Posted by admin on August 5, 2010 under Prescription Drugs | 
A new White House study found a 400 percent jump in prescription drug abuse between 1998 and 2008. Experts blame a lack of monitoring programs as well as Americans’ increasing unwillingness to bear even small pains.
Prescription Drugs Abuse - ASIPP Blog
Prescription drug abuse is not just on the rise – it has become a national crisis, according to a just-released White House study detailing a 400 percent increase in substance abuse treatment admissions for prescription pain relievers between 1998 and 2008.
The report underscores the need for regulation amid a culture that has become increasingly reliant on ever-more-powerful and addictive prescription drugs, say experts.
The non-medical use of prescription pain relievers is now the second-most prevalent form of illicit drug use in America “and its tragic consequences are seen in substance abuse treatment centers and hospital emergency departments throughout our nation,” says Pamela Hyde, administrator of The Substance Abuse and Mental Health Services Administration, in a statement.
The statistics are being released to highlight a problem that has become all too familiar through the high-profile deaths of such celebrities as Michael Jackson and Anna Nicole Smith. But the problem affects all ages and socioeconomic strata, says Dr. Scott Glaser, president of Pain Specialists of Greater Chicago.
From 1994 to 2003, the number of prescriptions for controlled substances rose from 22 million to 354 million annually, says Dr. Glaser. The number of admissions for misuse of prescription painkillers to hospital emergency rooms rose from some 40,000 in 1994 to over 300,000 in 2008, he adds.
“There has been a strong push among doctors in recent years to be more aggressive in addressing pain,” he notes. “This has led to the dramatic increase in opiates such as morphine, but the problem is there hasn’t been a whole lot of science to go along with that.”
The abuse of these strong drugs is an indication of a much more widespread cultural problem, says addiction specialist Clare Kavin of The Waismann Method, a treatment center for opiate dependency, which has treated many celebrity addicts.
“We are in a culture of immediate gratification and nobody will put up with even the slightest discomfort anymore,” she says. This underlying attitude leads many patients to push for stronger painkillers when lower strength – but non-addictive – drugs would have sufficed in the past, she adds.
“We are in a perfect nightmare,” says Andrea Barthwell, who has advised the White House on national drug policies. Many of the factors that have come together to fuel this explosive problem – such as the lack of effective monitoring of prescriptions not just between doctors, but between pharmacies, and from state to state – have been well known for years.
Glaser points out that a federal monitoring program was signed into law in 2005 but funding has languished ever since. Glaser and his colleagues from the American Society of Interventional Pain Physicians are just back from lobbying on Capitol Hill for $55 million to fund the program, which they say will pay for itself in five years.
Currently some 37 states have some form of monitoring, Glaser says, but they are inconsistent and lead to widespread abuse. He points to widespread practices such as:
- Easy access to prescription drugs through the Internet
- Caravans of people crossing state lines – Florida is well known for its open-door clinics with easy access to drugs
- Street sales fueled by lax oversight
- Teens selling prescription drugs to each other
The increasing potency of presciption drugs can lead to what Ms. Barthwell calls a “frightening and unprecedented scenario”: “In the past, the number of people exposed to opiate-level highs was very narrow,” she says. “But now, with a wide cross-section of the population for the first time experiencing this kind of dependency, we are seeing a record number of people turning to heroin when they can no longer afford the more expensive prescription drugs.”
The data released Thursday highlight “how serious a threat to public health we face from the abuse of prescription drugs,” said Gil Kerlikowske, National Drug Policy Director, in a statement. “The spikes in prescription drug abuse rates captured by this study are dramatic, pervasive, and deeply disturbing,” he adds.
Posted by admin on August 4, 2010 under Medicare |
Politico Pulse Logo - ASIPP Blog
DOC-FIX WATCH – Frustrated with a six-month patch, medical associations continue to push Congress on Medicare payments.
First up: The American Society of Interventional Pain physicians hits the Hill tomorrow pushing for (what else?) a permanent SGR fix – like the AMA, ASIPP is insistent that nothing less will do, even if it’s not political reality.
Their past president and spokesperson, Dr. David Kloth, tells Pulse: “What the House and Senate passed will get us six months but the bottom line is we need a long-term solution or we are going to lose a lot of doctors.”
Posted by admin on under Healthcare, Prescription Drugs |
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The Hill HealthWatch - ASIPP Blog
By Julian Pecquet – 06/28/10 07:56 PM ET
More than a hundred pain management specialists are in Washington this week to warn lawmakers about the dangers of prescription drug abuse.
The physicians — members of the American Society of Interventional Pain Physicians (ASIPP) — want lawmakers to appropriate $55 million over the next five years to help states collect data on consumers who “doctor shop” and on physicians who over-prescribe or incorrectly prescribe pharmaceuticals.
“There are many states now where there are more young people who die from prescription drug abuse than die from car accidents — and that’s the first time in history,” said David Kloth, past president of the association and a Connecticut pain management doctor.
The physicians want Congress to reauthorize a 2005 bill providing grants to states that collect prescription drug information and share it with physicians and pharmacists — and law enforcement officials when there’s an investigation — while protecting patients’ privacy. Rep. Ed Whitfield (R-Ky.), an original sponsor of the bill, is expected to introduce legislation shortly.
Despite widespread agreement that prescription drug abuse is a serious problem — the 2005 law passed by unanimous consent in the Senate and by voice vote in the House — finding money to fight the scourge has not been easy.
No funds were appropriated until last year, Kloth said, when the Obama administration set aside $2 million in the Federal Omnibus Spending bill for the program, known as the National All Schedules Prescription Electronic Reporting (NASPER).
Kloth said Capitol Hill sources have told ASIPP that Rep. Hal Rogers (R-Ky.) has blocked appropriations for the grants in the past. Rogers, the commonwealth’s former attorney general, supports a monitoring program that’s more focused on law enforcement and may fear NASPER would compete for funding, Kloth said.
Rogers’s office denied any blocking of grants and defended the lawmaker’s commitment to prescription drug abuse.
“Congressman Rogers has been a leader in the fight against the epidemic of prescription drug abuse for a decade, and while it’s true we disagree with the NASPER approach, to say the congressman has ‘blocked’ funding for the program is simply not true. If that were the case, the millions of dollars appropriated for the program over the years would not be established law today. Congressman Rogers believes NASPER is a duplicative program propped up by the pain physician lobby and six years too late. Instead, he has championed state-sponsored prescription drug monitoring programs, supported by the Department of Justice,” said Rogers’s spokeswoman Stefani Zimmerman.
To date, 41 states have monitoring programs in place, according to ASIPP, although six are not operational.
However, many states do not meet NASPER standards — failing, for example, to monitor prescriptions electronically; only covering certain drug categories; or giving pharmacies more than seven days to submit information.
Only two states — Kentucky and Connecticut — are attempting to share information among states, which ASIPP says is necessary to prevent drugs abusers from stocking up on pills in states such as Florida that have laxer standards.
“Fragmented funding of multiple unauthorized programs will only create confusion among states applying for funding,” ASIPP says in a fact sheet on the NASPER program, “as well as both [the departments of Justice and Health and Human Services] as they try to administer similar programs.”
The group is advocating for other issues as well:
• Healthcare reform: The law incorporates several provisions of the National Pain Care Policy Act, but they need to be appropriated. In particular, ASIPP wants funds allocated for an Institute of Medicine conference on pain next year and a training grant program for medical schools and other entities to educate and train healthcare professionals in pain care.
• Physician payments: A permanent repeal of Medicare’s Sustainable Growth Rate formula.
• Ambulatory Surgery Center payments: ASIPP wants higher reimbursement rates for surgical procedures performed outside of hospitals.
Posted by admin on under Healthcare |
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Even as some of the first pieces of President Obama’s health care reform legislation take effect, Republicans in Congress and conservative activist groups are still working to repeal or at least rewrite major sections of the legislation.
Rep. Steve King, Iowa Republican, is circulating a petition that would force an up-or-down vote in the House of Representatives on repealing the vast bulk of the estimated $940 billion, 10-year legislation the Democratic-controlled Congress passed this spring.
The petition had 80 signatures as of Thursday – the same day the White House formally launched HealthCare.gov, which officials described as a “one-stop shopping” place for health insurance. Other parts of the law, including a new 10 percent excise tax on indoor-tanning services and a new stopgap program to cover Americans with pre-existing health conditions who can’t get private-sector coverage, also went into effect Thursday.
A second House “discharge” petition to force a vote over the opposition of the Democratic majority, offered by California Republican Rep. Wally Herger, calls for a full repeal and the passage of a substitute GOP plan.
Support for Mr. King’s proposal sharply increased this week as House Minority Leader John A. Boehner of Ohio and Minority Whip Eric Cantor of Virginia joined the effort and the conservative Club for Growth informed lawmakers that the group would “score” their position on its influential legislative ranking.
“The American people asked Congress and President Obama not to pass the massive health care overhaul, and they were ignored,” said Mr. Boehner and Mr. Cantor. The two also said they could support Mr. Herger’s alternative.
The Republican Study Committee said Thursday at least five other straight repeal bills are in the House, all needing 218 signatures to advance.
The Heritage Foundation’s newly launched independent-advocacy wing, Heritage Action for America, also has a repeal effort. The group notes that most of the legislation’s major changes will not occur until 2013 and 2014 so there is still time to “bring the heat” and tell lawmakers “why you support a full repeal.”
Club for Growth spokesman Mike Connolly said if the repeal effort makes progress, the group would also expect lawmakers who voted against the legislation to “follow through and ultimately co-sponsor legislation in the next Congress.”
Though the economy and jobs will likely remain the key issues during the midterm elections, some Republican candidates – including Senate hopefuls Marco Rubio in Florida and Pat Toomey in Pennsylvania – have made repeal an important part of their campaigns.
Democrats, citing recent polls showing an uptick in popular support for the health plan, have at times appeared eager for a clash over repealing the health program, predicting the GOP blanket opposition will backfire at the polls.
“Some folks on the other side of the aisle … have said theyre going to run on a platform of repeal,” Mr. Obama said last month. “They want to go back to the system we had before. … Would you want to go back to discriminating against children with pre-existing conditions?”
The Democratic National Committee has already aired a 60-second cable television ad titled “We Can’t Afford to Go Back” slamming the repeal effort.
Despite an endorsement from the American Medical Association, many U.S. doctors say they still do not support the legislation.
A coalition of doctors urged Congress on Tuesday to protect them against provisions they fear will hurt their businesses and lower the quality of care of Americans.
Among the group’s primary concerns is that practicing doctors will be excluded from the law’s treatment-recommendation panel and that the new Independent Payment Advisory Board wields too much power and will make decisions based exclusively on cost.
“We’re worried about the [payment] board making decisions without considering a patient’s access to care and the effectiveness of care,” said Dr. Laxmaiah Manchikanti, chairman of the American Society of Interventional Pain Physicians.
The 18-member board, include 15 full-time members, will make recommendations on Medicare and other health care costs without congressional approval. For example, the recommendations go into effect if Congress votes against them, but the president vetoes the vote and Congress cannot get the two-thirds majority vote to overturn the veto.
“We’ll have no recourse in Congress,” Dr. Manchikanti said.
In group’s joint-effort with the North American Neuromodulation Society, nearly 200 doctors came to Capitol Hill to call upon such top Republican Party lawmakers as Louisiana Sen. David Vitter and Minnesota Rep. Michele Bachmann.
However, the most solid promise Tuesday perhaps came from Sen. Sherrod Brown, a Ohio Democrat who voted for the multi-billion dollar reform legislation.
Mr. Brown vowed to circulate a petition asking the House and Senate to put working doctors on the treatment board, officially known as the Patient Centered Outcomes Research Institute. The 40-member nonprofit includes the National Institutes of Health director and 17 appointees by the General Accounting Office.
“A letter doesn’t get it accomplished, but it’s a start,” said Dr. David S. Kloth, a Connecticut doctor and ASIPP director.
