Welcome to this month's edition of Comp Medical News. Medical marijuana distribution in Louisiana, chronic pain in the NFL, and opioid use as a factor in low workforce participation are your headlines for August.
White House Commission Recommends National Emergency Status for Opioid Crisis
A federal commission called by President Trump to address the national opioid crisis has recommended that opioid abuse and overdose be declared a national emergency. Such status would free up additional resources, and the bipartisan body said it was the most urgent suggestion contained in their report. The commission, chaired by New Jersey Governor Chris Christie and called in March, released only the interim report at this time. The final report is due in October. The members note in the report that the death toll from opioids in this country “is equal to September 11th every three weeks” at 142 people per day. Other recommendations in the report include waiving federal Medicaid rules that restrict addiction services, and increasing access to naloxone. In a speech yesterday (8/8/17) President Trump discussed the opioid crisis but stopped short of declaring a national emergency.
Senator McCaskill Expands Congressional Opioid Probe to Drugmakers, Others
U.S. Democratic Senator Claire McCaskill on Thursday expanded an investigation into the causes of the opioid crisis plaguing the country, seeking information from four more drugmakers and three drug distributors. The top-ranking Democrat on the Senate Homeland Security and Governmental Affairs Committee is focusing on the distribution of opioids and the efforts companies made to report and investigate the diversion of drugs for illicit use.
Fed Chief Yellen Suggests Opioids to Blame for Low Workforce Participation
In recent Congressional testimony, Federal Reserve Chair Janet Yellen alluded to the national scourge of opioid abuse as part of low workforce participation in the hard hit Ohio Valley, as well as other areas of the U.S. According to a New York Post report, Yellen told U.S. Senators, “I do think it is related to declining labor force participation among prime-age workers…I don't know if it's causal or if it's a symptom of long-running economic maladies that have affected these communities and particularly affected workers who have seen their job opportunities decline.”
NFL to Work with Players' Union to Explore Medical Marijuana as Pain Treatment
The Washington Post reported that the National Football League (NFL) has written to the NFL Players' Association (NFLPA) offering to work with the organization to study the use of marijuana to treat chronic pain amongst athletes. The rise of medical marijuana across the country, especially as a replacement for addictive opioid painkillers, has piqued the interest of the healthcare industry in recent years. The NFL still does not allow marijuana use of any kind and the drug is illegal under federal law. The NFLPA has made public statements in the past indicating that it is studying marijuana for pain, as well as marijuana addiction, as part of its Mackey-White traumatic brain injury committee. A representative for the players' union also told reporters that it is planning to propose changes to the penalties of recreational marijuana use for football players.
Seven Companies Applied to be Southern University's Medical Marijuana Partner
Southern University announced that seven companies have applied to help the school in its new medical marijuana program. The Southern University Ag Center is currently in the process of reviewing the applications. Reports from local news outlets indicate that Southern intended to finish the application reviews by the end of July 2017, but no further announcement has been made. The seven companies are: Advanced Bio Medical, Aqua Pharm, Citiva Louisiana, Columbia Care, Med Louisiana, Southern Roots and U.S. Hemp Corporation. LSU AgCenter already selected its medical marijuana vendor, GB Sciences.
Finally, two long-form pieces about opioid overdose, relapse and the mysteries that surround both:
Vivitrol Side Effects May Make the Addiction Treatment More Dangerous than Previously Thought
VICE investigated the effectiveness of the increasingly popular long-acting addiction treatment Vivitrol through the stories of several opioid addicts. The medication, which is administered as a monthly shot, is prescribed for both opioid and alcohol addiction. Vivitrol is popular among law enforcement because, unlike medication-assisted treatment mainstay buprenorphine or methadone, it contains no opioids to wean or maintain recovering addicts and cannot be abused. Instead, it blocks the effects of opioids in the brain.
However, critics argue that the drug's mechanism can cause severe depression in some users. VICE found that the maker of Vivitrol has utilized hard ball techniques to push or compel the treatment in jails and other facilities. Clinical trials of the drug have been small and industry-funded, and many patients refused to accept the entire course of six shots. Its label also reports two completed suicides of patients who received Vivitrol during clinical trials – and that 10 percent of patients reported depression, compared to 5 percent on placebo.
Shepard Siegel, professor of psychology, neuroscience and behaviour at McMaster University in Ontario, Canada, explores in a piece for Aeon the “heroin overdose mystery” in the context of New York City's 1960s heroin crisis, which killed almost 1,000 people in the city in 1969 – about the same as in 2015. He explains: “Some of these [overdose] victims die because they took too much of the drug. Others die following self-administration of a dose that appears much too small to be lethal, but why? This is the heroin overdose mystery, and it has been known for more than half a century.”
Siegel explains that the phenomenon may be due to the situation in which the person uses the drug. He posits that using in unfamiliar environments or circumstances can increase the likelihood of overdose, even with the same dose.
Nina Luckman is the writer and editor of New Orleans-based Louisiana Comp Blog, which launched in 2014 and is sponsored by LCI Workers' Comp. She is originally from Pennsylvania but lived most of her life in Florida. Her credentials include a Bachelor's and a Master of Arts degree from Tulane University, both in the study of English Literature.
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