In Prince’s age group, risk of opioid overdose climbs

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Prince - Photo: imieye from flickr.com

Prince – Photo: imieye from flickr.com

By Kristin Espeland Gourlay, RINPR
Kaiser Health New

Evidence is mounting that opioid pain medication may have played a role in the death of pop legend Prince.

While the medical examiner hasn’t yet released the results of the autopsy and toxicology tests in this case, opioid overdose in middle age is all too common.

In 2013 and 2014, according to the The Centers for Disease Control and Prevention, people ages 45 to 64 accounted for more than 40 percent of all deaths from drug overdose.

Prince died on April 21 at his home and music studio Paisley Park in Minneapolis. He was 57.

Experts say there are a number of scenarios that increase risk of overdose, which is often accidental, for people over 55.

Imagine you are in that age group and you injured your shoulder a while back. It just hasn’t gotten better, so you take prescription painkillers — an opioid like OxyContin — to help with the pain. Let’s say you’ve been taking it for a couple of years. Your body has built up a tolerance to the drug, and now, you need to change it up to get the same amount of relief.

When it comes to the potential for overdose, said Boston Medical Center epidemiologist Traci Green, this is one of the most dangerous crossroads. Continue reading

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With weather warming, King County officials urge caution around cold rivers, lakes, Sound

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With temperatures inching toward 80 degrees this weekend, King County officials urge everyone to be careful when heading out for fun on the water.

From Public Health – Seattle & King County

Mountain StreamWarm air temperatures don’t translate to warm water temperatures.

In fact, unseasonably warm weather will accelerate the typical Cascade Range spring snowmelt, and rivers will be running swift with icy cold runoff for weeks to come.

Lakes and Puget Sound are also quite cold this time of year, and swimmers can suffer from cold-water shock after just a few minutes in the water.

King County officials are on high alert because 17 people died in preventable drownings in the county in 2015.

River Safety Sign warningKing County, Public Health – Seattle & King County, and the King County Sheriff’s Office encourage kayakers, boaters, rafters, swimmers and other river users to check conditions and scout rivers thoroughly for hazards before entering the water.

“I urge everyone to use caution when going into the water, particularly in springtime when warm weather and cold water create a deadly combination,” said King County Sheriff John Urquhart. “Don’t drink, and always wear a life jacket.”

Quick Statistics

King County

  • In 2015, Public Health – Seattle & King County found that 17 people died in preventable drowning incidents.

  • Of these, 12 (70 percent) took place in open water, such as rivers, lakes, ponds, or Puget Sound.

  • Of the 12 open water deaths, nine (75 percent), may have been prevented with lifejacket use.

  • Over half (52 percent) of all King County deaths involved alcohol and or other drugs in the last five years.

Washington State

  • In 2014, there were 98 unintentional drowning deaths of Washington residents. 16 of these deaths were children and young adults under 20 years old.

  • Drowning is the second leading cause of unintentional injury death for children and teens age 1-17 in Washington.

Continue reading

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Four things to know about the Listeria recall

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listeria-largeBy Lydia Zuraw
Kaiser Health News and NPR

Frozen vegetables are a staple in many diets, so a huge recall of them has us peering at the packages in our freezers.

On Tuesday evening, the U.S. Centers for Disease Control and Prevention announced an outbreak of the Listeria monocytogenes bacteria and frozen vegetables and fruits are believed to be the cause.

More than 350 products like green beans, broccoli, peas and blueberries sold under 42 brands at U.S. and Canadian grocers including Safeway, Costco and Trader Joe’s have now been recalled.

Here are the four things to know about listeria and this massive recall:

Listeria is deadly.

Although much less common than other foodborne pathogens like salmonella or E. coli, listeria is the most lethal. Most healthy immune systems can keep an infection at bay, but if the bug makes it into the bloodstream, it causes listeriosis and kills one in five victims. Continue reading

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Aid-in-dying: Not so easy in California

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Flag_of_CaliforniaBy Emily Bazar
Kaiser Health News

Starting June 9, terminally ill Californians with six months or less to live can request a doctor’s prescription for medications intended to end their lives peacefully.

If that sounds simple, it won’t be.

California’s End of Life Option Act creates a long list of administrative hurdles that both patients and their doctors must clear.

For instance, you must make multiple requests for the drugs, orally and in writing, and provide a written attestation within 48 hours of taking the medication (you must be able to take the drugs yourself, without help, to qualify).

Two doctors must confirm your diagnosis, prognosis and ability to make medical decisions, and you must prove you’re a California resident.

“This will not be an on-demand service,” says Sarah Hooper, executive director of the UCSF / UC Hastings Consortium on Law, Science and Health Policy.

“The patient has to jump through a lot of hoops before accessing the prescription. Those hoops are designed to ensure that the patient has really thought about this and is making the decision voluntarily.” Continue reading

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Expectant moms: You have nine months for delivery decisions. You better shop around

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Blue Pregnant BellyBy Shefali Luthra
Kaiser Health News

If you’re expecting, you might want to do some homework before choosing the hospital where you’ll have your baby.

According to a report released Thursday, most hospitals overuse some medical interventions that can create health risks for both mother and child, while falling short in meeting other safety standards.

The report comes from the Leapfrog Group, a nonprofit organization that rates hospitals and emphasizes patient safety, working in conjunction with San Francisco-based Castlight Health, a company that compares quality and price among health care providers.

Researchers surveyed 1,750 hospitals, or about 46 percent of hospitals across the country, and rated them in four areas to gauge how safe women are when giving birth.

Almost 1 in 3 women had C-sections in 2014, most of which experts say would not be considered medically necessary.

Leapfrog’s maternity care expert panel devised the nationally standardized metrics, which outside experts also said aligned with reasonable best practices.

About 60 percent of hospitals give too many women cesarean sections, Leapfrog found. That meant hospitals performed the procedure on more than 24 percent of low-risk new mothers, exceeding the federal recommendations that Leapfrog’s panel used to determine its standard.

Meanwhile, almost 7 in 10 hospitals used episiotomies — a surgery that widens birth canals — for more than 5 percent of women, the maximum amount the expert panel deemed reasonable. That’s also contrary to recommended best practices against the procedure’s routine use.

And just under 80 percent didn’t have clinicians practiced in delivering babies who weigh less than 3.5 pounds.

For expectant mothers, “this can be a cause of concern,” said Erica Mobley, a spokeswoman for Leapfrog. For instance, “If you are looking at a few different hospitals, and one or two have a high risk of C-section, you are at a greater risk of having a C-section when it may not be needed.” Continue reading

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Study urges CDC to add medical error to cause of death counts

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Physician and Nurse Pushing GurneyBy Marshall Allen and Olga Pierce ProPublica, May 3, 2016, 6:31 p.m.

A study by researchers at Johns Hopkins Medicine says medical errors should rank as the third-leading cause of death in the United States — and highlights how shortcomings in tracking vital statistics may hinder research and keep the problem out of the public eye.

The authors, led by Johns Hopkins surgeon Dr. Marty Makary, call for changes in death certificates to better tabulate fatal lapses in care.

Study estimates that more than 250,000 Americans die each year from medical errors.

In an open letter, they urge the Centers for Disease Control and Prevention to immediately add medical errors to its annual list reporting the top causes of death.

Based on an analysis of prior research, the Johns Hopkins study estimates that more than 250,000 Americans die each year from medical errors.

On the CDC’s official list, that would rank just behind heart disease and cancer, which each took about 600,000 lives in 2014, and in front of respiratory disease, which caused about 150,000 deaths.

Medical mistakes that can lead to death range from surgical complications that go unrecognized to mix-ups with the doses or types of medications patients receive.

But no one knows the exact toll. In significant part, that’s because the coding system used by CDC to record death certificate data doesn’t capture things like communication breakdowns, diagnostic errors and poor judgment that cost lives, the study says. Continue reading

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State health centers awarded $5m to expand capacity

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HHS awards over $260 million to health centers nationwide to build and renovate facilities to serve more patients. $5 million will go to centers in Washington state.

Washington MapToday, HHS Secretary Sylvia M. Burwell announced over $260 million in new funding to 290 health centers nationwide for facility renovation, expansion, or construction.

In Washington state, six centers will receive a total of $5,036,675.

The Washington state funding will make it possible for the centers to provide care to nearly 18,500 more patients.

Health centers will use this funding to increase their patient capacity and to provide additional comprehensive primary and preventive health services to medically underserved populations.

The funding comes from the Affordable Care Act’s Community Health Center Fund, which was extended with bipartisan support in the Medicare Access and CHIP Reauthorization Act of 2015.

There are nearly 1,400 health centers operating about 9,800 service delivery sites in every U.S. state, D.C., Puerto Rico, the Virgin Islands and the Pacific Basin. They provide care for nearly 23 million people each year.

6 awards totaling $5,036,675 to serve a projected 18,475 additional patients

Organization City Amount
COMMUNITY HEALTH ASSOCIATION OF SPOKANE SPOKANE   $1,000,000
COMMUNITY HEALTH CARE TACOMA   $648,675
COMMUNITY HEALTH OF CENTRAL WASHINGTON YAKIMA   $1,000,000
LEWIS COUNTY COMMUNITY HEALTH SERVICES CHEHALIS   $388,000
PENINSULA COMMUNITY HEALTH SERVICES BREMERTON   $1,000,000
YAKIMA VALLEY FARM WORKERS CLINIC TOPPENISH   $1,000,000
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First Zika case reported in King County

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2016 Cynthia Goldsmith Caption:This is a transmission electron micrograph (TEM) of Zika virus, which is a member of the family Flaviviridae. Virus particles are 40 nm in diameter, with an outer envelope, and an inner dense core. Additional Information:“Zika virus is spread to people through mosquito bites. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon.”For more information on the Zika virus, follow the link below.

From Public Health – Seattle & King County

The first case of Zika infection in a King County resident has been identified by Public Health – Seattle & King County. This Zika case does not pose a risk to the public in Washington state.

The types of mosquitoes that transmit Zika are not found in the Pacific Northwest so local health officials do not expect Zika virus to spread.

Zika virus is primarily spread through the bite of infected Aedes aegypti and Aedes albopictus mosquitoes, or less commonly, through sexual contact with a recently infected man.

The illness was identified in a man in his forties who had recently been in Colombia, a country that has Zika virus spreading actively and is on the list of Centers for Disease Control and Prevention’s (CDC) travel advisories.

This is the third case of Zika found in Washington state. All three cases were found in people who became infected while in countries that have current Zika outbreaks.

With ongoing widespread outbreaks in the Americas and the Caribbean including Puerto Rico, the number of Zika cases among travelers visiting or returning to King County and elsewhere in the mainland United States will likely increase.

This Zika case does not pose a risk to the public in Washington state. Zika virus is primarily spread through the bite of infected Aedes aegypti and Aedes albopictus mosquitoes, or less commonly, through sexual contact with a recently infected man.

Continue reading

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Americans want more action against drug abuse, poll

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By Lisa Gillespie
Kaiser Health News

The fight against the growing abuse of prescription painkillers and heroin is not robust enough at any level — not federal and state governments’ efforts or those of doctors and users themselves, according to most Americans in a new poll out Tuesday.

Lack of access to care for those with substance abuse issues is a major problem, said 58 percent of those surveyed by the Kaiser Family Foundation. (KHN is an editorially independent program of the Foundation.)

kff_opioid-poll_770

The poll found that Americans had somewhat different views of heroin and prescription drug abuse. More than a third called heroin abuse an extremely serious health problem in the U.S., while just over a quarter of those surveyed said the same about the abuse of strong prescription painkillers. In contrast, fewer than a fifth regarded alcohol abuse in the same way.

The fight against opioid abuse has generated heavy news coverage in recent months, as well as government concerns. President Barack Obama recently proposed adding $1 billion to the federal budget for treatment programs. Yet more than 60 percent of respondents generally faulted federal efforts as too little. Similar shares were dissatisfied with state governments’ actions and those of doctors who prescribe painkillers, the Kaiser poll found.

But more than 70 percent believed drug users themselves aren’t doing enough. Continue reading

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CRF Frozen Foods of Pasco Washington issues massive recall of its frozen vegetables due to Listeria concern

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Recall includes approximately 358 consumer products sold under 42 separate brands sold in all fifty U.S. states and the Canadian Provinces of British Columbia, Alberta, Manitoba, Saskatchewan.

Screen Shot 2016-05-03 at 3.38.59 PMAs a precaution, CRF Frozen Foods of Pasco, Washington is expanding its voluntary recall of frozen organic and traditional fruits and vegetables.

We are performing this voluntary recall in cooperation with the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) because these products have the potential to be contaminated with Listeria monocytogenes.

The organism can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems.

Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain, and diarrhea, Listeriainfection can cause miscarriages and stillbirths among pregnant women.

This expanded recall of frozen vegetables includes all of the frozen organic and traditional fruit and vegetable products manufactured or processed in CRF Frozen Foods’ Pasco facility since May 1, 2014.

All affected products have the best by dates or sell by dates between April 26, 2016 and April 26, 2018. These include approximately 358 consumer products sold under 42 separate brands, the details of which are listed below.

Products include organic and non-organic broccoli, butternut squash, carrots, cauliflower, corn, edamame, green beans, Italian beans, kale, leeks, lima beans, onions, peas, pepper strips, potatoes, potato medley, root medley, spinach, sweet potatoes, various vegetable medleys, blends, and stir fry packages, blueberries, cherries, cranberries, peaches, raspberries, and strawberries. For a complete list of affected products go here. Continue reading

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More young children with ADHD could benefit from behavior therapy, CDC

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Behavior therapy recommended before medicine for young children with ADHD

More young children 2 to 5 years of age receiving care for attention-deficit/hyperactivity disorder (ADHD) could benefit from psychological services – including the recommended treatment of behavior therapy.

ABC blocks stacked in a pyramidThe Centers for Disease Control and Prevention’s (CDC) latest Vital Signs report urges healthcare providers to refer parents of young children with ADHD for training in behavior therapy before prescribing medicine to treat the disorder.

ADHD is a biological disorder that causes hyperactivity, impulsiveness, and attention problems. About 2 million of the more than 6 million children with ADHD were diagnosed before age 6.

Children diagnosed with ADHD at an early age tend to have the most severe symptoms and benefit from early treatment.

The American Academy of Pediatrics recommends that before prescribing medicine to a young child, healthcare providers refer parents to training in behavior therapy.

However, according to the Vital Signs report, about 75% of young children being treated for ADHD received medicine, and only about half received any form of psychological services, which might have included behavior therapy. Continue reading

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States urged to reduce pregnancy-related deaths

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Blue Pregnant BellyBy Michael Ollove
Stateline 

The relatively high percentage of American women who die as a result of pregnancy, which exceeds that of other developed nations, is prompting a new national prevention campaign that is relying on the states to take a leading role.

The key element in that effort is to encourage all states to go beyond the information provided on a typical death certificate by having mortality review panels investigate the causes behind every maternal death that occurs during pregnancy or in the year after delivery.

The hope is the investigations will reveal systemic causes for at least some of the deaths and lead to preventive measures to save the lives of more would-be or new mothers.

The death rate is significantly higher in the U.S. than in other developed countries. 

A number of studies suggest that one in three maternal deaths is preventable.

“It’s hard to do anything about a problem if you don’t have the problem fully defined,” said Cynthia Shellhaas, an associate professor in the division of maternal-fetal medicine at the Ohio State University Wexner Medical Center. Continue reading

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Opioid epidemic fueling hospitalizations, hospital costs

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Tablet Thumb BlueBy Shefali Luthra
Kaiser Health News

Every day, headlines detail the casualties of the nation’s surge in heroin and prescription painkiller abuse: the funeralsthe broken families and the patients cycling in and out of treatment.

Now, a new study sheds light on another repercussion — how this public health problem is adding to the nation’s ballooning health care costs and who’s shouldering that burden.

The research comes as policymakers grapple with how to curb the increased abuse of these drugs, known as opioids.

Hospitalizations related to use and dependence on opioids have skyrocketed, from about 302,000 in 2002 to about 520,000 a decade later.

State legislators in New YorkConnecticutAlaska and Pennsylvania have tried to take action by adding new resources to boost prevention and treatment.

In addition, President Barack Obama laid out strategies last month intended to improve how the health system deals with addiction. Continue reading

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Shortages of emergency drugs increase, study

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Vaccine SquareBy Michelle Andrews
Kaiser Health News

At some hospitals, posters on the wall in the emergency department list the drugs that are in short supply or unavailable, along with recommended alternatives.

The low-tech visual aid can save time with critically ill patients, allowing doctors to focus on caring for them rather than doing research on the fly, said Dr. Jesse Pines, a professor of emergency medicine and director of the Office for Clinical Practice Innovation at the George Washington University School of Medicine and Health Sciences, who has studied the problems with shortages.

The need for such workarounds probably won’t end anytime soon. According to a new study, shortages of many drugs that are essential in emergency care have increased in both number and duration in recent years even as shortages for drugs for non-acute or chronic care have eased somewhat.

The shortages have persisted despite a federal law enacted in 2012 that gave the Food and Drug Administration regulatory powers to respond to drug shortages, the study found. Continue reading

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