for the next Southern Hemisphere vaccine suggest that two of four viruses in the Northern Hemisphere vaccine that doctors and pharmacies are now pressing people to get may not be optimally protective this winter. Those two are influenza A/H3N2 and the influenza B/Victoria virus.
The strain selection committee concluded the H3N2 and B/Victoria viruses needed to be updated because the ones used in the Northern Hemisphere vaccine didn’t match the strains of those viruses that are now dominant. Influenza epidemiologist Dr. Danuta Skowronski described the significance of those two changes in one word: “mismatch.”
“I think the vaccine strain selections by the WHO committee are obviously important for the Southern Hemisphere but they’re also signals to us because they’re basing their decisions on what they see current predominating on the global level,” said Skowronski, who is with the British Columbia Center for Disease Control in Vancouver.
Scott Hensley, an associate professor of microbiology at the University of Pennsylvania, agreed. But Hensley cautioned that at this point it’s too soon to know what versions of the viruses will be circulating. And even if there is a mismatch, its impact may be not be massive, depending on which viruses are causing the most illness this winter.
“There are many ways that this flu season may pan out,” Hensley said. “For example, we’ve had a lot of H3N2 [activity] the last few years. So it’s possible that this flu season in the Northern Hemisphere will be dominated by H1N1 viruses. And if that’s the case we think that the H1N1 antigens [in the vaccine] are very well matched with the types of H1N1 viruses that are circulating right now.”
Flu vaccine is a four-in-one or a three-in-one shot that protects against both influenza A viruses — H3N2 and H1N1 — and either both or one of the influenza B viruses, B/Victoria and B/Yamagata. Most flu vaccine is made with killed viruses, and most vaccine used in the United States is quadrivalent — four-in-one.
There was great uncertainty around which version of H3N2 to choose for the Northern Hemisphere vaccine when the committee met last February — there was a lot of variation between the strain the U.S. was seeing and the H3N2 viruses sickening people in Canada and Europe. There was so much uncertainty, in fact, that the committee delayed making the choice of the H3N2 strain for a month to try to get a clearer picture.
In the end, the committee selected a version of the virus that was causing a wave of late season illness in the United States. (Canada also had a late season surge of H3N2 activity, but caused by a different version of the virus.)
“That H3N2 wave was late and it was evolving at the time that they met in February,” Skowronski said of the strain selection committee. “And there was a diverse mix of H3 viruses. And it wasn’t clear to them, I guess, [which strain] … would emerge the clear winner.”
It appears the virus that was ultimately selected is not the H3N2 that dominated during the Southern Hemisphere’s winter 2019 season.
Hensley said the variant of H3N2 viruses that just swept through the Southern Hemisphere is more likely to be the main cause of H3N2 infections for the Northern Hemisphere this winter than was the case in the U.S. late last winter and into the early spring.
But that version of H3N2 is difficult to grow in eggs, which is the way the vast majority of flu vaccines is made, he noted, suggesting that fact may have influenced the thinking of the selection committee last March.
In recent years the H3N2 component has generally been the least effective part of the vaccine. If H3N2 viruses predominate this coming flu season, a vaccine mismatch could add to the severity of the season. But if those viruses play a smaller role this winter, the impact of a mismatch will be less significant, making it hard to predict if this choice is going to turn out to be a problem.
Flu circulation “remains difficult to predict and flu viruses are constantly breaking rules that we try to establish for them,” Hensley said, adding that flu vaccines “often protect against severe disease even when … mismatched.”
The selection of a new B/Victoria virus for the Southern Hemisphere 2020 shot also concerns Skowronski. There was almost no influenza B activity in the 2018-2019 flu season and it’s been several years since B/Victoria viruses have caused much illness. As a result, there may not be a lot of immunity to those viruses in the population, she said.
B/Victoria flu viruses are especially hard on children, Skowronski said.
Given the possibility that a couple of the components of the vaccine might not be well-matched to circulating flu viruses, Skowronski said it will be important for doctors to realize vaccinated patients may still contract influenza. For those who are at high risk of developing severe illness, rapid treatment with flu antiviral drugs should be considered.
She also suggested older people or people who have underlying health problems — in other words, those who are likely to develop a severe case of flu if they contract the virus — should take steps to avoid being around sick people.
The sliver of good news: The officials meeting at the WHO last week concluded that the H1N1 and the flu B/Yamagata components of the Southern Hemisphere vaccine didn’t need to change, suggesting they are representative of the strains of those viruses we’re likely to encounter this winter.
NORTON SHORES, Mich. — Bonnie Drier said a state investigation into her nurse practitioner, Susan Drust, caught her by surprise.
“To hear what they’re saying, I don’t understand it because she was forthright, and she was always there when I needed her,” Drier said.
Drust, who runs a clinic in Norton Shores, is accused of prescribing controlled substances to alcoholics, allegedly prescribing unsafe combinations of opioids and/or sedatives without documenting the risk or reason. The state claims she didn’t document any consideration of alternate treatments outside of opioids.
So the state suspended her license and clinic operations.
Drier said she thought, “Oh my God, what am I supposed to do?”
The Norton Shores resident said she’s depended on Drust to prescribe her fentanyl patches monthly and says the nurse practitioner has been instrumental in decreasing that dependency.
“Susan helped me back down from 50 micrograms to 12.5 micrograms, and she did me a huge justice by doing that,” Drier said.
She said it’s progress following a failed back surgery in 2013. Now she’s concerned the loss of rapport with her healthcare provider poses a risk in safely managing her pain.
“Now I have to start it all over with a pain clinic,” Drier said.
She added, “Will I be able to go back to her for my regular stuff — my non-opioid stuff, my regular stuff? I’m terrified of trying to have to ween myself off when it’s dangerous to begin with.”
FOX 17 called the clinic, again, which had no further comment. It’s important to note the license suspension is only temporary for Drust. The state still needs to determine if she violated public health code. That’ll happen at a later date.
So much for innocent until proven guilty…this sounds like the state board will now go back and “draw up opinions” to validate their allegations, find her guilty and revoke her license and close the case.
At this point there appears to be NO ALLEGATIONS OF A “DEAD BODY” because of her prescribing.
Generally, the OPINIONS of those trying to prove their allegations is pretty fungible. That is how WITCH HUNTS go !!!
I just wonder how many legit chronic pain pts will just be “thrown to the wolves ” with little/no concern of their health outcomes ?
