Whаt аrе varicose veins?

Thе circulatory ѕуѕtеm іѕ mаdе uр оf thе heart, veins, аnd arteries. Arteries carry oxygen-rich blood frоm thе heart tо nourish уоur tissues, whіlе veins hаvе one-way valves whісh channel oxygen-depleted blood bасk tоwаrd thе heart. If thеѕе valves аrе damaged, thе blood pools іn thе leg veins аnd leads tо feelings оf fatigue, heaviness, aching, burning, itching, cramping, restlessness, swelling аnd еvеn eczema аnd leg ulcers.

Whаt causes varicose veins?

Heredity causes mоѕt varicose veins. If оnе оf уоur parents hаѕ varicose veins, уоur risk оf having thеm іѕ аbоut 70%. Othеr predisposing factors include obesity, leg injury, multiple pregnancies аnd standing occupations, ѕuсh аѕ nurses, teachers, аnd barbers.

Arе varicose veins a threat tо mу health оr аrе thеу just cosmetic?

Varicose veins indicate thаt thе pressure іn thе veins оf thе legs іѕ tоо high (a condition called venous hypertension). Longstanding venous hypertension саn result іn damage tо thе deep leg veins аnd tо thе overlying skin. Impairment tо thе deep veins саn lead tо blood clots аnd ѕоmеtіmеѕ tо sudden death frоm pulmonary embolism. Blood clots аrе especially frequent іf уоu аrе confined оn a lоng plane оr car trip. Injury tо thе skin wіll result іn stasis dermatitis, pigment changes, thickened skin аnd possibly, leg ulcers wіth scarring. In addition, venous hypertension саn саuѕе pain, fatigue аnd swelling оf thе legs. Thе presence оf increasing numbers оf spider veins mау аlѕо suggest venous hypertension.

Cаn thеѕе veins develop іn оnе leg аnd nоt thе other? Mоѕt patients develop varicose veins іn bоth legs. Hоwеvеr, thе severity оf thе varicosities wіll differ. Sоmе mау require treatment, whіlе оthеrѕ mау оnlу require compression stocking therapy.

Arе аll varicose veins visible frоm thе outside?

Nо. Varicose veins mау bе deep еnоugh thаt thеу аrе nоt visible. A duplex ultrasound evaluation оf уоur legs іѕ thе best wау tо detect аll varicose veins. Thіѕ іѕ a painless, noninvasive test using sound waves tо detect thе size оf veins аnd direction оf blood flow.

Whаt аrе thе options fоr varicose vein treatment?

A new procedure called endovenous laser ablation, оr EVLA, hаѕ bееn available tо treat varicose veins fоr аbоut seven years. EVLA involves a nonsurgical laser procedure іn whісh thе laser fiber іѕ inserted іntо thе damaged vein аnd іt іѕ switched оn, permanently sealing thе vein shut. Thе blood thаt normally flowed thrоugh thаt vein іѕ redirected іntо normal veins whісh carry іt bасk tо thе heart. EVLA іѕ performed undеr local anesthesia whіlе уоu аrе awake аnd іѕ vеrу comfortable. Mоѕt people return tо work thе nеxt day. EVLA іѕ a safe аnd effective procedure thаt іѕ replacing thе older technique оf surgical vein stripping. Anоthеr wау tо treat varicose veins іѕ called foam sclerotherapy. Fоr thіѕ treatment, nо anesthesia іѕ required аnd a small butterfly needles іѕ used tо deliver аn FDA-approved sclerosant chemical tо thе veins. Thеу immediately shrink аnd аrе cleared bу thе body’s metabolism оvеr ѕеvеrаl weeks tо months. Thіѕ procedure іѕ relatively painless аnd іѕ vеrу safe. Vein stripping surgery іѕ nоt performed vеrу оftеn nowadays ѕіnсе thеѕе newer procedures аrе ѕо safe аnd effective.

Dо thеѕе treatments cure varicose veins? Aftеr аll diseased veins аrе treated, mоѕt people hаvе a remission оf symptoms, leg swelling improves аnd thе skin begins tо heal, including leg ulcers. Mаnу patients dо nоt hаvе problems аgаіn fоr years. Duе tо mаnу factors including heredity, hоwеvеr, ѕоmе people аrе predisposed tо future problems. Sіnсе thеrе іѕ nо wау tо prevent оthеr veins frоm bесоmіng damaged, varicose veins mау bе аn ongoing challenge fоr ѕоmе patients.

Wіll mу varicose vein treatment bе vеrу painful?

Thе degree оf pain thаt a patient experiences durіng vein treatments varies frоm patient tо patient. Thе survey wе conducted indicated thаt mоѕt patients thought thе procedure tо bе pain-free, whіlе a fеw reported experiencing a moderate degree оf pain. Thе аmоunt оf pain іѕ dependent оn ѕеvеrаl variables, ѕuсh аѕ age, sex, weight, аnd pain tolerance level.

Arе thеrе аnу ѕіdе effects оf thе treatments?

Aѕ wіth аnу invasive procedure, risks оf vein treatments include allergic reaction tо оnе оf thе medications, bleeding, postoperative pain, infection, blood clots оr nerve injury. If аnу оf thеѕе ѕіdе effects occur, thеу аrе usually temporary іf promptly treated.

Hоw lоng аftеr laser treatments wіll I bе able tо return tо mу normal routine?

Mоѕt patients return tо thеіr normal routine thе nеxt day, hоwеvеr, уоu ѕhоuld nоt resume aerobics, heavy exercise routines, running, sports оr travel fоr аt lеаѕt a month аftеr уоur laser treatment. It іѕ vеrу important tо walk аt lеаѕt thirty minutes еасh day аftеr thе procedure tо prevent blood clots frоm forming іn thе veins. Walking оn a treadmill іѕ fine. Extended plane оr car travel ѕhоuld bе postponed fоr a month аftеr thе procedure.

Does insurance cover thе procedures?

Yes. Thеѕе аrе medically necessary procedures. Wіthоut treatment, уоu mау bе аt risk fоr worsening symptoms оf pain, blood clots, аnd skin changes including leg ulcers.

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Leading pharmacy chains report multiple HIPAA violations

https://www.nuemd.com/news/2016/02/16/leading-pharmacy-chains-report-multiple-hipaa-violations

In recent years, the Department of Health and Human Services’ Office of Civil Rights has ramped up its efforts to enforce the privacy rule of the Health Insurance Portability and Accountability Act of 1996. The privacy rule concerns the protection of patient confidentiality, and enforcement of the rule by healthcare providers has come under increased scrutiny from the OCR due to the increased number of digital platforms, such as electronic health records, that make a privacy violation more likely. Penalties for violations of HIPAA usually include a substantial fine and mandatory retraining sessions. The OCR recently announced that 2016 will feature the debut of a new system of routine audits for major healthcare providers, a process that is set to begin early this year, according to Law360.  

Major pharmacy chains are significant HIPAA offenders
According to a recent article from Pharmacy Times, two of the nation’s leading pharmacy chains – CVS and Walgreens – have been at the center of multiple HIPAA violation complaints during a period spanning from 2011 to 2014. The data was accrued from a ProPublica investigation into federal records pertaining to HIPAA. The research revealed that CVS topped Walgreens with a reported 204 complaints – Walgreens was reported to the OCR 183 times during the period. Other pharmacy chains also made the top 10 list of offenders, with Walmart being reported 71 times and Rite Aid pharmacy receiving 48 complaints of misconduct.

As Pharmacy Times detailed, some of the most common reported infractions included pharmacy staff members speaking too loudly, compromising patient confidentiality, and giving medication to the wrong patients. 

A majority of the complaints involved minor breaches, involving just one individual, and subsequently the response from the OCR was cautionary in nature. In each case, the OCR responded by sending letters to the organizations, requesting that they review HIPAA mandates and enforce HIPAA compliance training for all staff. CVS responded to the investigation by asserting that as a company it takes patient confidentiality extremely seriously. Spokesman for CVS Mike DeAngelis was quoted by Pharmacy Times. 

“We are never complacent about privacy matters, and we constantly strive to address and reduce disclosure incidents by enhancing our training and safeguards. Whenever we discover that our privacy policies or procedures have not been properly followed, we take corrective action such as retraining the employees involved. Those who intentionally violate our privacy requirements and safeguards are subject to the termination of their employment,” he said.

Executives from Walgreens responded in a similar way, emphasizing that patient confidentiality remains a paramount concern for the company.

Is the OCR too lax?
Pharmacy Times detailed that since 2009, little, if any, action has been taken against large organizations with multiple complaints of HIPAA violations. The ProPublica investigation found that less than 30 incidences had seen a company pay out a financial penalty. This is because the OCR generally refuses to punish organizations for violations that include two patients or fewer. The multiple complaints that Walgreens and CVS received, however, will likely have some critics wondering if the OCR is too lax in its approach. Other commentators, however, might suggest that the numbers are relative and that a couple of hundred complaints in a three-year period for a large organization isn’t particularly significant.

Large hospitals pay out
In contrast to the mild response that CVS and Walgreens both received from the OCR, a number of large hospitals have recently been slapped with enormous financial penalties for more serious transgressions. A notable example is the $750,000 fine that University of Washington Medicine had to pay out in December 2015. According to the HHS, the organization was fined after a large patient security breach, which saw over 90,000 patient records compromised by malicious malware that was opened in an email by a nurse. The records contained highly sensitive information such as billing records and Social Security numbers.

It’s clear that the response from the OCR was far stricter, given the sheer number of patients who were impacted by the violation. In addition to the substantial financial penalty, UWM was required to implement a new plan of action to ensure that HIPAA violations will not occur in the future. 

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Sen. McCaskill seeks repeal of law that limited DEA amid opioids crisis

http://www.washingtontimes.com/news/2017/oct/16/mccaskill-seeks-repeal-law-limited-dea/

Red-state Democrats cried foul Monday over a 2016 law that made it harder for federal agents to freeze suspicious shipments of pain pills, saying Congress and the Obama administration goofed by approving what turned out to be an industry-friendly bill, rather than the stiff crackdown they’d wanted.

The law, which cleared both chambers of Congress with no real opposition, was intended to make sure legitimate pharmaceutical shipments weren’t stopped by federal investigators.

But the result was that it is now “virtually impossible” for the Drug Enforcement Administration to suspend orders of narcotics that could fall into the hands of corrupt doctors or illicit pharmacies, according to internal agency documents used in a Sunday report by The Washington Post and CBS’s “60 Minutes” program.

Now lawmakers who supported the bill last year say they were misled. One of them — Sen. Joe Manchin III, West Virginia Democrat — said the revelations should force President Trump to scuttle his nomination of Rep. Tom Marino to lead the White House’s drug policy office, after the Pennsylvania Republican championed the bill.

Mr. Trump responded by saying he will investigate the issue as he prepares for a major announcement next week to declare the opioids crisis a national emergency.

“We’re going to look into the report. We’re going to take it very seriously,” the president said in the White House Rose Garden.

Mr. Trump called Mr. Marino, an early backer of his campaign, a “good man,” though he added: “We’re going to be looking into Tom.”

Mr. Manchin, who must defend his seat next year, said he was “horrified” by the Post investigation, which described the bill as the “crowning achievement” of drug company lobbyists who teamed with select members of Congress to overcome early opposition from corners of the DEA.

Sen. Claire McCaskill, Missouri Democrat also facing reelection, said she will push to repeal the law.

“Media reports indicate that this law has significantly affected the government’s ability to crack down on opioid distributors that are failing to meet their obligations and endangering our communities,” said Ms. McCaskill, the top-ranking Democrat on the Homeland Security and Governmental Affairs Committee.

The opioids crisis is killing more people than car crashes do in some parts of the country, sparking a scramble in Washington to devise policies that expand treatment options and the use of overdose-reversing drugs, while stemming the flow of powerful opioids to U.S. communities.

Congress, though, has struggled to find a starring role in what is mostly a problem for local authorities.

One new law last year pushed for wider use of naloxone, medication that can combat an overdose.

But Congress also passed the Ensuring Patient Access and Effective Drug Enforcement Act, designed to make sure legitimate pain suffers got their treatment. The bill breezed through Congress without significant opposition, clearing the Senate by unanimous consent.

Language in the law says the DEA has to demonstrate that flagged drug shipments pose a “substantial likelihood of an immediate threat” of death, serious bodily harm or drug abuse before it issues an immediate suspension on distributors or manufacturers.

Previously, it could freeze shipments that appeared to pose an “imminent danger.”

Richard C. Ausness, a University of Kentucky law professor who tracks the opioids issue, said the Post investigation “proves once again that many politicians are unduly influenced by campaign contributions from lobbyists,” while some didn’t bother to pry into the details.

“My guess is that most members of Congress did not know what was in the bill, did not read it, and relied on party leader and others for their information,” he said. “Either that, or they just did not care what the bill would do to DEA enforcement if enacted.”

The Post said the Obama administration had initial concerns but didn’t pursue them because neither the Justice Department nor the DEA objected to the final text.

Some DEA officials told the newspaper they reluctantly relented to get the best result possible in the face of pressure from bill sponsors and industry players, though Sen. Orrin G. Hatch, a Utah Republican who helped craft the law last year, said the goal was to strike a balance between government enforcers and patients who rely on drug companies to manage their pain.

“Not one senator, a member of the House, opposed this bill. Do you know why? Because DEA, the very agency the bill impacts, the very agency that supposedly can no longer do its job because of this legislation, agreed to let it go forward,” Mr. Hatch said.

In 1914 a Democratic Controlled Congress passed the Harrison Narcotic Act  and signed into law by Pres Woodrow Wilson… this created the “black drug market”…  in 1917 our judicial system declared that opiate addiction was a CRIME and not a DISEASE and any doc found to be treating/maintaining a addict would be arrested and put into jail…

In 1970, a democratically controlled Congress passed the Controlled Substance Act which was signed into law by Pres Nixon.

Some claim that a function of socialism is for a bureaucracy to create a problem and then create another bureaucracy to address/solve the issues created by the first bureaucracy.

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Today my phone ran and on the other end was a woman with a “foreign accent”.

She stated that she worked for a MEDICARE PROVIDER and they had access to my Medicare Medical Records and that they understood that I suffered from BACK PAIN and that it was their job to help me get everything that I was entitled to under Medicare. What do you think the odds of some being on Medicare ( old/disabled) having some sort of back problem is ?

I asked the woman what was the name of the company — claimed to be SIMBLE Medical Co and they are located in FAIRFAX VIRGINIA, phone number on my phone displayed 800-503-5246. Phone number will not connect and could not find them on the web in Fairfax.

My first concern is that Medicare rules PROHIBITS any vendor to contact medicare pts unless the pt has first contacted them and/or the vendor has provided the pt some covered medicare services in the last SIX MONTHS.

Secondly, they claimed that they had access to my HIPAA protected Personal Health Information (PHI).. on file with Medicare.

I knew that it would be useless to call Medicare, after all the Feds/Medicare have been trying to stop fraud/abuse within Medicare for DECADES.

I called the AARP Fraud Watch Helpline 877-908-3360 and much to my surprise, I got to talk to a REAL LIVE PERSON… didn’t have to leave a VOICE MAIL… and according to this person… both Medicare and AARP are aware of this particular scam going on.  Of course, with these scam criminals are able to “spoof ” phone numbers that are displayed on phones…  Hard to track them down, and they could change their business name in a “heart beat”

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https://youtu.be/LiV3MSm40xU

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DEA responds to explosive “60 Minutes” report about opioid crisis

https://www.cbsnews.com/news/opioid-crisis-dea-responds-60-minutes-report/

WASHINGTON — Lawmakers and the Drug Enforcement Administration are facing tough questions following an explosive joint investigation by “60 Minutes” and The Washington Post that says Congress helped disarm the DEA. 

Drug overdose deaths in the United States have more than doubled over the past decade. The CDC says 188,000 people have died from opioid overdoses from 1999 to 2015. 

Joe Rannazzisi used to run the DEA’s diversion control. He told “60 Minutes” correspondent Bill Whitaker that the opioid crisis was aided in part by Congress, lobbyists and the drug distribution industry. 

The DEA says it has taken actions against far fewer opioid distributors under a new law. A Justice Department memo shows 65 doctors, pharmacies and drug companies received suspension orders in 2011. Only six of them have gotten them this year. 

The DEA has issued no suspension orders against a distributor for nearly two years. It says in a statement it will continue to “use all the tools at our disposal to combat this epidemic.” 

“During the past seven years, we have removed approximately 900 registrations annually, preventing reckless doctors and rogue businesses from making an already troubling problem worse,” the DEA said in a written statement. “Increasingly, our investigators initiated more than 10,000 cases and averaged more than 2,000 arrests per year.”   

CBS News’ Paula Reid reports the Justice Department, which overseas the DEA, does not dispute any of the “60 Minutes” reporting. It says the drug crisis is a top priority for the Trump administration. 

“One of the president’s and the attorney general’s highest priorities is ending the devastating and unacceptable drug crisis in America that saw 64,000 deaths in 2016, many of them caused by opioids,” Ian D. Prior, principal deputy director of public affairs at the Justice Department, said in a written statement. “From street dealers to corrupt doctors to the distributors that allow diversion of deadly pills, this administration is absolutely committed to reversing this disturbing and heartbreaking trend and will use every tool available to do so.”      

But as the “60 Minutes” report detailed, the DEA’s efforts may have been undermined by the so-called “revolving door” culture in Washington. 

At least 46 investigators, attorneys and supervisors from the DEA, including 32 directly from the division that regulates the drug industry, have been hired by the pharmaceutical industry since the scrutiny on distributors began.

Among them is Linden Barber, former associate chief council at the DEA. He’s now a senior vice president at Cardinal Health, one of the nation’s top drug distributors. 

Mike Gill, chief of staff for the former acting DEA administrator, was hired by one of the country’s largest healthcare law firms. 

And most recently, Jason Hadges, a senior DEA attorney overseeing enforcement, joined the pharmaceutical division of a high-powered D.C. law firm. 

CBS News reached out to former acting DEA administrator Chuck Rosenberg, who oversaw the agency from May 2015 until earlier this month when he stepped down. He said he has not seen the “60 Minutes” story and does not intend to do so. 

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Meet 60 Minutes’ DEA whistleblower

https://www.cbsnews.com/news/meet-60-minutes-dea-whistleblower/

“Joe Rannazzisi is not gonna give this fight up,” says Whitaker. “He’s like a dog with a bone. He’s going to pursue this until he gets some satisfaction.”

In the video player above, watch the full Overtime interview (produced by Will Croxton, Lisa Orlando, and Ann Silvio) or read the transcript below:

CREW: Speeding, We’re good, Let’s go…

BILL WHITAKER: Okay. Well, Joe, if you would first of all please state your name, so we have it at the top of your interview?

JOE RANNAZZISI: Okay. My name is Joseph Rannazzisi—

BILL WHITAKER: My story on 60 Minutes this week is about a former DEA agent who saw the opioid epidemic growing, and tried to stop it, and ran into a brick wall in the form of Congress.

JOE RANNAZZISI TO CONGRESS: 16,651 people in 2010 died of opiate overdose, ok? Opiate-associated overdose. This is not a game.

BILL WHITAKER: Are you the most high-level whistleblower to come out of the DEA?

JOE RANNAZZISI: As far as this? Yes. As far as pharmaceutical opioid abuse and the way we’ve handled it? Yeah, I’m pretty much the highest-level person that’s come out.

60 MINUTES OVERTIME: Joe Rannazzisi is in your story called one of the most important whistleblowers ever to be on 60 Minutes. What’s your sense of what drives him?

BILL WHITAKER: He is a no-nonsense principled man. He saw this crisis and wanted to stop it. What he zeroed in on was the distribution of the pills. So he started to put pressure on the distributors. And the distributors pushed back.

JOE RANNAZZISI: This is an industry that allowed millions and millions of drugs to go into bad pharmacies and doctors’ offices, that distributed them out to people who had no legitimate need for those drugs.

BILL WHITAKER: This story was like a continuation of the two previous stories we did on the opioid crisis. That one was personal.

[Excerpt from “The Heroin Epidemic“:
ANGIE PELFREY: We call this the “death wall.”
BILL WHITAKER: The death wall?
ANGIE PELFREY: Yes.
BILL WHITAKER: Why is that?
ANGIE PELFREY: Majority of the people on this wall have died of drug overdose.
BILL WHITAKER: I thought of those people we met and the people who died– all the time.
MAN: There’s 23 in there on the wall from my hometown.
BILL WHITAKER: Is it a small town?
MAN: Yeah.]

BILL WHITAKER: It seems that some investigators with the DEA were aware that these pills were getting out of the pharmacies and into the streets, and they tried to ring the alarm bells. But not only did no one pay attention to them, it seems that members of Congress took steps to try to limit the DEA’s abilities to stop this. And the result was a bill in Congress that actually ended up taking away the most potent tool that the DEA had to go after the distribution of so many drugs.

JOE RANNAZZISI: This bill is going to protect defendants that we have under investigation, that we are investigating. And it restricts or prevents us from filing immediate suspension orders to stop– to stop the hemorrhaging of drugs downstream.

CONGRESSMAN TOM MARINO: It is my understanding that Joe Rannazzisi, a senior DEA official, has publicly accused we sponsors of the bill of –quote supporting criminals –unquote. This offends me immensely.

BILL WHITAKER: You know you have a reputation. And even people who support you tell us that you can be a bit of a hothead. True?

JOE RANNAZZISI: Yeah, I do get angry. I get angry when people don’t do their jobs.  I get angry when people don’t do their jobs well.

BILL WHITAKER:  And this crisis that he saw happening in front of his eyes enraged him.

JOE RANNAZZISI: I– I– I’m guilty. I’m guilty of being passionate. I’m builty of b– guilty of being angry. But I think anybody else in that situation would’ve done the exact same thing.

BILL WHITAKER:  “People are dying.” He would say that to us over and over and over again. “People are dying.” So he was trying to figure out what he could do about it. And every time he ran into a roadblock, he got angrier and more forceful. And it depends on who ya talk to what his reputation is. If you talk to his investigators, the people who worked in the field for him, they love him. You talk to some people in Washington– at the DEA– his higher-ups at the DEA or at the Justice Department, certainly in Congress, they think he was too aggressive, to the point of being boorish.

JOE RANNAZZISI: What I needed was support. And it infuriated me that I was over there, trying to explain what my motives were or why I was going after these corporations. And when I went back to the office, and I sat down with my staff, I basically said, “You know, I just got questioned on why we’re doing– why we’re doing what we’re doing. This is– now this is war. We’re going after these people, and we’re not gonna stop.

BILL WHITAKER: He’s not the most diplomatic person you’ve ever come across.

60 MINUTES OVERTIME: No, but he makes a good whistleblower.

BILL WHITAKER: He makes a great whistleblower, and he’s got a reason to be upset.

JOE RANNAZZISI: It just hurts when somebody says, “Well, DEA should be doing more.” DEA was doing everything it could. DEA ran into a wall.

60 MINUTES OVERTIME: Do you think this investigation by 60 Minutes and The Washington Post will make waves?

BILL WHITAKER: I sure hope so. This is a terrible crisis. What I would hope would happen from this story is that Americans get angry. 

60 MINUTES OVERTIME: It doesn’t look like Joe Rannazzisi’s gonna let this go.

BILL WHITAKER: Joe Rannazzisi is not gonna give this fight up. He’s like a dog with a bone. He’s going to pursue this until he gets some satisfaction.

CONGRESSMAN TOM MARINO: You know before coming to Congress, I was a prosecutor and an United States Attorney.

BILL WHITAKER: Congressman Marino has been nominated to be the next drug czar. What was your reaction when you heard that?

JOE RANNAZZISI: Total disbelief. Total disbelief. He’s just not qualified to do that job. Besides the fact that he pushed through a bill that’s curtailing the ability of DEA to do their job, I don’t understand how you could look at a congressman who’s done all of this and then decide he would be a great drug czar– to basically set policy for the United States; drug policy for the United States.

BILL WHITAKER: We will soon have a hearing with Congressman Marino. I would think that this would be an issue that will be brought up in his hearings.

JOE RANNAZZISI: The bill was bad. Him being the drug czar is a lot worse.

Could this “whistle blower” just be unhappy that those in the medication distribution system “pooled money from their deep pockets” to beat the DEA at their own game.

He was obsessed that a claimed 200 million people died of opiate OD’s in TWO DECADES…  It takes Nicotine use/abuse on SIX MONTH to kill that many and Alcohol TWO YEARS .. and medical errors SIX to TWELVE MONTHS  to kill that many people.

Abortions kill that many in abt THREE MONTHS… the questions has to be asked… is abortion necessary because all too many people are “addicted to sex”…  and have no personal control over their “urges” ?

And those are just the LARGE NUMBERS of deaths caused by various substances or actions

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Report Finds ‘Rush to Judgment’ in Kratom Deaths

www.painnewsnetwork.org/stories/2017/10/13/report-finds-rush-to-judgement-in-kratom-deaths

A medical examiner listed Waldron’s cause of death as “intoxication by Mitragynine,” one of the active ingredients in kratom. The coroner who performed the autopsy on Dana blamed his death on a hemorrhagic pulmonary edema (blood in the lungs) caused by high levels of kratom.

“In both of these cited cases, the conclusions reported by the coroner and medical examiner citing ‘kratom overdose’ and ‘kratom intoxication’ appear to add to the long list of mistaken, inaccurate, and now discredited reports implicating kratom,” wrote Jane Babin, PhD, a molecular biologist and lawyer.

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10 actions the government should take to address the opioid crisis, according to 2 experts

https://www.beckershospitalreview.com/opioids/10-actions-the-government-should-take-to-address-the-opioid-crisis-according-to-2-experts.html

Former CDC director Tom Frieden, MD, and Andrew Kolodny, co-director of opioid policy research at the Heller School for Social Policy and Management at Brandeis University in Waltham, Mass., shared 10 actions the federal government should take to address America’s opioid overdose crisis in a paper published Thursday in JAMA.

The two “experts” open the paper by describing the nation’s ongoing opioid crisis as the worst drug addiction epidemic in the country’s history. Opioid deaths quadrupled between 1995 and 2010, according to the paper. By 2015, more than 33,000 people died of an opioid-related overdose in the U.S. More than 90 million people were issued an opioid prescription in 2015.

Here are the 10 steps Dr. Frieden and Dr. Kolodny laid out in the paper.

1. Improve surveillance of opioid addiction with real-time assessment of data, patterns and trends.

2. Improve quality and timeliness of response to opioid-related overdoses and fatalities by delivering better data to law enforcement and increasing funding for coroners and medical examiners.  

3. Promote cautious opioid prescribing for acute pain by pushing the Food and Drug Administration to change opioid labels to reflect the CDC acute pain prescribing recommendations, which suggest a three-day supply is ample for acute pain, but exceptions of seven-day prescriptions will sometimes be warranted.

4. Greatly restrict or completely eliminate opioid prescriptions for chronic pain.

5. Expand insurance coverage and access for nonopioid and nonpharmacological pain medications.

6. Coordinate efforts between legal and public health officials to stem the international influx of heroin and deadly synthetic opioids like fentanyl into the U.S.

7. Incentivize states to identify possible opioid addiction in patients early and provide them access to treatment for substance use.

8. Expand access to medication-assisted opioid addiction treatments.

9. Promote harm reduction measures like access to naloxone and clean needles.

10. Consider banning ultra-high-dose opioids from the marketplace.

“The opioid addiction epidemic has worsened over the course of a generation and will not end overnight,” the “experts” wrote. “Rapid implementation of the 10 steps outlined here could enable tracking and reduction of both new opioid addiction and fatal overdoses … the healthcare system has a responsibility to support actions … that could prevent addiction and save lives.”

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