Drug makers stand firm on TV ad for opioid-induced constipation

first_img Related: Ed Silverman Two drug makers are ignoring a demand from Vermont Governor Peter Shumlin to yank a television ad that he believes is a “shameful attempt” to exploit the opioid crisis.The dispute arose last week when Shumlin released an open letter to Daiichi Sankyo and AstraZeneca after they ran an ad during the Super Bowl. The ad promoted awareness of opioid-induced constipation, a condition that can occur when someone is taking opioid painkillers. Massachusetts drops funding for opioid prescribing program as crisis rages [email protected] He also noted that a one-minute Super Bowl ad cost a reported $10 million — or more precisely, $5 million for each 30-second spot — and wants the drug makers to, instead, divert some of their promotional dollars toward prevention and treatment programs.The ad, by the way, did not mention a particular medicine. But AstraZeneca and Daiichi Sankyo market Movantik, which was approved by the Food and Drug Administration in September 2014 to treat opioid-induced constipation. The ad, however, directs viewers to a web site about the condition, where consumers can click on a button that directs them to the Movantik web site.advertisement About the Author Reprints PharmalotDrug makers stand firm on TV ad for opioid-induced constipation “He’s way off base,” Richard Meyer, an industry consultant who writes The World of DTC Marketing blog, told us. “If he is so concerned about addiction, he needs to tighten the prescribing parameters and make it tougher for patients to become addicted.”But another marketing expert disagreed.“I suppose he, like many other state governors, is faced with increasing Medicaid costs and other expenditures related to opioid addiction,” said John Mack, who publishes Pharma Marketing News. “So, I don’t think he is the misguided one.” Tags drug adsopioidspolicySuper Bowlcenter_img Related: Vermont Governor Peter Shumlin wants a TV ad for opioid-induced constipation to be pulled, but two drug firms aren’t budging. Andy Duback/AP In the shadow of an opioid crisis, Super Bowl ad spotlights chronic pain patients By Ed Silverman Feb. 17, 2016 Reprints As far as Shumlin is concerned, the ad is “poorly timed,” given the “irrational exuberance” with which opioids are sometimes prescribed. “Now is the time to change that, not attempt to further normalize long-term opiate use by advertising a drug to help people take even more opiates during the most watched sporting event of the year,” he wrote the companies.advertisement @Pharmalot Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. So what will the drug makers do?A Daiichi Sankyo spokeswoman sent us a statement saying the drug maker acknowledges that opioid abuse is a “very serious public health” issue in the United States, but did not mention the possibility of pulling the ad. Instead, she wrote us that the company — along with AstraZeneca and five advocacy groups that also sponsored the ad — is “committed to raising awareness” about the condition.In a letter to Shumlin, AstraZeneca wrote that “we believe our message encourages a clinically important conversation about OIC between patients and their doctors, which may also facilitate a broader discussion about safe and appropriate opioid use. While these discussions are separate and distinct, both are important for patients and their families.”Their responses, however, did not mention pulling the ads or using advertising funds as Shumlin suggested.A spokesman for the governor wrote us that “the governor stands by his letter. At a time when the entire country is battling an opiate and heroin epidemic, the last thing we need is for drug companies to take advantage of that crisis to boost their bottom line.”Shumlin was not the only public official to take offense to the ad. As STAT previously reported, White House Chief of Staff Denis McDonough tweeted this to the companies after seeing the ad:“Next year, how about fewer ads that fuel opioid addiction and more on access to treatment?”One pharmaceutical marketer, however, believes that Shumlin is misguided, because the TV ad does not promote opioid use, but does attempt to address a legitimate condition.last_img read more

Hospital’s new opioid policy addresses gap highlighted by ex-addict’s harrowing odyssey

first_img I told my doctors my drug history. Yet they gave me opioids without counseling About the Authors Reprints The medical community has spent the past two decades focused on treating pain. Now we need to learn how to balance the sometimes competing needs of compassionate pain relief and addiction prevention, treatment, and recovery management.advertisement Hospitals seeing an influx of drug-dependent newborns Recently on STAT, Seth Mnookin shared a personal story of managing a painful episode of kidney stones from the perspective of someone in long-term recovery from a substance-use disorder. Throughout his medical journey at Massachusetts General Hospital, he was open and forthright with his caregivers about his history of addiction.Given the stigmatization of patients with substance-use disorder, that took courage. Mnookin’s frankness enabled his medical team to factor his history into treatment decisions. A troubling — though sadly not surprising — point he raised in his article was that with his history of addiction, he didn’t get adequate counseling about how to manage opioids for pain upon his discharge from the hospital. [email protected] Such patients and their health care providers are challenged to strike a fragile balance between undertreating pain and giving the patient opioids. Both of these pathways come with the risk of disease recurrence for someone with addiction. Negotiating this balance with a patient is essential. Yet it is not something most physicians have been trained to do. Pat Greenhouse/The Boston Globe Please enter a valid email address. Newsletters Sign up for Morning Rounds Your daily dose of news in health and medicine. @DrSarahWakeman By Sarah E. Wakeman and Eric M. Weil June 22, 2016 Reprints Privacy Policy Related: Related: Eric M. Weil Leave this field empty if you’re human: The national opioid epidemic continues to strain the health care system in many ways, and hospitals and physicians today are struggling to figure out the most effective ways to care for patients with addiction who come through their doors.At Massachusetts General Hospital, we have made addressing addiction the hospital’s top clinical priority. More than a year ago, we formed a multidisciplinary addiction consult team, one of only a handful of hospitals across the country to have such a resource. We integrated addiction treatment within our community health centers and other primary care practices. And we hired seven recovery coaches who have experienced firsthand the struggles of addiction and are there to support patients in the community on their path to recovery.In the emergency department, we have an addictions advanced practice nurse and social workers to help patients with substance-use disorders. We are also piloting a transitional clinic that provides short-term care for patients from the hospital and emergency department who need ongoing treatment but are not yet connected to outpatient and community services.For nearly a year, our opioid task force has worked to develop guidelines for the safe and compassionate treatment of pain in all care settings. These guidelines, which are being released Wednesday, provide strategies for prescribing opioids for both acute and chronic pain. Specific recommendations include:prescribing opioids only for severe pain not relieved by other treatments;screening patients to determine who might be at risk for problems with opioids;counseling patients on the potential risks of opioids, including addiction and overdose;regularly monitoring and reevaluating patients on long-term opioids for chronic pain;and, when appropriate, prescribing nasal naloxone for patients at increased risk of overdose.Once fully integrated into the MGH community, these guidelines will address the gap that Mnookin described in his narrative. First OpinionHospital’s new opioid policy addresses gap highlighted by ex-addict’s harrowing odyssey [email protected] Sarah E. Wakeman Addiction is a chronic, treatable disease, like diabetes and high blood pressure. Unlike most other chronic diseases, though, addiction comes with the burden of stigma. This stigma presents enormous problems.It can limit access to evidence-based care and may prevent those with addiction from feeling comfortable disclosing their history. Sharing that information is as vital and as relevant to getting good medical care as a patient revealing that she has heart disease or had surgery several years ago. Relapse to active substance use can happen at any point in the recovery process, even after years or decades of sobriety, and care providers should be aware and ready to support all patients in all steps of recovery.As we have seen firsthand in our work developing Massachusetts General Hospital’s new guidelines for using opioids, the situation becomes particularly complicated for individuals with a substance-use disorder, or in recovery from one, who experience an acute, painful medical episode like recovering from surgery.advertisement Health care providers have the responsibility of safely managing their patients’ pain while devising new and innovative ways to treat those suffering from substance-use disorders. Mnookin’s story highlights the need for greater screening and counseling, not just for patients with active addiction but also for those in recovery.The challenge has never been greater, and our commitment to it has never been stronger.Sarah E. Wakeman, MD, and Eric M. Weil, MD, are chairs of Massachusetts General Hospital’s Opioid Task Force. Tags addictionopioidssubstance abuselast_img read more

I’m going to #sciencemarch in Washington. Here’s why

first_imgUnder the Microscope About the Author Reprints I’m going to #sciencemarch in Washington. Here’s why Mike Reddy for STAT STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Tags educationimmigrationpolicyresearchWhite House What is it? [email protected] Sara Whitlockcenter_img When the March for Science happens, I’m going to be there. I’ll be marching on behalf of muzzled government scientists who can’t share their work. I’ll be marching against a president who has said alarming things about vaccines and climate change.But I’m also going to march on behalf of scientists who should be in the US, but won’t be, because of the executive order on immigration President Trump signed on Friday. I am appalled by his temporary ban on immigration from seven nations not only for humanitarian reasons, but also because I am concerned for my fellow scientists and the scientific enterprise. Log In | Learn More Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. GET STARTED What’s included? By Sara Whitlock Jan. 30, 2017 Reprintslast_img read more

Just don’t do it: Compression tights fail to curb runners’ muscle fatigue

first_imgThe result? The compression tights were a bust.They didn’t cut down on muscle fatigue or help runners keep up a fast pace for a longer stretch of time. (The researchers do say it’s possible the tights might help in ways that can’t be measured.) The results were presented Thursday at the American College of Sports Medicine’s annual meeting.advertisement Jetting off for a jog in snug-fitting compression tights won’t help a runner go farther or faster, according to a new study that’s not doing any favors for its sponsor, Nike.The sports gear giant — which offers compression tights in every color of the rainbow — funded the study, which was conducted by sports medicine researchers at Ohio State University. It was meant to test a long-standing theory that compression tights tamp down on muscle vibrations during exercise and, in turn, reduce fatigue.Researchers had 20 participants run on a treadmill for 30 minutes on two different days, sporting compression tights during one session and roomier running clothes in the other. The treadmill was equipped with sensors that could measure the force of each step hitting the ground and the force pushing the foot back up, and track how that changed over time. Researchers tested participants’ leg strength and jump height before and after each run to get an idea of how much wear and tear the workout exerted on their muscles.advertisement @meggophone Please enter a valid email address. By Megan Thielking June 1, 2017 Reprints Related: Privacy Policy Newsletters Sign up for Morning Rounds Your daily dose of news in health and medicine. HealthJust don’t do it: Compression tights fail to curb runners’ muscle fatigue It’s all good: Any exercise cuts risk of death, study finds center_img [email protected] Leave this field empty if you’re human: Compression tights are popular among runners, but don’t seem to actually help curb fatigue. APStock Megan Thielking About the Author Reprints It’s relatively rare to see an industry-sponsored study turn up negative results — and even more uncommon for those results to be published and trumpeted in a press release.Nutrition research, in particular, has been plagued by the problem of industry-sponsored studies turning up results favorable to industry.There was the study that hyped canola oil as a way to cut down on belly fat — sponsored by the Canola Council of Canada. The paper that claimed spaghetti could help people stay skinny — sponsored by the pasta professionals over at Barilla. And how about the research finding that chocolate can boost your attention span — sponsored by Hershey. The list goes on.Nutrition scientist Marion Nestle has looked at dozens of those industry-funded studies. Nearly all have reported results favorable to their sponsors, she said.Publication bias — the increased likelihood that a paper will be published if the results are positive — affects scientific studies across the board, but it seems to be a particularly thorny problem for industry-sponsored research.“Overall, the vast majority of studies that are published are ‘positive,’ but industry funded ones are even more likely to be positive,” said Lisa Bero, a health outcomes researcher who has studied the issue at the University of Sydney.But the Nike-sponsored research doesn’t fall into that bucket. The company seems to have stuck to its motto: Just do it. And then, just publish it. Even if the research runs the risk of harming sales. Tags nutritionresearchwellness News Editorlast_img read more

CDC officials were advised not to use terms like ‘evidence-based.’ The FDA chief uses them all the time

first_imgPolitics CDC officials were advised not to use terms like ‘evidence-based.’ The FDA chief uses them all the time Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. What is it? Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED Log In | Learn More What’s included? By Rebecca Robbins Dec. 20, 2017 Reprints STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. J. Scott Applewhite/AP A report that the Trump administration discouraged officials at the Centers for Disease Control and Prevention from using seven words — including “vulnerable” and “evidence-based” — in its budget submissions sparked outrage over the weekend in the scientific and public health community.It also got us wondering: How often — and in what context — do these words get used in other government agencies focused on health and science? GET STARTED Tags CongresspolicySTAT+White Houselast_img read more

Dr. Phil says he rescues people from addiction. Others say his show puts guests’ health at risk

first_imgSTAT + Boston Globe InvestigationDr. Phil says he rescues people from addiction. Others say his show puts guests’ health at risk Privacy Policy Martin Greenberg, director of professional affairs for Dr. Phil show Related: @evanmallen Leave this field empty if you’re human: Other treatment centers contacted by STAT and the Globe similarly said they are barred in most cases from providing the kind of medical supervision described by the show.Origins, which has treated scores of people who have appeared on “Dr. Phil,” provides a nurse to accompany a patient only on the airplane ride from Los Angeles to one of the company’s addiction treatment facilities in Texas or Florida, said chief executive Drew Rothermel.Thomason also said he talked to Herzog’s mother after the show, and she told him her son was sober when he arrived at the studio that day.Herzog’s mother, Shirley Herzog-Keeler, declined to comment but said the show helped her son get well. “I have nothing to say but good things” about the show, she said. “We were on the show to help Todd.”Herzog said the show gave him opportunities to enter treatment, which he is thankful for. He said he was recently contacted by a show producer and asked to write a letter thanking McGraw for his help, which he did.“I’m grateful in a lot of ways for the show. For getting me help in the nicest places in the country. That’s a gift right there,” he said. “There are some things about the show that I don’t like, and that I don’t think are real. … I should have been in the hospital, in that sense. There should not be liters of vodka in my dressing room.” LOS ANGELES — He had won “Survivor,” the reality TV test of grit and strength. But Todd Herzog was so drunk when he appeared on the “Dr. Phil” show in 2013 that he had to be carried onto the set and lifted into a chair.“I’ve never talked to a guest who was closer to death,” show host Phillip McGraw declared on camera.TV viewers, however, didn’t see the setup for this shocking scene. Herzog, who was battling alcoholism, told STAT and the Boston Globe that he was not intoxicated when he arrived at the Los Angeles studio. In his dressing room, he said, he found a bottle of Smirnoff vodka. He drank all of it. Then someone handed him a Xanax, he said, telling him it would “calm his nerves.”advertisement Todd Herzog appears on the “Dr. Phil” show in 2013. Photo illustration: STAT, Screen capture: via YouTube Newsletters Sign up for Daily Recap A roundup of STAT’s top stories of the day. Leave this field empty if you’re human: The “Dr. Phil” show said staff members have no right to detain guests or direct or restrict their behavior, and may not even know they are in danger of withdrawal or overdose.“Addicts are notorious for lying, deflecting and trivializing. But, if they are at risk when they arrive, then they were at risk before they arrived,” Greenberg said in the statement. “The only change is they are one step closer to getting help, typically help they could not have even come close to affording.”The show’s addiction segments aren’t just compelling TV and good for driving huge ratings: They also serve to boost related businesses. Treatment center operators are being offered valuable endorsements in exchange for buying a new virtual reality product that features “Dr. Phil” offering tips and coping skills to people in treatment.Centers that buy “Dr. Phil’s Path to Recovery” have been promoted on the “Dr. Phil” show as well as a second program called “The Doctors” that is owned by the production company founded by McGraw and his son, Jay.Many guests are sent to Origins Behavioral HealthCare, a company so closely associated with the show that some in the field refer to it as the company that Dr. Phil built. So intertwined are the two that Origins, in a Florida licensing report, bragged that the company has “a reputation that even Dr. Phil recognizes.”Origins, which was founded in 2009, lists McGraw’s graduate school mentor, Frank Lawlis, as a member of its executive team. Lawlis has been a key adviser to the “Dr. Phil” show since its inception. His biography on the Origins website indicates Lawlis “consults with Dr. Phil about potential guests, and oversees resources for the guests as they leave the show.”The show said, through Greenberg, that Origins is one of many treatment centers used as a resource and that the show doesn’t consider Lawlis’ role with Origins a conflict of interest. Greenberg said “no money changes hands” between the show and Origins. “It’s a callous and inexcusable exploitation.” “We cannot control what we cannot control.” Newsletters Sign up for Weekend Reads Our top picks for great reads, delivered to your inbox each weekend. Family members of two other show guests said that they had no medical support and, in one guest’s case, that staff members allegedly helped her get drugs.Marianne Smith’s niece, Jordan, appeared on the show in 2012, in an episode called “Young, Reckless, and Enabled.”  Smith said she contacted the show to help her niece break her heroin addiction. Smith said that when she, Jordan, and Jordan’s mother arrived in Los Angeles from out of state, Jordan began going through withdrawal. Smith said she and Jordan’s mother were concerned for her well-being, and told a show producer she needed heroin.“They told us where to go, Skid Row,” Smith said. “I was so scared.”The producer also told them not to say who suggested the trip, Smith said. She did not remember the name of the producer.One reason Smith said she and her sister were so panicked about Jordan’s situation is they had no medical assistance for her. “We never had anyone,” she said. “It was just the three of us girls the entire time.” She said the three were in L.A. for two nights before appearing on the show.When asked about the experience described by Smith, Greenberg issued a denial: “We could go on and talk about Jordan L. or ten others,” he said. “Same reality. All had medical supervision.”Joelle King-Parrish brought her 28-year-old daughter Kaitlin from Lansing, Mich., to the “Dr. Phil” show in October of last year for help with her heroin addiction. Kaitlin was six months pregnant, and King-Parrish said she assumed that when they touched down, there would be some kind of medical supervision — if Kaitlin went into withdrawal, it could endanger the life of her unborn baby.But they were alone when Kaitlin began to detox. King-Parrish, who is a registered nurse, said staff members told her to “take care of it.” So she took her daughter to the hospital. A Dr. Phil staffer accompanies Kaitlin and Joelle to Skid RowVolume 90%Press shift question mark to access a list of keyboard shortcutsKeyboard ShortcutsEnabledDisabledPlay/PauseSPACEIncrease Volume↑Decrease Volume↓Seek Forward→Seek Backward←Captions On/OffcFullscreen/Exit FullscreenfMute/UnmutemSeek %0-9 facebook twitter Email Linkhttps://www.statnews.com/2017/12/28/dr-phil-guests-say-show-risks-health-of-some-addicts/?jwsource=clCopied EmbedCopiedLive00:0002:1102:11  Kaitlin’s mother, Joelle, says in an interview from Lansing, Mich., that before the taping they traveled to Skid Row with a show staffer to buy heroin. Matthew Orr/STAT After four hours, Kaitlin left without receiving treatment. The producer texted to say she should stay at the hospital. But Kaitlin would not, and King-Parrish was terrified the baby would die if her daughter did not get medicine or drugs.King-Parrish and Kaitlin went to the “Dr. Phil” studio, where another show staffer joined them. All three got into a cab headed for Skid Row.The staffer shot video, which later aired on the show. In it, King-Parrish tells the camera, “I am scared to death right now.” The camera follows Kaitlin from behind as she walks towards homeless encampments. King-Parrish said Kaitlin was gone for about a half-hour while she shot up heroin.The trip made for riveting television. Experts say it could have harmed Kaitlin or her baby.“That is incredibly deadly. You never know what you’re getting in a single dose,” said Boyle, adding that Kaitlin should have been under medical care the moment she landed in L.A.Greenberg said that show officials agreed to do Kaitlin’s story only if “her mother agreed to be 100% responsible for managing her daughter’s health and possible withdrawal.” The show’s motivation for doing the story, Greenberg said, was to get Kaitlin’s unborn child out of danger.The staffer that filmed the Skid Row trip, Greenberg said, “simply documented the natural behavior she observed, which would have occurred whether she was there or not.”King-Parrish attempts to call her daughter Kaitlin. She was not able to reach her. Matthew Orr/STATThe statement said it was unfair to highlight the experiences of a few guests out of thousands who have appeared on the “Dr. Phil” show.“Few people contact us just to let us know how well things are going,” the show stated. “The fact you can ‘cherry pick’ three, or thirty, or three hundred guests for that matter, who seek to blame others for their plight or struggle in life, is not the least bit surprising.”One guest who credits the “Dr. Phil” show with saving her life is Niki Dietrich, who was eight months pregnant and addicted to heroin when she appeared on an episode last year. She said she was living in an abandoned house with her boyfriend, and prostituting herself for money to buy drugs.She was sent to an Origins facility after her appearance, and is now sober. The 28-year-old said she is working at a treatment facility and trying to get custody of her daughter.“That was like a miracle,” Dietrich said of her appearance. “They hooked it up, for sure. The ‘Dr. Phil’ show, I have nothing bad to say about that experience.”Even after intensive treatment for opioid and alcohol addiction, relapse is common. But the show does not track the success or failure rate of guests for whom it arranges treatment.“Why, why, why on earth would they?” Greenberg said, adding that the show is not the organization providing treatment.After his first appearance, Herzog went for treatment but then resumed drinking. When he returned to the show for a third time, in 2014, he found vodka placed in his dressing room again, he said, but this time he was wary of becoming incoherent. He drank some but not all of the bottle. The show denied that vodka was left in Herzog’s room.Herzog’s last appearance was late last year, and this time, he said, he initiated it. He said the first three times, he felt coerced into appearing. The last time, he wanted the free treatment that guests are offered by centers appearing on the show.“I know this time … I wanted help, I wanted to get sober, because I was dying,” the now-32-year-old Herzog said in an interview. This appearance, he was with a handler who supervised him closely before taping, giving him a shot of alcohol to hold off seizures, Herzog said. He has no memory of what happened on stage.He knows from watching the show that he was brought out in a wheelchair, then suffered some sort of medical distress.As staff members rushed to help him, a camera followed him off the set. Dr. Phil makes a house callVolume 90%Press shift question mark to access a list of keyboard shortcutsKeyboard ShortcutsEnabledDisabledPlay/PauseSPACEIncrease Volume↑Decrease Volume↓Seek Forward→Seek Backward←Captions On/OffcFullscreen/Exit FullscreenfMute/UnmutemSeek %0-9 facebook twitter Email Linkhttps://www.statnews.com/2017/12/28/dr-phil-guests-say-show-risks-health-of-some-addicts/?jwsource=clCopied EmbedCopiedLive00:0002:2302:23  After Todd Herzog relapses, Dr. Phil visits his home and convinces him to return for another taping. Matthew Orr/STAT Herzog said this week that he is sober. He works at a restaurant in Utah; he’s reconnected with friends and family; and he’s dating someone.“I’m so much happier now. I mean, so much happier,” he said. “I’m living again.”Jordan also went to treatment after her appearance, but she didn’t get well, her aunt said.“It was a complete bust,” Smith said of the “Dr. Phil” show. “Didn’t help at all. Just ratings for him. People are going to him, like us, with serious, life-threatening problems looking for help. It just doesn’t happen.“McGraw promised Kaitlin “the best help, in my opinion, in the United States,” and, on stage, guaranteed that she would be in treatment until her baby was born. Kaitlin left against medical advice after 15 days. Her baby was born addicted in January, King-Parrish said, and went into foster care.“The treatment facility is not a locked ward, and she is a hard-core heroin addict. That’s what they do,” Greenberg said in his statement. “We deal with people in the real world.”The show had the family back, after King-Parrish wrote them a letter saying she believed their appearance had been “for ratings and not help.” Kaitlin was sent to treatment a second time but kicked out for noncompliance, King-Parrish said.Today, Kaitlin is homeless and she was recently admitted to the hospital with liver failure, her mother said. Kaitlin did not respond to requests for comment.“Poor, middle class, high class. Rich. It doesn’t matter. Heroin will take it and kill you. And that’s what I have to make myself know, that that’s probably going to be Kaitlin’s end,” King-Parrish said.She has resigned herself to what she fears is coming. [email protected] center_img The show, through Greenberg and a lawyer, offered a series of shifting explanations over two weeks regarding the medical oversight of guests when they come out to L.A.In the interview, Greenberg said the show was not a medical facility, and did not have a responsibility to monitor guests.“No, of course not, it’s a television show,” he said.After STAT and the Globe sent detailed questions about Herzog’s case and others, however, the show, in a lengthy response signed by Greenberg, said guests with substance abuse problems are medically supervised “100% of the time.” The show said that any time a guest is likely to need inpatient rehabilitation, medical personnel from a treatment center are flown to L.A. “to supervise and manage any medical needs.”Herzog, the response said, was “medically supervised the entire time he was involved with tapings of ‘Dr. Phil.’” The supervision, according to the show, included a nurse-practitioner flying with him to L.A., a nurse sitting up with him during the night, and a medical professional from a treatment center who “happened to be in LA at the time.” The show declined to name any medical personnel.Then this week, Greenberg, through the lawyer, responded to follow-up questions by qualifying his earlier statements about medical supervision: “We mean 100% of guests agreeing to treatment. It does not mean that a guest is being monitored 100% of the time,” he wrote. He noted that “substance abusers adopt very clever means” to obtain alcohol or drugs, and “we cannot control what we cannot control.”The director of the treatment center where Herzog agreed to go for help at the conclusion of the show said no one from that facility monitored Herzog while he was involved in the taping of the show.“I was watching them walk him out severely intoxicated,” said Steve Thomason, who was then the executive director of The Arbor in Georgetown, Texas. “That was the first time I ever laid eyes on him.”Thomason said he and his medical staff couldn’t offer medical supervision in California because they are licensed in Texas, and the person being monitored must first give consent to treatment and be on the premises of the treatment facility.He said he was so upset by the condition of Herzog on the “Dr. Phil” show and the manner in which the show was conducted that he never had anything to do with it again.“I honestly regret having ever done it,” Thomason said. America’s best-known television doctor presents himself as a crusader for recovery who rescues people from their addictions — and even death. But in its pursuit of ratings, the “Dr. Phil” show has put at risk the health of some of those guests it purports to help, according to people who have been on the show and addiction experts. Guests have been left without medical help as they face withdrawal from drugs, a STAT/Boston Globe investigation has found, and one person said she was directed by a show staff member to an open-air drug market to find heroin for her detoxing niece.While McGraw has been buffeted by controversy and lawsuits since he broke out as a celebrity on “The Oprah Winfrey Show” two decades ago, the show’s handling of guests seeking treatment for substance abuse disorders has largely escaped scrutiny.McGraw declined an interview request through a “Dr. Phil” show representative. Martin Greenberg, a psychologist who serves as the show’s director of professional affairs, said guests have never been provided alcohol or directed to where to buy drugs.advertisement Please enter a valid email address. On television, McGraw, 67, plays the role of a tough-love, no-nonsense adviser with a southern twang and a dogged determination to help his guests. He promises to “haunt them to the ends of the earth” once he gets involved in their lives. Segments where guests resist his advice often feature harangues from McGraw, prodded by cheering from his studio audience.Many of his guests view “Dr. Phil” as a savior. Parents come to him begging for help saving their children’s lives. For many treatment centers, his endorsement brings patients and legitimacy; they offer guests free care in return for the show’s promotion. For viewers, McGraw offers hope. Some pepper the show’s Facebook page with their own requests for help, leaving sad stories and phone numbers where they can be reached.The show seeks to “educate, inform, inspire and entertain our viewers,” Greenberg said. He said hundreds have emailed the show “thanking us for helping them face or address an issue that either they, or a family member might be struggling with.” The American Psychological Association presented McGraw its presidential citation in 2006, saying his “work has touched more Americans than any other living psychologist.”The show has also made him wealthy: McGraw, according to Forbes, is the highest-paid daytime TV personality, earning $79 million last year.Phillip McGraw on “The Tonight Show with Jay Leno” in 2002, the year he started “Dr. Phil.” Kevin Winter/Getty ImagesMcGraw holds a doctorate in psychology, but has not been a licensed psychologist since 2006, when he let his Texas license expire. He became “Dr. Phil” after he worked with Oprah as a consultant when she was unsuccessfully sued by cattle ranchers in Texas for bad-mouthing the beef industry. He started appearing on her show, and then, in 2002, launched his own.His show has been a subject of unsuccessful lawsuits by guests, and his forays into the lives of celebrities Britney Spears and Shelley Duvall have sparked outcries because of concerns they were exploited.Some of McGraw’s own employees have raised alarms about the treatment of guests. In one lawsuit filed last year against McGraw and his production company in Los Angeles Superior Court, a former segment director, Leah Rothman, accused McGraw of false imprisonment for trapping employees in a room to threaten them over leaks to the media. Rothman also alleged that guests complained that their lives were “ruined.” One guest attempted suicide after the show, according to a deposition with another staff member.McGraw denied the allegations.  Rothman’s attorney said the case was settled and dismissed in September. A representative of McGraw said Rothman was a “disgruntled” employee, and noted that McGraw’s production company is currently suing her in federal court. Rothman’s attorney, however, said she was a hard-working and long-time employee who is “vigorously defending herself” in the federal case.“Plaintiff’s experience with Dr. Phil was that his primary interest was not about helping people on the show, but rather, done for the sake of ratings and making money,” says Rothman’s suit. “Dr. Phil often embarrassed guests on his show in their darkest hour, leaving the staff to pick up the pieces of the broken people who had put their trust in Dr. Phil.”Herzog, pictured in Salt Lake City, says he is now sober and has reconnected with friends and family. Matthew Orr/STATWhen camera crews arrived unannounced at Todd Herzog’s apartment in Utah in 2013, he had no idea what was happening. The footage that later aired on “Dr. Phil” shows him sitting bewildered and barefoot on his couch, surrounded by his family and a two-person intervention team dispatched by the show after it was contacted by his family.“What … is this?” he asked, his speech slurred and halting. “Can someone please tell me?”Herzog’s hands were shaking and he said he was afraid he was going to die. One of the interventionists explained that Dr. Phil wanted to meet with him. Herzog was a flight attendant when he won “Survivor” at age 22 – and its $1 million prize. But his life spiraled downward after that, and he said, his alcoholism intensified while dating someone who was a heavy drinker.After the show flew him to L.A. and put him up in a hotel, Herzog said he detoxed in his room over about two days. In a recent interview in Salt Lake City, he said he was sober when he walked into his dressing room on the set, and intoxicated on vodka and Xanax when he emerged. Herzog’s father, Glen, confirmed in an interview that his son was sober when he arrived at the studio to tape the show.“Today, I had an entire bottle, like a liter, of vodka,” Todd Herzog told McGraw on stage. When Dr. Phil breathalyzed him in front of the studio audience, Herzog blew a .263 — more than three times the legal limit to drive.“You know, I get that it’s a television show and that they want to show the pain that I’m in,” Herzog said in the interview. “However, what would have happened if I died there? You know, that’s horrifying.”The combination of alcohol and Xanax can be deadly, said Dr. Maureen Boyle, the chief scientific officer for the Addiction Policy Forum, an advocacy organization for patients and families. No one should detox from serious alcohol addiction without medical supervision, she said, as withdrawal can cause seizures.“The important thing here, this isn’t a TV drama,” she said. “This is someone’s life.” Dope Sick: A harrowing story of best friends, addiction — and a stealth killer Jeff Sugar, assistant professor of clinical psychiatry, University of Southern California Evan Allen — Boston Globe Privacy Policy About the Authors Reprints Please enter a valid email address. Tags addictionopioids By David Armstrong and Evan Allen — Boston Globe Dec. 28, 2017 Reprints In a statement, he denied Herzog was left alone with a bottle of vodka in his dressing room, or given Xanax. “We do not do that with this guest or any other,” he wrote. He called the allegations “absolutely, unequivocally untrue.” Vodka and Xanax in the green roomVolume 90%Press shift question mark to access a list of keyboard shortcutsKeyboard ShortcutsEnabledDisabledPlay/PauseSPACEIncrease Volume↑Decrease Volume↓Seek Forward→Seek Backward←Captions On/OffcFullscreen/Exit FullscreenfMute/UnmutemSeek %0-9 facebook twitter Email Linkhttps://www.statnews.com/2017/12/28/dr-phil-guests-say-show-risks-health-of-some-addicts/?jwsource=clCopied EmbedCopiedLive00:0002:3802:38  Todd Herzog, interviewed in Salt Lake City, says before taping the show, he was provided vodka and a Xanax, a potentially deadly combination. Matthew Orr/STAT “Dr. McGraw has a very strong sense of trying to not exploit people,” Greenberg said in an earlier interview. “Now it is a television show. These people volunteer to come on. They beg to come on. And he tries to treat them with respect … and to give them the opportunity to get help if they want to do that. It’s not a complicated formula.”But in interviews, show guests and their families described a different reality.Guests confront a painful and potentially dangerous detox as they wait up to 48 hours in hotel rooms for their scheduled taping, leading some to look for illegal drugs. One guest bought heroin with the knowledge and support of show staff, according to a family member. Another guest, who was pregnant, was filmed by a show staffer while searching for a dealer on Skid Row in L.A.“It’s a callous and inexcusable exploitation,” said Dr. Jeff Sugar, assistant professor of clinical psychiatry at the University of Southern California. “These people are barely hanging on. It’s like if one of them was drowning and approaching a lifeboat, and instead of throwing them an inflatable doughnut, you throw them an anchor.”last_img read more

Affirmative action doesn’t hurt white medical school applicants

first_imgFirst OpinionAffirmative action doesn’t hurt white medical school applicants About the Author Reprints Adobe [email protected] The assumption that minority applicants are “stealing seats” in medical schools bothered me. So I put it to the test. Using publicly available data from the Association of American Medical Colleges (AAMC), I compared the odds of getting into medical school between 2013 and 2016 for white applicants and black applicants with the same MCAT scores and GPAs. (At the time, the top score on the MCAT was 45. The scoring system has since changed, and the top score is now 528.) Some of those who contend that affirmative action is what kept them out of medical school argue that some low-scoring black applicants are in the med school seats they should have gotten. I did the math to see how likely that is.Figure 4 shows that it’s far more likely a white applicant “stole a spot” than a black applicant. For a white applicant with a 31 MCAT score and a 3.7 GPA, for every black applicant who scored lower and was accepted there are, on average, 4.11 white students who also scored lower and were accepted.It’s only low-scoring white applicants (less than a 26 on the MCAT and a GPA less than 3.2) who are more likely to have “their” seats offered to black students than to white students. Yet at that end of the statistical spectrum, the chance of getting into medical school is less than 5 percent for both whites and blacks. But look at the average number of low-scoring black students accepted each year (132) and the total number of white applicants accepted each year (26,420). The chance that a low-scoring white medical school applicant will “lose” a spot to a low-scoring black applicant is 0.5 percent. How unlikely is that? It’s even less likely as the applicant dying in a car accident.White applicants with low scores should realize that their MCAT scores and GPAs are holding them back far more than their black colleagues.These analyses didn’t surprise me. When I interviewed at 11 medical schools last year, I saw no more than 10 black applicants among the 100-plus applicants I met. How could such a small group — blacks make up 9 percent of medical school applicants — be usurping so many white applicants medical school seats? The answer is that they aren’t.My message to those who whine that minority students took their spots in medical school: Think about the five other white applicants who got in with the same statistics as each minority student. Then notice the amazing minority students who did cutting-edge research and incredible volunteer work just like you. Notice the obstacles that many of them have faced every day because of the color of their skin yet have excelled as students and as people in and out of the classroom. Think about how many more amazing doctors we could have if we had equality of opportunity earlier in the educational system.Increasing the number of blacks and other minority students in medical schools can change the trajectory of the medical field for the better. And it isn’t costing white applicants a thing.Spencer Dunleavy is a Rhodes Scholar at the University of Oxford. He will begin medical school at the Columbia University College of Physicians and Surgeons in the fall of 2019. Newsletters Sign up for First Opinion A weekly digest of our opinion column, with insight from industry experts. Related: With role models, can minority students change medicine’s racial imbalance? Please enter a valid email address. As shown in Figure 1, at nearly every comparison, black applicants were, on average, preferentially admitted to medical school over their academically similar white peers. For example, a black applicant with an MCAT score of 31 (the median for all individuals accepted to medical school) and a GPA of 3.7 (the median for all individuals accepted to medical school) had, on average, a 30.7 percent higher chance of getting into medical school than a white applicant with a similar MCAT score and GPA.I can almost hear the anti-affirmative-action readers saying, “I told you so. Why should we be giving such a massive boost to black applicants?”In addition to righting the decades-long structural and historical factors that have limited opportunities for black students to enroll in medical school, there are many benefits to having diversity in the medical profession. A diverse physician population encourages innovation, promotes cultural competence to reduce health disparities, and shows minority youths that there are places for them in science and medicine. And physicians of color help society at large, not just minority communities.But convincing readers that affirmative action is important and necessary isn’t my goal. I want to demonstrate how little affirmative action hurts white applicants, how few medical school spots black applicants get, and who is most likely to lose a spot to a black applicant with lower scores.To start, realize that today there are only about seven black medical students in a class of 100. Affirmative action opponents somehow seem to think those seven take more spots from qualified white applicants than the other 93 white applicants do.center_img I compared only white and black applicants because underrepresentation in medicine is most clearly defined for these two groups. However, it is likely that the results would also apply to other underrepresented minorities.advertisement Spencer Dunleavy By Spencer Dunleavy Jan. 9, 2018 Reprints Privacy Policy Related: Experts discuss how to improve diversity in medicine Six in 10 medical school applicants end up with nothing more than a pile of rejection letters after pouring their hearts and souls into studying, volunteering, researching, and more. A few understand that their quest was a long shot. Many others start looking for reasons why they didn’t get in. Was it low test scores? Not enough volunteer time? Or was affirmative action the culprit?Lively — and often bitter — threads on studentdoctor.net and Reddit condemn the use of affirmative action in medical school applications, usually with claims that black or Hispanic students got in while white students, with the same or higher scores, were rejected. Despite the social, capital, and educational advantages of growing up white, these gripers seem to believe that the world has suddenly flipped and being white is holding them back.Many look past the importance of hard-to-quantify factors for getting into medical school like research, volunteering, recommendations, essays, and interviews and instead fixate on how minority applicants have lower scores on the Medical College Admission Test (MCAT) and lower grade point averages (GPAs).advertisement Leave this field empty if you’re human: Let’s set the acceptance rate of black and white applicants equal to each other. If 63 percent of white applicants with a 31 MCAT score and 3.7 GPA are accepted, then 63 percent of black applicants with the same stats are accepted. This essentially takes away the advantages seen in Figure 1. By holding black applicants to the “same standards” as white applicants, we would expect about 750 fewer black applicants accepted to medical school each year, effectively halving the number of blacks who get into medical school.Now let’s give all of those 750 spots to white applicants. (Of course, that’s not what would happen in the real world.) Figure 2 shows the outcome: Those who get the biggest bump in their odds of getting into medical school are the ones who are already most likely to get into medical school — applicants with high MCAT scores and GPAs. Those who have little to gain are already on the edge of not getting in anyway. By opening up 750 medical school seats to white applicants, those with a 26 on the MCAT and a 3.6 GPA probably still aren’t getting in.Reducing the number of black applicants admitted to medical school by 750 and giving all those seats to white applicants would increase the acceptance rate of white applicants from 45.15 percent to 47.97 percent, a 2.82 percent increase. But as I learned from my analyses, that small increase is negligible when compared to the impact of increasing MCAT scores on applicants’ chances of admission. Though I do not show the analysis for GPA here, small increases in a white applicant’s GPA (maybe getting a B+ instead of a B in one class) improves his or her chances much more than reducing the number of accepted black applicants.As shown in Figure 3, an increase of one to three points on the MCAT score does more to improve a white applicant’s odds of getting into medical school than would eliminating affirmative action. With a median 3.7 GPA, going from a 29 on the MCAT to a 32 increases the odds of getting into medical school by 17.38 percent — far more than the “equal acceptance” scenario posed above.From the perspective of the AAMC, though such an increase in the MCAT score is relatively meaningless. A 3-point higher score on the MCAT could mean answering correctly just three more of the 230 questions, perhaps getting 75 percent of the questions right instead of 73 percent. Given that some guesswork is involved, and that applicants would likely get slightly different scores if they took the test multiple times, the AAMC reports MCAT scores with a 4-point range. If an applicant scores a 29 on the MCAT, the AAMC reports that his or her true MCAT score is somewhere between 27 and 31. In other words, a white applicant with a 3.7 GPA and 29 MCAT who correctly guesses the answer to one more question, simply by chance, is better off than if we “level the playing field” by holding black applicants to the same score-based admission standard. Tags affirmative actioneducationphysicianslast_img read more

Canadians are hopping mad about Trump’s drug importation plan. Some of them are trying to stop it

first_img While importation is popular with American consumers (a recent poll found that 80% of Americans surveyed liked the idea), the success of the plan will largely depend on the willingness of wholesalers, both in the U.S. and Canada, as well as retailers, to play ball. Wholesalers, in particular, would have to decide it’s in their best interest to break or renegotiate contracts with pharmaceutical companies that often expressly ban the export of drugs sold for Canadian consumption, and the sales of drugs in the U.S. that weren’t originally packaged for the U.S. market. “The reason they do this is because there’s a big difference in the wholesale price of a drug outside of the U.S. versus inside of the U.S.,” said Neeraj Sood, a professor at the University of Southern California, who studies the drug supply chain. “It’s written to prevent importation.” Sood added that such provisions are commonplace. Wholesalers who have been accused of breaking these contracts have ended up in court, according to Sood, who disclosed he was involved in one such case, although he declined to provide STAT with further details. And early signs show wholesalers are  less than eager to renegotiate these contracts: The Healthcare Distribution Alliance, the U.S. lobby group representing distributors, has called Trump’s plan “simply not worth the risk.” Then there’s the possibility that the threat of importation will give states, wholesalers, and pharmacists the leverage to negotiate better terms with manufacturers, making it unlikely they’d need to import drugs in the first place. “My suspicion is in the short term … it gives the retail sector greater leverage in trying to negotiate some kind of better terms of trade with manufacturers,” Morgan said. There’s already early signs this is occurring. Florida Gov. Ron DeSantis, for example, has said drug makers approached his office after it began pushing an importation bill with offers to sell drugs at a cheaper price. Morgan said: “It’s premature to panic.” In the meantime, that won’t stop Canadians from grousing over the prospect Americans creeping across the border and taking their cheap drugs. “There is no Canadian constituency for this,” the Wilson Center’s Dawson said. Canada’s major newspapers have been peppered in recent weeks with editorials slamming the plan. “Donald Trump, keep your hands off our drugs,” the Globe and Mail wrote. “Welcome,” the paper added, “to the socialist paradise of Canada, Mr. Trump.” Please enter a valid email address. Leave this field empty if you’re human: The process is relatively simple: Canada’s federal cabinet, known as the Governor in Council, can add goods to the export control list at any time. There are some limits on what goods can go on the list, but the government essentially has carte blanche to protect any good against the possibility of shortages, particularly if it can make the case that doing so is in the interest of national defense. The cabinet is technically required to open any such proposal for public comment, but the government has the power to bypass those rules. “Putting a particular good on the export control list is relatively quick and easy,” Geoffrey C. Kubrick, a partner at the Canadian law firm McMillan, told STAT. Passing a new lawWhile Prime Minister Justin Trudeau’s government has unilateral power to control exports, Parliament could also pass a law explicitly banning exports of drugs meant for Canadians. It’s not uncommon for Parliament to do so, even when the cabinet has the power to act unilaterally. “Sometimes legislative actions are taken for the demonstration effect, just so it’s really, really clear that this is not an activity that Canada is in any way sanctioning,” said Laura Dawson, who heads the Canada Institute at the Wilson Center in Washington. And veteran MPs are already familiar with this issue: Parliament nearly passed a similar law in 2005 after the U.S. Congress passed a law two years earlier giving the secretary of health and human services the power to greenlight drug importation. That bill would have empowered Canada’s health minister to “prohibit, by order, the export of a drug or class of drugs” if the government determined such exports could lead to a drug shortage. The proposal was eventually tabled because the ruling party lost power and Parliament dissolved. There’s a major roadblock to passing a similar bill in the coming months, however: Parliament is out of session and the country is in the midst of a federal election. Members of the left-flank New Democratic Party have criticized the ruling Liberal coalition for a lackluster response and called for the legislature to reconvene to address the issue, and the opposition Conservative Party has called for the federal government to act to prevent drug shortages.Advocates like the Best Medicines Coalition have also called for an emergency session of Parliament, but that option seems unlikely. Imposing new tariffs or taxes on drugsCanada could also impose an additional fee — essentially a tariff —  on exports of pharmaceuticals from Canada, thus making the drugs prohibitively expensive for Americans. “It would be easy for other countries to stop this with tariffs,” said Dr. Bob Kocher, a former special assistant to President Obama and a venture capitalist. “The U.S. has certainly broken the glass already on using tariffs to protect local markets.”But the Wilson Center’s Dawson isn’t so sure that’s a great idea, or even possible. These sorts of taxes, for one, are very unwieldy and nobody uses them, she told STAT. “Why would you want to use the least efficient instrument to block these sales, when Canada could simply impose an export control?” she asked. “They could put those spike belts across the highway for trucks that have pharmaceuticals in them … but not so efficient.” Asked if there was a precedent for such a move, the closest example Canada trade experts could point to was Canada’s restrictions on exports of certain lumbers. As part of a long-simmering trade dispute, Canada has at times required exporters to pay a tax when exporting lumber to the U.S. However, even that is an imperfect corollary.  The wait-and-see approachSteve Morgan, a professor at the University of British Columbia, predicts at least in the short term Canada’s strategy will be “watchful waiting.”The reasoning: Even if the U.S. moves forward with its plan and Canada doesn’t respond, existing contracts and business practices make it almost impossible to send prescription drugs across the border. Attempts to do so, experts said, could result in drug companies canceling contracts with wholesalers, wholesalers canceling contracts with pharmacies, and pharmacists being called before professional review boards.  @levfacher Washington Correspondent Nicholas Florko reports on the the intersection of politics and health policy. He is the author the newsletter “D.C. Diagnosis.” By Nicholas Florko and Lev Facher Aug. 12, 2019 Reprints About the Authors Reprints “It’s time for it to crash and burn,” said John Adams, the board chair of the Best Medicines Coalition, a coalition of Canadian patient advocacy organizations, who will be joining the meeting by phone. “Canadians may die.”The meeting will almost certainly be just a first step in a long and complicated process potentially involving obscure trade laws, international treaties, and some cutthroat diplomacy. In advance of that meeting, STAT spoke with nearly a dozen trade and health policy experts in Canada and the U.S. to determine how, exactly, Canadians could thwart Trump’s plan — and how drug makers might just thwart it for them. Here’s what we learned. Adding pharmaceuticals to Canada’s export control listThe most expedient way for Canada to stop Trump’s plan would be to put prescription drugs on its “export control list,” a watchlist of sorts that would require exporters get permission from Canada before shipping drugs across borders, multiple experts told STAT. It’s an odd proposition, to be sure. The list is used primarily to prevent export of deadly weapons. Canada has, however, used the list to protect key products, including certain lumber, and even peanut butter.  Washington Correspondent Lev Facher covers the politics of health and life sciences. Comparing the Covid-19 vaccines developed by Pfizer, Moderna, and Johnson & Johnson Related: Everything (or almost everything) you need to know about importing drugs from Canada Trending Now: [email protected] Privacy Policy [email protected] WASHINGTON — Canadians are furious about the Trump administration’s plan to import their prescription drugs. And some of them are determined to stop the proposal in its tracks. Trump’s plan, which was announced late last month, would allow states, wholesalers, and pharmacies to import cheaper drugs from Canada. It’s a long way off from being implemented, but Canadians are baffled that America would look north to lower its own drug prices, and indignant that such a plan could exacerbate an already pressing drug shortage issue plaguing the country. “You are coming as Americans to poach our drug supply, and I don’t have any polite words for that,” said Amir Attaran, a professor at the University of Ottawa, who calls the plan “deplorable” and “atrociously unethical.” “Our drugs are not for you, period.” advertisement Newsletters Sign up for D.C. Diagnosis An insider’s guide to the politics and policies of health care. Lev Facher PoliticsCanadians are hopping mad about Trump’s drug importation plan. Some of them are trying to stop it @NicholasFlorko Molly Ferguson for STAT Nicholas Florko In the face of opposition, Canada’s health minister will meet Monday with pharmacists, patients, and industry officials to discuss a response. The minister, Ginette Petitpas Taylor, has publicly pledged to “ensure there are no adverse effects to the supply or cost of prescription drugs in Canada.” For the advocates likely to fill the room, that means stopping American businesses from importing Canadian drugs.advertisement Tags drug pricinglast_img read more

Who is really behind a proposed new definition of pain?

first_imgFirst OpinionWho is really behind a proposed new definition of pain? The chronic-pain quandary: Amid a reckoning over opioids, a doctor crusades for caution in cutting back As a writer, I care as deeply about words. Here’s the old definition of pain that the International Association for the Study of Pain (IASP) laid out in 1994: An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.advertisement Tags addictionopioidspain Related: Comparing the Covid-19 vaccines developed by Pfizer, Moderna, and Johnson & Johnson Newsletters Sign up for STAT Health Tech Your weekly guide to how tech is transforming health care and life sciences. Related: One thing I notice about the opioid crisis is this: the more talk, the less pain care. Will a new definition help, or will it harm?How did we get here? The IASP always seemed to be a good guy in the conversation about pain relief — by whatever methods it takes. Since 2010, the organization has been associated with what was long considered one of the world’s best pain clinics, at McGill University in Montréal. The clinic’s former director is past president of IASP. He’s written thoughtfully about untreated pain, even mourning Spain’s Philip II, a 16th-century Catholic who died in needless agony from cancer while refusing all help but God’s.Back in 2010, IASP issued its “Declaration of Montréal,” after the city in which it was crafted during the group’s 13th world congress. It’s strong stuff. “Recognizing,” it says, “the intrinsic dignity of all persons and that withholding of pain treatment is profoundly wrong, leading to unnecessary suffering which is harmful; we declare that the following human rights must be recognized throughout the world:The right of all people to have access to pain management without discriminationThe right of people in pain to acknowledgment of their pain and to be informed about how it can be assessed and managedThe right of all people with pain to have access to appropriate assessment and treatment of the pain by adequately trained health care professionals.”Who could argue with that?Almost everyone, it turns out: governments, prescribers, insurers, news media, the public. It’s wonderful that professionals who really know pain once declared these rights for people like me — for all of us, actually, since at some point we’ll all have pain. But who’s listening now? The deprescribing whirlwind has battered many like me beyond repair. However carefully chosen the words of the declaration, they’re not binding in the least. As someone who lives with a lot of pain, I care deeply about pain treatment. In the last two years, I’ve lost care twice, without warning, because of the thoughtless, often self-interested policy that’s fueling the fad to get everyone off pills. My longtime primary care doctor in Halifax, Nova Scotia, threatened by her regulator, suddenly stopped prescribing opioids. Next, the Nova Scotia Health Authority abruptly closed my pain specialist’s practice. Stop persecuting doctors for legitimately prescribing opioids for chronic pain Dawn Rae Downtoncenter_img Opioid pills have become demonized, even for people who have been using them successfully for years to treat chronic pain. Adobe [email protected] It ain’t broke. Why fix it?Here’s the proposed new definition: An aversive sensory and emotional experience typically caused by, or resembling that caused by, actual or potential tissue injury.Look what the cat dragged in. Something only resembling damage might cause pain. Despite disclaimers in the notes attached to the new definition, here’s the slippery slope: Pain might result from a verifiable injury, or it might not. It might be an illusion, an inconvenient mental trick. If it’s all in your head, pain obviously won’t need a Percocet.And there’s more — or in this case, less. Treatment, which was declared a must in the notes accompanying the old definition, goes unmentioned in the notes accompanying the new one.The IASP is accepting comments on the new definition until midnight on Sept. 11. A new definition of pain is out for comment from the International Association for the Study of Pain, an influential global alliance of researchers.When I heard about it, my hair stood on end. Some people think a new definition could lead to new therapies. But as a 23-year veteran of serious pain from a progressive disorder, I dread losing the old therapy: opioids.Prescription opioids have lost favor since the national opioid crisis, when a growing number of people fell victim to an increasingly unrelated supply of these drugs. Prescribed drugs, illicit drugs — the distinction between the two, and their respective contributions to overdoses, hasn’t been widely grasped. And so there’s much ado about opioid replacements such as ineffective drugs, “mindfulness,” chiropractic, cognitive behavior therapy, “coping and acceptance,” acupuncture, virtual reality, and more. The problem is that none of these has been proven or even properly tested. New drugs likely to work on severe pain aren’t anywhere near the pipeline. And most of us already know what we’d pick for a broken bone or a kidney stone.advertisement Please enter a valid email address. Leave this field empty if you’re human: What, exactly, is pain? It’s not something I need spelled out. But as the IASP rejiggered its answer to that question, did these colleagues weigh in? Another PROP director, Dr. Mark Sullivan, sits on the definition task force, where opinion lists the ship by favoring “nonnarcotic methods” and “risk containment for opioid misuse, abuse and addiction associated with medical prescribing.”The IASP and its task force comprise many points of view. But even if the rewrite were less trendy, I’d question the need for it.In our new no-opioids culture, pronouncements like the IASP’s lead to more resources going to “innovations” and “emerging research” that disparage and displace proven therapies, leaving nothing for people living with pain.What matters is what’s done, not what’s said. George Orwell wasn’t the first to observe that what’s said can be designed to obscure what’s done. Funding attaches to words. Will more parsing mean more mindfulness and acupuncture for victims of head-on car crashes? And more advantage for opioid detractors, whose opinions spell opportunity in the form of research grants, publishing records, jobs, media prominence, speaking engagements, paid testimony and other consulting for law firms, as well as promoting alternative analgesics and addiction drugs for pharmaceutical companies?Let’s look at who is behind new declarations and definitions, and who isn’t — understanding the players helps us understand the argument. Let’s watch the data, not the news, and check facts and sources. The IASP’s rewrite is on the way to kicking medical opioids to the curb. Maybe we will do that someday, and maybe that will be fine.But until then, I’ll stick with opioids … if I can.Dawn Rae Downton writes on health policy from Halifax, Nova Scotia. Dr. Yoram Shir, the current director of the McGill clinic, has said that pain patients on opioids “hate” the drugs. Prescription pills feed overdoses. Doctors should be dissuaded from prescribing them and patients from taking them.IASP has changed, too, and some of the changes unnerve me. For instance, Christine Chambers, a psychologist, is championing a new IASP initiative called the North American Pain School. Health Canada ponied up $1.6 million for her work to “bridge the gap between current treatments and evidence-based solutions.” At the annual conference of Canada’s pain specialists last year, Chambers brought in her colleague Dr. Jane Ballantyne, the enduring president of the opioid-averse lobbying group Physicians for Responsible Opioid Prescribing, as the conference keynote speaker — and then declined to comment to the media on her choice.PROP’s executive director, Dr. Andrew Kolodny, has called medical opioids “heroin pills.” Ballantyne famously recommends “coping and acceptance” over drugs for intractable pain, and has been a paid consultant to states suing drug manufacturers, whom they blame for overdoses.Ballantyne also helped craft IASP’s 2018 Position Statement on Opioids. It advises caution “when prescribing opioids for chronic pain, focusing instead on strategies that integrate behavioral and physical treatments,” because, we’re told, opioids are good only for acute pain, cancer pain, and end-of-life care. When used “indiscriminately” (meaning for chronic pain, according to the statement), we’re also told that the use of opioids has led to “high rates of prescription opioid abuse, unacceptable death rates, and enormous societal burdens.”Recent research, and much of IASP’s own work, says otherwise. Take, for example, the largest study to date, of 2.2 million North Carolinians, which pegs the risk of dying due to medical use of opioids at just 0.022%. About the Author Reprints Trending Now: By Dawn Rae Downton Sept. 5, 2019 Reprintslast_img read more

Pharmalittle: Trump and senators push for drug prices in TV ads; Sanofi looks to spin off consumer business

first_imgPharmalot Top of the morning to you, and a fine one it is. We may have returned from a sojourn abroad, but we are enjoying another busy day, thanks to the first ever #STATSummit taking place today in Cambridge (Massachusetts, not England). All sorts of interesting people and topics are on hand, so take a peek if you are unable to join us. Of course, we also look forward to the cups of stimulation being served. Meanwhile, we are pleased to provide the latest menu of tidbits. Have a smashing day and do keep in touch.President Trump and senators from both parties are still hoping to force drug makers to disclose list prices in TV ads, The Hill reports. The disclosure rule was one of Trump’s highest-profile initiatives and the first policy released after the administration unveiled its drug pricing “blueprint” in 2018. But in July, a federal judge sided with a coalition of three drug makers and advertisers and blocked the Trump administration from implementing the policy. By Ed Silverman Nov. 21, 2019 Reprints What is it? Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. What’s included? Alex Hogan/STAT Ed Silverman STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Tags pharmalittleSTAT+center_img About the Author Reprints @Pharmalot Pharmalittle: Trump and senators push for drug prices in TV ads; Sanofi looks to spin off consumer business Log In | Learn More Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. GET STARTED [email protected] last_img read more