Pills, Guns and Missile Launchers

According to an article published in today's Sun Sentinel officers of the Broward Sheriff's Office raided the office and home of the Pompano Beach pain clinic owners Frank and Bernice Turturo and discovered, among other items, $250,000 in cash, gold coins and nuggets, two short-barreled assault rifles, a portable rocket launcher case and a tiny .22-caliber pistol that would fit in a brassiere. During a news conference at BSO's Fort Lauderdale headquarters today , Sheriff Al Lamberti called the firearms array "scary" and "sophisticated" and "not the day-to-day, target practice weapons you'd normally see." It does not surprise me that pain clinics in South Florida are operating in the criminal underworld of racketeering and drug trafficking . Guns are the necessary accessories required to intimidate anyone probing these shady businesses. Our law enforcement officers need more resources to crack down on drug traffickers and drug dealers in white coats. Yours Bernd

Getting High For Higher Scores

Attached a link to an article titled " Risky Rise of the Good-Grade Pill" reporting the abuse of ADHD drugs by high-school students to improve their grades. Its is troubling that the number of prescriptions for A.D.H.D. medications dispensed for young people ages 10 to 19 has risen 26 percent since 2007, to almost 21 million yearly, according to IMS Health, a health care information company — a number that experts estimate corresponds to more than two million individuals. But there is no reliable research on how many high school students take stimulants as a study aid. Doctors and teenagers from more than 15 schools across the nation with high academic standards estimated that the portion of students who do so ranges from 15 percent to 40 percent. I share the observation that physicians are being asked for prescriptions for Adderall solely for better grades. I recently " lost" a patient because I refused a mothers request to prescribe Adderall for her daughter to prepare for an " important exam." Despite the observation of increased ADHD prescription abuse a respected annual survey financed by the National Institute on Drug Abuse, “Monitoring the Future,” reports that abuse of prescription amphetamines by 10th and 12th graders nationally has actually dipped from the 1990s and is remaining relatively steady at about 10 percent. However, some experts note that the survey does not focus on the demographic where they believe such abuse is rising steadily — students at high-pressure high schools — and also that many teenagers barely know that what they often call “study drugs” are in fact illegal amphetamines. Most of these drugs are now being snorted to achieve the desired effect. A number of teenagers interviewed laughed at the ease with which they got some doctors to write prescriptions for A.D.H.D. Many youngsters with prescriptions said their doctors merely listened to their stories and took out their prescription pads. The prescription abuse is increasing because users were becoming more common, they said, and some students who would rather not take the drugs would be compelled to join them because of the competition over class rank and colleges’ interest. Whats the solution? Physicians should abide by the treatment guidelines. The disorder’s definition requires inattentiveness, hyperactivity or impulse control to present “clinically significant impairment” in at least two settings (school and home, for example), according to the Centers for Disease Control and Prevention. Crucially, some of this impairment must have been in evidence by age 7; a proper diagnosis for a teenager claiming to have A.D.H.D., several doctors said, requires interviewing parents, teachers and others to confirm that the problems existed long before. As physicians we have the ability to control this problem by carefully monitoring our own prescribing habits. I am interested in your response(s) Yours Bernd

Adverse Economic Impact of Opioid Abuse

Attached a link to an article titled "Pain Pills Add Cost and Delays to Job Injuries" highlighting the adverse economic impact of narcotic pain prescriptions. According to the article workmans compensation insurance carriers spend an estimated $1.4 billion annually on narcotic painkillers, or opioids. But they are also finding that the medications, if used too early in treatment, too frequently or for too long, can drive up associated disability payouts and medical expenses by delaying an employee’s return to work. Workers who received high doses of opioid painkillers to treat injuries like back strain stayed out of work three times longer than those with similar injuries who took lower doses, a 2008 study of claims by the California Workers Compensation Institute found. When medical care and disability payments are combined, the cost of a workplace injury is nine times higher when a strong narcotic like OxyContin is used than when a narcotic is not used, according to a 2010 analysis by Accident Fund Holdings, an insurer that operates in 18 states.Between 2001 and 2008, narcotics prescriptions as a share of all drugs used to treat workplace injuries jumped 63 percent, according to insurance industry data. Costs have also soared. In California, for example, workplace insurers spent $252 million on opioids in 2010, a figure that represented about 30 percent of all prescription costs; in 2002, opioids accounted for 15 percent of drug expenditures. Nationwide, data suggests that a vast majority of narcotic drugs used to treat occupational injuries are prescribed by a tiny percentage of doctors who treat injured workers; in California, for example, that figure is just 3 percent. Also, the bulk of such prescriptions go to a relatively small percentage of injured workers, including those who might be addicted to the drugs or those who sell them, experts said. Whats the solution? We must adopt new pain treatment guidelines for doctors which include the emphasis on NON-narcotic pain treatment modalities. In New York, one proposal would require a doctor to refer a patient who is not improving to a pain specialist when an opioid dose exceeds a certain level,Washington State has already adopted such a policy. Furthermore, we need to financially incentivize doctors to apply alternative approaches like specialized psychotherapy or referring addicted workers to treatment facilities. I am interested in your responses. Yours Bernd