A Magic Pill


Pills (Photo credit: madcowIV)


Pills (white rabbit)

Pills (white rabbit) (Photo credit: erix!)



At least twice a week someone tells me about a magic pill. They discovered it on Dr. Phil or Dr. Oz, an infomercial or a magazine, from the recommendation of a friend or with the help of an alternative healer. No matter what the magic pill cures/heals/improves, it never requires the taker to do anything except remember to take the pill.


I’m always a little skeptical. Most things in life, to me at least, require some effort.


And it’s not like the people who believe in a magic pill are dumb. Incredibly intelligent people look me straight in the eye and tell me about the latest one. On some level, we all desperately want to believe there’s a shortcut to our dreams or a work around to our pain. But that’s not the case.


Life isn’t easy, it isn’t fair, it’s full of pain. If a magic pill could cure that, wouldn’t we all take one?


Except there’s something to be said for fighting the good fight and emerging successful. Whether it’s losing fifty pounds, marrying the man of your dreams, or conquering an addiction, the journey is the part that helps us to grow. The magic pill takes that away from us. It makes us believe in trickery.


It’s time we value the work of improving ourselves and our lives more than we value the magic pill. Yes, working through our problems is hard, but it is only when we fully accept and embrace the tough times and the difficult choices that we move forward.


Dealers Gotta Protect Their Turf

English: Vicodin tablets Italiano: Pillole di ...

English: Vicodin tablets Italiano: Pillole di Vicodin. (Photo credit: Wikipedia)

In New Hampshire, more people die of prescription drug overdoses than car accidents. CDC statistics report that prescription drugs are involved in 75% of all drug-related deaths in the United States. In 2011, the Centers for Disease Control estimated 14,800 deaths related to opioids (opioids or opiates defined as morphine, heroin, oxycodone, codeine, methadone, hydrocodone and hydromorphone.)  Note that with the exception of heroin, all drugs of abuse are available from your friendly healthcare provider.

Whether drug sales are illegal enterprises selling vials on the corner or a transaction that takes place in an exam room, it’s all about numbers and turf. Getting people hooked and keeping them coming back are the keys to a thriving business. For people with insurance, getting narcotics (opiates) from their local doctor or Emergency Room is easier and less expensive than going to the corner drug dealer, particularly since drug dealers don’t settle for a co-pay. Just as dealers rename their products to generate interest,  Big Pharma continues to feed the appetite of addicts with new medications and new formulations of old medications.

Narcotic painkillers have been combined with over the counter meds because of  the belief that the two medications together provide better pain relief than either of the medications taken alone. Unfortunately when people take two Vicodin (hydrocodone and acetaminophen) every 4 hours for pain round the clock (12 pills daily), they run the risk of liver damage because of the amount of acetaminophen bundled in the pill.  The makers of Tylenol (brand name acetaminophen) are so concerned about acetaminophen overdoses that they have decreased the recommended maximum daily dose from 8 pills daily (4000 mg)  to 6 pills daily (3000 mg). This change forces the makers of Vicodin to lower their recommended maximum dose to stay within the new guidelines and will result in Vicodin users having their daily dose decreased.  Sad that in the face of increasing numbers of overdose deaths due to prescription narcotics and the increasing number of prescription drug addicts,  the push to change labeling is due to the potential for a Tylenol overdose resulting in liver damage, rather than concern about overdose or addiction.

Of course the makers of Vicodin don’t want to see their business cut in half. They want to keep on selling the same number or more pills every year. Faced with the very real possibility that providers will decide to switch patients on Vicodin to a drug without any pesky daily maximums, the makers attempted the business affirming move of  trying to get approval for a pure hydrocodone pill. Luckily the FDA panel on pain relief voted against it.

The panelists agreed the higher dose of hydrocodone would be an effective pain reliever, but they felt uneasy providing another formulation of a drug in a class that is already widely abused. According to the Drug Enforcement Agency (DEA), hydrocodone is on the top of the list of most abused drugs in the United States. Sounds like a no-brainer.

Hopefully the FDA will agree with the panel and prevent a new dangerous drug from flooding America’s streets, school yards, and homes. In the war on drugs, our government has gone after the dealers of meth, pot, heroin, and crack. Somehow the legal dealers, Big Pharma, are allowed to thrive while they destroy lives.

opioid prescriptionsDo some people need narcotic painkillers to control their pain? Of course.  In the face of increasing narcotic use, do we need to add more potential drugs of abuse to the marketplace? I think not.  Big Pharma seems to be doing pretty well with what they have.

chart courtesy of the National Institute on Drug Abuse.

Celebrating Labor Day

Labor Day was created as a way to pay tribute to the worker’s of American, particularly those in trade and labor organizations. Today, trade organizations and labor unions are often categorized in negative terms, even while studies show these organizations save lives.

A history of the IBEW notes that: “Some statistics support the fact that one out of two men who entered the industry did not survive their first year.” Currently the United States Department of Labor estimates “The annual fatality rate for power line workers is about 50 deaths per 100,000 employees.”

An article reporting on a  federally backed study on the hazards of working in mines concluded,  “In the past two decades, there have been 18-33 percent fewer traumatic injuries per miner in union mines than nonunion mines and 27-68 percent fewer fatalities per miner, according to a draft of the study sponsored by the National Institute of Occupational Safety and Health.”

An ILR review study purports that “After controlling for patient and hospital characteristics, the authors find that hospitals with unionized R.N.’s have 5.5% lower heart attack mortality than do non-union hospitals.”

In Rhode Island “Between 1998 and 2005 there were 354 fatalities at non-union workplaces throughout New England. During those same years, there were 77 deaths at unionized locations, according to OSHA figures.”

Whether you like unions or not, there’s something to be said for organizations that may very well increase your chances of celebrating another Labor Day. 

MD Doesn’t Stand for Know It All

Medical doctors are used to people listening to them. Their words are rarely disputed and oftentimes even the most outlandish beliefs seem reasonable when spoken by a doctor. Case in point, Rep. Todd Akin’s comments about rape victims and pregnancy: “From what I understand from doctors, that’s really rare. If it’s a legitimate rape, the female body has ways to try to shut that whole thing down.”

Try as I might, I can’t find any scientific evidence, even on the internet, that rape victims are able to send out ninja assassin eggs to kill rape sperm or deploy mini razors in their uterus to prevent egg implantation.

But, hey, if a doctor said it, it must be…right?

Every day woman are counseled by doctors that taking antibiotics will lessen the effectiveness of their birth control pill. The early data to support this only related to one antibiotic, rifampin. Even though rifampin is now rarely used, and there’s been no subsequent link between the use of other antibiotics and unwanted pregnancies, doctors and pharmacists still perpetuate this myth.

Hyper kid? Your doctor might recommend restricting sugar intake. As we’ve seen on shows like “Toddlers and Tiaras,” filling young children with pixie sticks and energy drinks turns exhausted, ill tempered children into enthusiastic dancers and runway walkers. Scientific research debunks the link between sugar and hyperactivity. Instead parents that believe sugar causes excess energy “see” the effect, even when there is none.

Wear glasses? Some doctors believe it’s because you spent too much time reading in dim light. Even though reading in dim light may strain eyes, it won’t damage your eyes. In fact, strain your eyes all you want on computers, sitting too close to the television, and not wearing your glasses when you need them. None of these will cause permanent damage.

I could go on with doctor misperceptions about using antibiotics, vaccination side effects, and even the use of thong panties, but I won’t. Possessing a medical degree and a title doesn’t automatically make someone intelligent and well informed. Doctors have as many crackpot, half-baked, and totally wrong ideas as the rest of us.

Too bad our representatives in Washington aren’t smart enough to figure that out.

How Not to Solve the Problem

The Exeter Hospital healthcare worker who picked up unattended syringes of potent narcotics, injected himself, and then either refilled the syringes with saline or replaced them with his own previously used needles, causing at least 32 patients to become infected with Hepatitis C, is not an isolated occurrence. This has happened before and will happen again, unless the real problem is addressed.

The incident is being used as a scare tactic to further a bill requiring certain hospital employees, including lab and medical imaging personnel, to meet national standards in order for the facility to receive Medicare reimbursement.

This will not solve the problem. 
People who are entrusted by a hospital to draw up and administer medicine should be held accountable when they don’t safeguard the medication. Even if they are doctors. Even if they are nurse anesthetists. Even if they are registered nurses. Leaving syringes of narcotics lying about is irresponsible and dangerous. Blaming an addict for picking up these syringes makes no sense.

Instead let’s hold accountable the hospitals that don’t follow their own policies on medication security. Let’s expect to hear how the hospital disciplined the healthcare front line staff that made this tragedy possible through their carelessness.

It has nothing to do with the presence or absence of national licensing standards. It has everything to do with accountability. Until hospitals and their employees are willing to admit their part in this tragedy, nothing will change.

Pain Free Isn’t Painless

There’s no question that, at one time or another, everyone will suffer from pain.  The question is how it will be managed.  In the past, before every ache and pain justified an emergency room trip or visit to the doctor’s office, pain was treated with non-narcotic medications, such as ibuprofen and acetaminophen, as well as rest, ice, and heat.  Now, whether it’s a sprained ankle suffered sliding into home plate or a longstanding backache, pain is routinely treated with the narcotics once solely reserved for cancer.
The choice is not without hazards. Tolerance to the medication (requiring ever increasing amounts to achieve the same effect), addiction (both physical and psychological), and respiratory depression leading to death are all known side effects of narcotic treatment.  Unfortunately, the current mindset that every healthcare encounter includes a prescription combined with the unwillingness to man up, has led to an explosion in legally written prescriptions for narcotics and a corresponding increase in the number of drug related deaths.
In four of the last five years New Hampshire has had more drug overdose deaths than deaths due to car accidents. The majority of these overdoses weren’t from heroin or other illicit drugs, they were from prescription narcotics. 
Why? Obtaining prescription narcotics and selling them is easy.  
How easy? The Union Leader newspaper recently reported the arrest of a suspect with more than eleven hundred 30-milligram oxycodone pills, street value approximately $35,000.00.
Where did the pills come from?  Not from thefts at the pharmacy or factory.
Most likely from thefts of medicine cabinets and the voluntary sale of legally acquired pills. Have a little pain? Get a few narcotics. Need extra money? Sell them. Worried about getting caught? Don’t be.
In New Hampshire, over the counter decongestants are more tightly regulated than prescription drugs. Pharmacies won’t dispense OTC decongestants such as Sudafed or Mucinex D without seeing a photo I.D., noting the purchaser’s name, and ensuing the purchaser hasn’t received more than a specified number in thirty days. You’d think it would be a no-brainer to implement a similar process with prescription painkillers. 
No. There’s no widespread method of keeping track of how many pills someone fills per month. There’s no method to determine if they are visiting multiple doctors, various Emergency Rooms, or using aliases to obtain their pills. Walk into any pharmacy and, with enough cash in your pocket, you can walk out with a bottle of pills with excellent resale value and wide appeal. Convince a doctor you have chronic pain, you can repeat this process on a monthly basis. It’s surprising more people aren’t profiting from this easily exploited system.
Our country regulates alcohol. It regulates firearms. It regulates tobacco. It even regulates over the counter decongestants. What’s so hard about regulating prescription painkillers? Maybe no one wants to force the healthcare system to acknowledge the monkey they’ve put on the back of our society.
I’m thinking it’s easier to just write another prescription.