How Ibuprofen May Affect Your Heart

https://www.attn.com/stories/15721/how-ibuprofen-may-affect-your-heart?utm_source=facebooklife&utm_medium=fbpost&utm_campaign=internal

Ibuprofen and other non-steroidal anti-inflammatory (NSAID) drugs might be more dangerous than most people think, according to a new study that links these over-the-counter painkillers to heart problems.

Though drugs containing ibuprofen such as Advil are widely sold without a prescription in gas stations and grocery stores around the world — giving consumers the impression that they’re relatively safe — researchers at Copenhagen University Hospital determined that these drugs raise the risk of cardiac arrest by about 31 percent on average.

The researchers are calling for stricter regulation of NSAIDs, such as requiring a prescription to obtain these products, in order to ensure that patients are better informed about the health risks. The risk is greatest for individuals suffering from heart conditions like cardiovascular disease, they found.

Stocksy/Margaret Vincent – stocksy.com

“Allowing these drugs to be purchased without a prescription, and without any advice or restrictions, sends a message to the public that they must be safe,” Gunnar Gislason, a professor of cardiology who co-authored the study, said in a press release. “The findings are a stark reminder that NSAIDs are not harmless.”

Though past studies have arrived at similar conclusions about the cardiac risks of ibuprofen, this new research only looked at NSAID use among patients who were prescribed the drug. The ingredients are the same, but as one UK trade group representing over-the-counter drug makers told The Guardian, “[p]rescribed NSAIDs would normally contain a higher dosage than those medicines available over-the-counter and would typically be used for longer durations.”

For the study, which was published in the European Heart Journal on Wednesday, researchers looked at about 29,000 patients in Denmark who experienced heart attacks from 2001 and 2010. About 3,300 of those patients had taken an NSAID in the 30 days before the cardiac event, and the study compared that finding to each patient’s medical records from the preceding 30 days to evaluate the risk. Here’s what they found, according to the press release:

“Use of any NSAID was associated with a 31 percent increased risk of cardiac arrest. Diclofenac and ibuprofen were associated with a 50 percent and 31 percent increased risk, respectively. Naproxen, celecoxib and rofecoxib were not associated with the occurrence of cardiac arrest, probably due to a low number of events.”

Wikimedia – wikimedia.org

NSAIDs appear to raise the risk of cardiac arrest by causing platelets to build up, which can lead to blood clots. The study also indicated that these drugs make arteries constrict and increase blood pressure.

To avoid adverse cardiac effects of NSAID use, the researchers recommend taking no more than 1,200 milligrams of ibuprofen per day, and to limit use in general.

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If you or someone you know will need infusion therapy in the coming weeks, this Infusion Center locator resource can help identify an alternative site of care in a nearby community: https://locator.infusioncenter.org

About Rx Open

Open Pharmacies Map

This map is used to provide pharmacy status in a region when Healthcare Ready activates for a response (or is requested to activate the map by a local government). When active, you can search or zoom to find open pharmacies or Red Cross shelters in your area.

This map reflects the pharmacies enrolled in Rx Open. If you would like to enroll your pharmacy, please email Admin@healthcareready.org.

To make sure a pharmacy has your medication call before you visit.

County Overview

The overview map displays a high level view of how each county within an affected region’s pharmacies are impacted by an emergency. Click on a county to see a pharmacy status summary.

Click here for a downloadable Excel file which lists all of the pharmacies in the affected area, their address, and their operational status. (Choose download from the file menu on the page)

Is the status of your pharmacy incorrect? Please click here to send feedback, and include your NCPDP or NPI number.

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Antidepressant Use Among Persons Aged 12 and Over: United States, 2011–2014

https://www.cdc.gov/nchs/products/databriefs/db283.htm

Key findings

Data from the National Health and Nutrition Examination Survey

• During 2011–2014, 12.7% of persons aged 12 and over, 8.6% of males, and 16.5% of females took antidepressant medication in the past month.
• For both males and females, non-Hispanic white persons were more likely to take antidepressant medication compared with those of other race and Hispanic-origin groups.
• One-fourth of persons who took antidepressant medication had done so for 10 years or more.
• Antidepressant use increased from 1999 to 2014.

Antidepressants are one of the three most commonly used therapeutic drug classes in the United States (1). While the majority of antidepressants are taken to treat depression, antidepressants can also be taken to treat other conditions, like anxiety disorders. This Data Brief provides the most recent estimates of antidepressant use in the U.S. noninstitutionalized population, including prevalence of use by age, sex, race and Hispanic origin, and length of use. This report also describes trends in the prevalence of antidepressant use from 1999–2002 to 2011–2014.

 

Keywords: depression medication, prescription drugs, NHANES

 

In 2011–2014, 12.7% of persons aged 12 and over reported antidepressant medication use in the past month.

• Overall and in each age group, females were about twice as likely as males to take antidepressant medication (Figure 1).
• Overall, antidepressant use increased with age, from 3.4% among persons aged 12–19 to 19.1% among persons aged 60 and over. Increased use with age occurred among both males and females.

 

Figure 1. Percentage of persons aged 12 and over who took antidepressant medication in the past month, by age and sex: United States, 2011–2014

¹Statistically significant trend by age.
²Significantly lower than females in all age groups.
³Significantly lower than the older age groups.
⁴Each age group is significantly different from all other age groups.
NOTE: Access data table for Figure 1.
SOURCE: NCHS, National Health and Nutrition Examination Survey, 2011–2014.

 

During 2011–2014, non-Hispanic white persons were more likely to take antidepressant medication in the past month compared with other race and Hispanic groups.

• Among persons aged 12 and over, non-Hispanic white persons were five times more likely than non-Hispanic Asian persons to have taken antidepressant medication in the past month (16.5% compared with 3.3%) and three times more likely than Hispanic (5.0%) and non-Hispanic black (5.6%) persons (Figure 2).
• Females in every race and Hispanic-origin group were significantly more likely than males of the same race and Hispanic-origin group to have taken antidepressant medication.
• More non-Hispanic white females took antidepressants than females of any other race and Hispanic-origin group.

 

Figure 2. Percentage of persons aged 12 and over who took antidepressant medication in the past month, by sex and race and Hispanic origin: United States, 2011–2014

¹Significantly lower than all other race and Hispanic-origin groups.
²Significantly higher than all other race and Hispanic-origin groups.
³Significantly lower than females in each race and Hispanic-origin group.
⁴Significantly higher than non-Hispanic Asian females.
NOTE: Access data table for Figure 2.
SOURCE: NCHS, National Health and Nutrition Examination Survey, 2011–2014.

One-fourth of persons who took antidepressant medication in the past month had been doing so for 10 years or more.

• During 2011–2014, 68.0% of persons aged 12 and over who took antidepressant medication had been taking antidepressants for 2 years or more (Figure 3).
• During 2011–2014, 21.4% of males and 27.2% of females had been taking antidepressant medication for 10 years or more.
• There were no statistically significant differences between males and females in the length of antidepressant use.

 

Figure 3. Length of antidepressant use among persons aged 12 and over, by sex: United States, 2011–2014

NOTE: Access data table for Figure 3.
SOURCE: NCHS, National Health and Nutrition Examination Survey, 2011–2014.

 

Antidepressant use increased from 1999 to 2014.

• Antidepressant use in the past month increased overall, from 7.7% in 1999–2002 to 12.7% in 2011–2014 (Figure 4).
• The percentage increase in antidepressant use over time was similar among males and females.
• Females were approximately twice as likely as males to have taken antidepressant medication at all time points.

 

Figure 4. Trends in antidepressant use among persons aged 12 and over, by sex: United States, 1999–2014

¹Significant increasing trend.
²Significantly higher than males for all years.
NOTE: Access data table for Figure 4.
SOURCE: NCHS, National Health and Nutrition Examination Survey, 1999–2014.

 

Summary

During 2011–2014, about one in eight Americans aged 12 and over reported taking antidepressants in the previous month. Antidepressant use increased with age and was twice as common among females as males. Non-Hispanic white persons were more likely to take antidepressants than non-Hispanic black, Hispanic, and non-Hispanic Asian persons.

Long-term antidepressant use was common. One-fourth of all people who took antidepressants in the past month reported having taken them for 10 years or more.

Antidepressant use increased nearly 65% over a 15-year time frame, from 7.7% in 1999–2002 to 12.7% in 2011–2014. This increase was similar among males and females. At every time point, females were about twice as likely as males to report antidepressant use in the past month.

 

Definitions

Antidepressant medication: Prescription drugs were classified based on the three-level nested therapeutic classification scheme of Cerner Multum’s Lexicon (2). Antidepressants were identified using the second level of drug categorical codes, specifically code 249.

Length of use of antidepressants: Evaluated by asking participants how long they had been taking the medication. Among persons taking more than one antidepressant, the one they had taken the longest was included in the data shown in (Figure 3).

Prescription drug use: National Health and Nutrition Examination Survey (NHANES) participants were asked if they had taken any prescription drug in the past 30 days. Those who answered “yes” were asked to show the interviewer the medication containers of all prescription drugs. For each drug reported, the interviewer recorded the product’s complete name from the container.

 

Data source and methods

This report is based on the analysis of data from the 14,034 persons aged 12 and over who participated in the NHANES 2011–2014 household interview. Of these participants, 13,951 persons gave information on medication usage. Questions were administered in English and Spanish.

NHANES is a continuous survey conducted to assess the health and nutrition of the American people. The survey is designed to be nationally representative of the U.S. civilian noninstitutionalized population. Survey participants complete a household interview and visit a mobile examination center for a physical examination and private interview. The annual interview and examination sample includes approximately 5,000 persons of all ages.

For 2011–2012 and 2013–2014, non-Hispanic black, non-Hispanic Asian, and Hispanic persons were oversampled to obtain reliable estimates for these population subgroups. Specific race and Hispanic-origin estimates reflect persons reporting only one race. Those reporting “other” race or more than one race are included in all figures except (Figure 2), where they are not reported separately.

NHANES sample interview weights, which account for the differential probabilities of selection, nonresponse, and noncoverage were used for all analyses. Standard errors of the percentages were estimated using Taylor series linearization, a method that incorporates the sample design and weights.

Overall differences between groups were evaluated using the chi-square statistic. Where the chi-square test was significant, differences between subgroups were evaluated using the univariate t statistic. A test for linear trends was done to evaluate changes in the estimates by age in (Figure 1) and over time in (Figure 4). All significance tests were two-sided 0.05-level tests, with no adjustment for multiple comparisons. All comparisons reported are statistically significant at the 0.05 level unless otherwise indicated. Data analyses were performed using SAS version 9.4 (SAS Institute, Cary, N.C.) and SUDAAN version 11.0 (RTI International, Research Triangle Park, N.C.).

 

About the authors

Laura A. Pratt is with the National Center for Health Statistics (NCHS), Office of Analysis and Epidemiology. Debra J. Brody and Qiuping Gu are with the NCHS Division of Health and Nutrition Examination Surveys.

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‘It’s coming’: Kansas health professionals, leaders consider opioid crisis impact on state

http://cjonline.com/business/local/2017-08-29/it-s-coming-kansas-health-professionals-leaders-consider-opioid-crisis

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Harvey Strains Hospitals, Shuts Down Services

http://www.medscape.com/viewarticle/884995

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People are urging donations for Harvey relief efforts — just not to the Red Cross

https://www.washingtonpost.com/news/post-nation/wp/2017/08/28/people-are-urging-donations-for-harvey-relief-efforts-just-not-to-the-red-cross/?utm_term=.32a5f7eb1d7c

With many ways to help the tens of thousands of people estimated to be temporarily displaced by surging floodwaters brought by Harvey, some are asking people to donate — but to be choosy about where they spend the money.

As former president Barack Obama — as well as celebrities and local leaders — encourage donations to the American Red Cross, others on social media are telling donors to give elsewhere, criticizing the leading disaster-relief organization for its response to recent natural disasters, particularly the 2010 earthquake in Haiti.

That sentiment has been shared in the past — following investigations by NPR and ProPublica, which revealed how the Red Cross bungled its response in Haiti.

“It’s heartbreaking because I know how seriously the Red Cross takes its responsibility,” Red Cross spokeswoman Bristel Minsker told The Washington Post about the continued backlash.

Minsker said Monday that when people donate to the Red Cross, the humanitarian organization “absolutely honors the intent of their donations” and makes sure the donations are spent wisely to provide people in need with safe shelter, hot meals and health care.

[Here’s how you can help victims of the storm and flooding in Texas]

But not everyone agrees with that.

People were urging donors Monday to seek out churches and local organizations, saying, “Please don’t donate money to the Red Cross! Houston will never see it.”

“For the umpteenth time,” one person wrote, “don’t give red cross your money. Find grassroots efforts so people can actually get helped.”

“They don’t help and pocket majority of your money,” another said. “Very little if any goes to those that need it.”

“Any recs for where to donate to Harvey relief?” another person asked. “Red Cross is out but I don’t know which local charities are on the ground & doing good work.”

Over the weekend, Dan Gillmor, author and professor at Arizona State University’s Walter Cronkite School of Journalism, also advised people on Twitter not to give money to the organization.

The Red Cross said Sunday that it had set up 34 shelters in Texas, where the hurricane hit the Texas coast Friday, sending wind, rain and roaring floodwaters across parts of the state.

Minsker, the Red Cross spokeswoman in Austin, said some 6,000 people stayed in shelters on Sunday night and that the organization is prepared to house up to 30,000 estimated to be displaced by the storm because “many people aren’t going to have a home to go back to when the floodwaters subside.”

Asked how much money the Red Cross had raised so far for Harvey relief efforts, she said those figures are not yet available.

“The size of this disaster is so huge, we’ve been focused on providing immediate needs to people, especially shelters,” she said.

[Texans are trying to keep their heads above water as Harvey batters region]

Brad Kieserman, who is coordinating disaster relief efforts in Texas for the Red Cross, said the destruction is “overwhelming.”

“The situation feels, I think, as well managed as any situation like this could be,” he told NPR on Monday. “I mean, the very definition of catastrophe is when the very capability and capacity you need to respond has been destroyed or deeply affected by the thing you’re responding to, and that’s what’s happened here. Everyone who is involved in this response is coordinating and cooperating, but it is overwhelming.”

Kieserman said Harvey has turned Southeast Texas into “an inland lake the size of Lake Michigan,” and the greatest challenge right now is that workers can’t get around because of the floodwaters.

“This is, in my career, the most catastrophic event I have seen,” he said. “The hurricane came in. It brought all of these winds and storm surge and rain and now we’re going to deal with 50 inches of flooding, basically turning the entire southeast portion of the state into an inland lake. We’re going to deal with rivers out of their banks for weeks, massive destruction, structural damage to homes, and I think we’re going to have an incredible long-term housing challenge.”

[Haitians are desperate for help. But they don’t want it from the American Red Cross.]

As The Washington Post’s Peter Holley reported last year, a 2015 NPR and ProPublica investigation revealed that the Red Cross had only built six permanent homes in Haiti even though it had collected almost a half-billion dollars in donations. The year before, the news organizations published a report about Red Cross’s response to hurricanes Isaac and Sandy.

They reported:

After both storms, the charity’s problems left some victims in dire circumstances or vulnerable to harm, the organization’s internal assessments acknowledge. Handicapped victims “slept in their wheelchairs for days” because the charity had not secured proper cots. In one shelter, sex offenders were “all over including playing in children’s area” because Red Cross staff “didn’t know/follow procedures.”

According to interviews and documents, the Red Cross lacked basic supplies like food, blankets and batteries to distribute to victims in the days just after the storms. Sometimes, even when supplies were plentiful, they went to waste. In one case, the Red Cross had to throw out tens of thousands of meals because it couldn’t find the people who needed them.

The Red Cross marshaled an army of volunteers, but many were misdirected by the charity’s managers. Some were ordered to stay in Tampa long after it became clear that Isaac would bypass the city. After Sandy, volunteers wandered the streets of New York in search of stricken neighborhoods, lost because they had not been given GPS equipment to guide them.

The skepticism was shared again in 2016 as Hurricane Matthew hurtled toward Haiti.

American Red Cross President and chief executive Gail McGovern responded in a blog post on HuffPost at the time, acknowledging the “persistent myths circulating online” about the Red Cross response in Haiti.

“It creates the false impression that the only thing the American Red Cross did with $488M in donor money was to build six homes — when, in fact, we have funded 100 different humanitarian aid projects in Haiti,” she continued, adding: “It would be a shame if myths circulated online by people who want to help Haiti, actually end up hurting relief efforts.”

On Monday, Minsker, with the Red Cross, further criticized the claims, arguing that all the donations had either been spent or were committed to be spent there.

 

 

http://www.businessconnectworld.com/2017/06/07/donating-to-poor-makes-them-more-poor/

5 Reasons why donations to the poor may bring bad results!

 

 

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Houston TX area has a population of 2.3 million +

If one presumes that 30% of the population are chronic pain pts… abt 690,000 chronic pain pts in the Houston area

If one presumes that each get their pain meds in 30 days supplies

Presuming that most pharmacies will hold chronic pain pts to a 2 day early refills..  some won’t even allow ONE DAY EARLY…

Since Harvey has been pounding Houston since Friday…

That would suggest that potentially up to  abt 23,000 chronic pain pts will be running out of their pain medication EACH DAY.. and being thrown into cold turkey withdrawal…

AND NOW… TROPICAL STORM HARVEY is headed for New Orleans/Louisiana … to impact more pts.

Of course, probably a lot of healthcare providers are more concerned about their own personal issues caused by this natural disaster … after all … now.. it is every person for themselves…

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Former Cuyahoga County Jail inmate sues, says staff ignored severe withdrawal symptoms

http://www.cleveland.com/court-justice/index.ssf/2017/08/former_cuyahoga_county_jail_in_1.html

CLEVELAND, Ohio — A Cleveland man is suing Cuyahoga County, county jail staff and employees of The MetroHealth System for what he says was negligent care provided to him while he was in jail and suffering obviously painful symptoms of drug and alcohol withdrawal.

Adam Bartlett, 29, says in a lawsuit filed Monday that he told jail staff when being booked in September 2016 that he was abusing alcohol and opioids and was also prescribed and dependent on Xanax, an anti-anxiety medication.

He did not get his Xanax or any treatment for his addiction or the corresponding withdrawal, and his mental and physical condition deteriorated in the days after being booked, the lawsuit says.

(You can read the lawsuit here or at the bottom of this story.)

Court records show that Bartlett was in jail from Sept. 7, 2016 to Sept. 26, 2016 on a community control violation after pleading guilty to a drug charge.

Staff from the jail and MetroHealth, which provides medical services for inmates, did not properly rate and treat the symptoms as serious, even though he was at times catatonic, disoriented and hallucinating, the lawsuit says.

At one point, a jail guard found Bartlett lying on the floor next to his cell, though he was treated like an uncooperative inmate, and a physician’s assistant determined that Bartlett was faking.

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Study: Opioid Users Don’t See Overdose as Wakeup Call

Brush with death had little effect on subsequent use

https://www.medpagetoday.com/PublicHealthPolicy/by-the-numbers/67454

Turns out, even a close call with an overdose isn’t enough to deter opioid users.

As described in a JAMA research letter, Julie M. Donohue, PhD, of the University of Pittsburgh, and colleagues looked at five years of claims data for Medicaid-covered patients in Pennsylvania. They examined records of opioid use both before and after the overdose for 6,000 patients with continuous coverage. About a third of those patients had overdosed on heroin, while the rest overdosed on prescription drugs.

Both heroin and prescription overdosers saw a slight reduction in use, at least as measured by filled prescriptions. Filled opioid prescriptions fell from 43.2% before a heroin overdose to 39.7% afterward. Prescription overdosers, meanwhile, fell from 66.1% to 59.6%.

Along the same lines, rates of medication-assisted treatment such as buprenorphine or methadone similarly increased after an overdose, but not by much.

 

 

The slight changes in behavior represented a failed opportunity by the medical community, the authors wrote.

“Despite receiving medical attention for an overdose, these patients in Pennsylvania Medicaid continued to have persistently high prescription opioid use, with only slight increases in MAT engagement, signaling a relatively weak health system response to a life-threatening event,” they wrote.

Intervention has been shown to reduce overdose risk, and studies of commercially-insured patients found the potential intervention opportunities represented by overdoses are underutilized. The research letter found evidence of similar underutilization among Medicaid patients, who are three times as likely as their commercially-insured counterparts to have an overdose in the first place.

The authors acknowledged that the results may be specific to Pennsylvania, and that filled prescriptions were an imperfect measure of continued opioid use. Further, focusing on overdoses that required medical attention probably underestimated the number of overdoses and patients affected.

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