DEA Revises Rule on Prescribing Painkillers
Doctors Freed to Write Multiple Prescriptions
The Drug Enforcement Administration yesterday overturned a two-year-old policy that many pain specialists said was limiting their ability to properly treat chronically ill patients in need of powerful, morphine-based painkillers.
While defending its efforts to aggressively investigate doctors who officials conclude are writing painkiller prescriptions for no "legitimate medical purpose," the agency agreed with the protesting experts that it had gone too far in limiting how doctors prescribe the widely used medications.
The unusual turnaround was welcomed by relieved doctors, who said it will help restore "balance" in government policy between the needs of pain patients and the effort to control prescription drug abuse and diversion.
The Mayo Clinic explains that the biological differences between men and women and cultural factors seem to result in a different impact on women with depression and a higher incidence of the condition than is experienced by men:
Depression in women: Understanding the gender gap
About twice as many women as men experience depression. Hormones, work overload and sexual abuse are among the factors that may increase a woman's risk of depression.
I bumped into the following article earlier this week, and I was pleased to see how seriously this football player's coaches are taking his migraine disease and their willingness to try to understand the severe impact it has on his life:
Cardinal Losing Linebackers
"I've been having migraines my whole life. I just thought everybody had headaches," the fifth-year senior explains. "I've always had this predisposition to getting migraine headaches. I guess playing a couple years of college football exacerbated it and made it worse."
His migraines since last fall have been so problematic for his playing football that Silva sat out all contact work during the spring. He has been given a new helmet, designed specially to give extra cushion. The Cardinal also furnished a new, thicker mouthpiece to help protect against concussions.
Not only do collisions present a problem for Silva and his migraines, but additional activities that go along with practices and games can contribute. He says that there are a wide range of "triggers" that differ from person to person in bringing on migraines, and his include elements such as bright light, certain foods and certain conditioning or lifting exercises. He has continued to learn about his triggers and strived to manage them and his condition, while also working with the Stanford doctors in finding the right medicine and dosages to help him.
"It's basically day-to-day," he says of the migraines. "I can't predict."
"I think Mike has a real challenge because of his health issues," the coach comments. "We are very protective of him. For sure, we would treat it no other way.
The FDA wants to regulate certain diagnostic tests. As with most ideas, there are pros and cons to this proposal.
F.D.A. Seeks to Regulate New Types of Diagnostic Tests
to log in, use: (username) migraineur / (password) somebodyhealme
Advice on how you can help prevent drug errors:
To be safe, keep track of pills
Drug mix-ups harm more than a million people a year in the U.S., a report finds. You can reduce the risk.
to log in, use: (e-mail) email@example.com / (password) somebodyhealme
"Nothing that patients can do by themselves will make them truly safe," said Dr. Albert Wu, a professor at the Johns Hopkins Bloomberg School of Public Health in Baltimore and a coauthor of the report. "But they can start doing things that can make them safer."
To keep doctors from prescribing inappropriate drugs, the most important thing is to make a list of all your medications — including vitamins, herbal remedies and dietary supplements — keep it up-to-date and take it with you every time you go to the doctor's office or hospital. Many people see multiple doctors, and it's often only the patient or a family member who knows all the drugs involved.
Keeping on top of medications is especially important in the hospital.
"It's critical for patients — or family members — to be involved as much as they can to make sure the patient gets the right medications at the hospital," said Dr. David Bates, chief of general internal medicine at Brigham and Women's Hospital in Boston and a coauthor of the report.
Guidelines for assessing the usefulness of the health information you encounter online:
Living with pain: Hunting for health online
So how can you weigh whether you're getting good information? Check four criteria. First, who sponsors the site? Consider whether the person or organization has a stake in your taking any particular advice. Second, how current is the information? Medical knowledge grows and changes, so a recent publication or revision date is key. Third, can the source of the info be traced, and can the material be easily identified as fact or opinion? And fourth, is the site comprehensible by a general audience or are the discussions highly technical?
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