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  1. #16081

    Re: National, Regional and Local News

    Unfortunately, this is a tweet laden article because that's where the discussion began, so please excuse the layout and the abundance of hashtags. I believe that the tweet that Ti posted yesterday was largely in response to this proposed legislation. This helps show some of the response to her proposal that is referenced in the article Ti posted above this one.


    Sen. Kirsten Gillibrand Tweeted An Opioid Proposal: Here's The Reaction


    Some people have said that the television series Lost started well but ended badly. How about the following tweet by Senator Kirsten Gillibrand (D-N.Y.) about the ongoing opioid crisis:

    Sen. Kirsten Gillibrand
    Verified
    @gillibrandny

    If we want to end the opioid epidemic, we must work to address the root causes of abuse. That’s why @SenCoryGardner and I introduced legislation to limit opioid prescriptions for acute pain to 7 days. Because no one needs a month’s supply for a wisdom tooth extraction.
    Few would argue with the first part of the tweet. Yes, to solve a major problem, you should try to address its root cause or root causes.

    But the second part of her tweet, which started with "That's why" and ended with "tooth extraction," seem to go off like a root canal with a number of people on Twitter. Here were just some of the responses to Gillibrand's tweet:

    • Melissa Jo Peltier (@MelissaJPeltier): I’d be interested in @Peter_Grinspoon’s take on this. IMO it’s an appalling invasion into a doctor-patient relationship & a misunderstanding of the complexities of chronic or recurrent (breakthrough)pain. Meanwhile big pharma, pill mills, get a pass?


    • Erin Biba (@erinbiba): This is truly awful and will do extremely great damage to chronic pain sufferers who are already extremely dehumanized by the terrible hardships of US healthcare and I really hope you will research this more before proceeding.


    • Erin Biba (@erinbiba): Surgeries and "Acute" pain don't just wrap up in a neat package of being finished with pain in 7 days. C-sections, for example, aren't just feeling great in a week. The definition of "Acute" is less then 6 months. Imagine having to call your doctor once a week for 6 months.


    • Jason O'Malley (@jpo_mpls): This seems like dream legislation for insurance and pharma. New doctor visit, co-pay and prescription cost when the pain from a major surgery isn't over after 7 days.


    • Meagan (@chronicallywtf): No no no no no please!!!!! Surgeries can and will take longer to heal!! Chronic pain patients rely on these meds to function!! Suicides related to inadequate pain control are increasing!! The inability to use opioids to manage pain is CAUSING them to seek heroin!!!


    • Spartek (@sparteksolution): Essentially, the legislation would make it mandatory for weekly visits to the doctor when prescribed potent pain medication. This is beyond dumb! There are only so many hours in a work day.


    • Molly Jong-Fast (@MollyJongFast): This is really very stupid and dumb.


    It's safe to say that people did not unanimously agree with Gillibrand's tweet about her and Senator Cory Gardner's (R-Colorado) jointly proposed legislation. In fact, Esther Choo MD MPH (@choo_ek), an emergency doctor and Associate Professor at the Oregon Health & Science University, referred to the ratio of the nay's versus the yay's when she tweeted the following: "The ratio on this tweet is a good opportunity to get clinical and research experts and patient advocates in the room and talk through this a bit more with evidence and logic on your side."

    Beth Linas, PhD, MHS (@bethlinas), an infectious disease and digital health epidemiologist with the MITRE Corporation, added: "The #opioidepidemic is STILL misunderstood by policy makers. The sheer number of comments from #publichealth and #health professsionals regarding this tweet should shed light on the importance of having these sorts of experts when developing #evidencebased #healthpolicy #SDOH."


    https://www.forbes.com/sites/brucele.../#42f1e5583833

  2. #16082
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    Re: National, Regional and Local News

    Quote Originally Posted by Ti-Amie View Post

    This seven-day prescription limit would not apply to the treatment of chronic pain; pain being treated as part of cancer care, hospice care, or other end-of-life care; or pain treated as part of palliative care. This federal legislation is modeled after laws in several states. Currently, fifteen states, including New York, limit initial opioid prescriptions for acute pain.

    https://www.gillibrand.senate.gov/ne...-to-seven-days
    If this statement truly reflects what is in the legislation, then some of the hysteria expressed in the Tweets is baseless.

    But here's the thing... The part of the statement I am quoting appears at the very end. It should have been in paragraph 2 AND mentioned in Gillibrand's original Tweet. Doing so would have reduced the panic level. Again... Assuming this is an accurate reflection of the legislation itself.

  3. #16083

    Re: National, Regional and Local News

    I'm afraid I don't have time for a long comment.....But, if you're looking for a country with a really sane approach to opioid addiction, you might also read about Portugal. There are Wikipedia sites and many articles on the web.

    GH

  4. #16084

    Re: National, Regional and Local News

    Quote Originally Posted by dryrunguy View Post
    If this statement truly reflects what is in the legislation, then some of the hysteria expressed in the Tweets is baseless.

    But here's the thing... The part of the statement I am quoting appears at the very end. It should have been in paragraph 2 AND mentioned in Gillibrand's original Tweet. Doing so would have reduced the panic level. Again... Assuming this is an accurate reflection of the legislation itself.
    She admitted that the last paragraph was an update to the original proposal.

    I agree that should've been considered and included in the original proposal.
    "Even if you dance for your enemy on the rock, he will accuse you of splashing water on him." ~ African Proverb




  5. #16085
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    Re: National, Regional and Local News

    Quote Originally Posted by GlennHarman View Post
    I'm afraid I don't have time for a long comment.....But, if you're looking for a country with a really sane approach to opioid addiction, you might also read about Portugal. There are Wikipedia sites and many articles on the web.

    GH
    Yeah, my understanding is that the Portugal approach is very treatment-based and extends more into a recovery support model. Treatment is strongly encouraged and supported post-treatment.

    On a policy front, there are basically three components to any substance use treatment policy: 1) prevention, 2) treatment, and 3) recovery. When it comes to the opioid epidemic in the United States, we haven't really emphasized this approach until recently. Once naloxone (Narcan) was developed, the emphasis immediately went into training law enforcement, first responders, emergency room personnel, and others on how to properly administer naloxone. (I think I mentioned before that my company developed a naloxone training for national use.) And this was great--we were finally able to resuscitate people who had overdosed whether they were lying on a sidewalk or in their home.

    But now we have new problems: 1) Some folks are being resuscitated more than once a week, and 2) The word is out about naloxone, so many people at high risk of overdose now assume the risk of overdose is significantly reduced because naloxone will save them. I'm not kidding. Many people assume law enforcement or first responders will have sufficient time to save them.

    ::

    The legislation in question is focused solely on the prevention policy component. It's a good thing, though it may still need some work and refinement.

    But when it comes to the treatment component, we're just getting started. In many areas (rural communities) there are no substance use treatment providers. So where do you go? What do you do? Lots of folks are looking at telehealth technologies to bridge these gaps, but that costs money, public sector funds are limited to nonexistent, insurance companies are still deciding whether they'll cover it or not, etc. And why should we be surprised? We've had the same problems regarding general substance use or mental disorders for decades. "Such a big problem, such a terrible problem, but we're not gonna pay for it."

    Not to mention the strong social stigma still attached to addiction. Every now and then I'll still come across the phrase "drug addicts" in materials. Why would people even consider getting treatment if you're going to call them a drug addict? You're not exactly welcoming them and making them feel like you want to help them.

    Meanwhile, the recovery support model is virtually nonexistent in the United States. If someone is saved from an overdose, manages to find a way to get treatment, and then is abandoned to be on their own with no long-term support, what do we think is going to happen?

    There are only two organizations in the United States that deal in recovery support services--MARS and Faces and Voices of Recovery (FAVOR). These are organizations led by people in recovery. We have worked with them quite a bit. In fact, last year we won a large recovery-support contract in which we bid both of them as subcontractors. We won that contract by a landslide.

    And then Elinore F. McCance-Katz, Assistant Secretary for Mental Health and Substance Abuse, got wind of it and cancelled the procurement.

    Why, you ask? Because recovery support is a threat to the medical model of substance use treatment, and if it actually worked, no one would ever relapse. (Never mind the fact that people who relapse almost never have access to recovery support services. How convenient.)

  6. #16086
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    Re: National, Regional and Local News

    Much shorter post...

    When it comes to a policy issue like opioid addiction, you have two choices:

    1) Prevention, treatment, and recovery support

    2) Hospitalize, incarcerate, or just let people die.

    The United States, to date, has chosen the latter.

  7. #16087

    Re: National, Regional and Local News

    That clarification from Gillibrand is not going to cut it to me. Cancer, hospice, and end-of-life care? Is that the only groups of people living with chronic pain? What is she including in palliative care? And man is this written by people who don't worry about money. This is totally going to require people to have to return to the doctor's office more often which means additional costs and pay additional prescription co-pays that likely would've been charged the as just the one. To say nothing of having to get to and from appointments and how that is difficult for plenty in terms of transportation costs along with time off work.

  8. #16088

    Re: National, Regional and Local News

    Quote Originally Posted by dryrunguy View Post
    Once naloxone (Narcan) was developed, the emphasis immediately went into training law enforcement, first responders, emergency room personnel, and others on how to properly administer naloxone.
    But naloxone was not just developed. Its from the 60s and been available since the 70s. I'll give you one guess as to why they didn't use it during the 80s epidemic that they treated with mass incarceration and suddenly care now about keeping people alive and not throwing them in jail at the same rates.

  9. #16089
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    Re: National, Regional and Local News

    Quote Originally Posted by JazzNU View Post
    But naloxone was not just developed. Its from the 60s and been available since the 70s. I'll give you one guess as to why they didn't use it during the 80s epidemic that they treated with mass incarceration and suddenly care now about keeping people alive and not throwing them in jail at the same rates.
    I actually was not aware that naloxone has been around that long. Shameful. And yes, we all know why.

  10. #16090

    Re: National, Regional and Local News

    Largest U.S. Christian Charity Reportedly Donated $56.1 Million to Hate Groups

    by
    JakeThomas
    23 hrs
    The National Christian Foundation donated to Alliance Defending Freedom and the Family Research Council.

    According to Newsweek, National Christian Foundation, which is the largest Christian Charity in the U.S., donated $56.1 million to hate groups from 2015 to 2017. The foundation, which identifies as one of the largest donor-advised funds in the country, has become a vehicle which allows individuals to anonymously send money.

    With donor-advised funds, people can send tax deductible contributions which will remain anonymous from the IRS. Many payments that have gone through NCF have been gifted to 23 organizations labeled as hate groups by the Southern Poverty Law Center. Most of the groups opposed LGBT rights, and the NCF also donated to anti-Muslim and anti-immigrant organizations.

    Alliance Defending Freedom is one of the organizations which has received the most money from NCF. The Alliance advocates for sterilizing transgender people. Another organization receiving notable amounts of funding from the NCF is the Family Research Council, which advocates for conversion therapy.

    According to the NCF website, it has "accepted over $12 billion in contributions and made over $10 billion in giver-recommended grants to more than 55,000 charities."

    "NCF is a national network of givers who are working to further the generosity movement in the areas they care about the most. Like other donor-advised fund sponsors, NCF helps thousands of generous people give to the charitable causes they care about, and we help them do so in the most efficient and effective manner possible," Steve Chapman, a spokesperson for NCF, said. "In 2018, we sent $1.7 billion in grants to more than 26,000 charities who are bringing clean water to the thirsty, homes to the homeless, food to the hungry, healing to the hurting, and much more. We are solely focused on helping people give generously and wisely to their favorite charities."

    Legislative director of watchdog organization Common Cause, Aaron Scherb, said that in the past conservative religious groups have donated to groups that further their cause.

    "The Religious Right and certain conservative religious groups have significant resources at their disposable. As we detailed in a 2015 report, they often flex their political muscle to further enhance their ability to spend big money in politics to drown out the voices of dissenting views," he said.

    "It’s interesting to me that big donors have a mechanism to give money to causes that would be unpopular, like going after gay rights.... It’s not always so much about the total amount as it is about the mechanisms for funneling money into politics," Lisa Gilbert, the vice president of legislative affairs at consumer advocacy group Public Citizen noted. *"*This is like a shell-game funnel of corporate money. So it might be an organization that has an innocent name, that sounds like a good, upstanding, innocent group" but is backed by wealthy donors, she continued.


    https://mavenroundtable.io/theintell...erm=Alessandra
    "Even if you dance for your enemy on the rock, he will accuse you of splashing water on him." ~ African Proverb




  11. #16091

    Re: National, Regional and Local News

    U.S. Posts Largest-Ever Monthly Budget Deficit in February
    By Katia Dmitrieva and Laura Davison
    March 22, 2019, 2:00 PM EDT Updated on March 22, 2019, 3:08 PM EDT
    Shortfall rises 40% to $544b in first 5 months of fiscal year
    Corporate, income taxes decline as tariff revenue climbs

    The U.S. posted its biggest monthly budget deficit on record last month, amid a 20 percent drop in corporate revenue and a boost in spending so far this fiscal year.

    The budget gap widened to $234 billion in February, compared with a fiscal gap of $215.2 billion a year earlier. That gap surpassed the previous monthly record of $231.7 billion set seven years ago, according to data compiled by Bloomberg.

    February’s shortfall helped push the deficit for the first five months of the government’s fiscal year to $544.2 billion, up almost 40 percent from the same period the previous year, the Treasury Department said in its monthly budget report Friday. The release was delayed a week by the government shutdown earlier this year.

    Receipts dipped less than 1 percent to $1.3 trillion in the October-February period from the previous year, while spending accelerated 9 percent to $1.8 trillion.

    The fiscal shortfall is widening following President Donald Trump’s $1.5 trillion tax-cuts package that’s weighing on receipts and raising concerns about the national debt load, which topped a record $22 trillion last month.

    Federal Reserve Chairman Jerome Powell reiterated his concern over the government deficit in a press conference Wednesday, saying that the nation’s growing debt pile needs to be addressed. At the same time, there’s a shift among some economists -- led by proponents of Modern Monetary Theory -- on the dangers of a growing deficit, with low inflation and cheap borrowing costs suggesting there’s room for additional spending.

    The Treasury data show tax receipts declined for both corporations and individuals in the five-month period, while revenue from customs duties almost doubled, boosted by income from tariffs imposed by the Trump administration.

    The 2017 tax law slashed the corporate tax rate from 35 percent to 21 percent.

    Corporations have so far this fiscal year paid $59.2 billion, compared to $73.5 billion in 2018, when the tax law was only partially in effect for some corporations. In 2017, however, the year before the law was enacted, corporations had paid $87.4 billion at this point in the year.

    Individual income tax receipts dropped slightly from this point last year, but have risen compared to some years before the tax law. Despite the law cutting tax rates for most people, rising wages and lower unemployment have spurred higher tax revenue.

    — With assistance by Wendy Hoagland


    https://www.bloomberg.com/news/artic...rd-in-february
    "Even if you dance for your enemy on the rock, he will accuse you of splashing water on him." ~ African Proverb




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