"Stop Meth, Not Meds," ad sponsored by drug industry advises

With some legislators saying a law is needed to make the decongestant pseudoephedrine available only by prescription, the Kentucky Healthcare Products Association has launched an advertising campaign to fight the effort. The radio commercials urge "public support for a bill that would require prescriptions for pseudoephedrine — but only for people with drug convictions," reports Ryan Alessi of cn|2's "Pure Politics." State Rep. Brent Yonts, D-Greenville, has pre-filed a bill to that effect.

"Can we really afford to miss work or school to go to our doctor every time someone in our family needs Allegra D and Mucinex D?" a female narrator asks in the ad. "The paper said politicians are pushing this because meth dealers use an ingredient in these medicines to help make their drugs." There seems to be a consensus that pseudoephedrine, the key ingredient to make meth, needs to be made less accessible in order to curb meth production, which has skyrocketed in the past year.

House Speaker Greg Stumbo, D-Prestonsburg, and Attorney General Jack Conway say Yonts' bill does not go far enough and won't prevent smurfing, "in which meth makers pay others to buy the maximum amount of pseudoephedrine for them," Alessi reports. Stumbo supports a bill drafted by Rep. Linda Belcher, D-Shepherdsville, that would require a prescription for pseudoephedrine but would expire after three years. (Read more)

Foundation funded by drug companies calls pill abuse overblown

Almost 15,000 Americans die a year from prescription pain medication, a statistic that has the Centers for Disease Control and Prevention calling the problem "an epidemic." But while the issue has been substantiated by troubling facts — in Kentucky, more people die from prescription drug overdoses than car accidents — the American Pain Foundation says it's overblown. (Photo by Darren McCollester/Getty Images)

ProPublica found that "The foundation collected nearly 90 percent of its $5 million in funding last year from the drug and medical-device industry," Charles Ornstein and Tracy Weber report for the nonprofit, independent investigative news service. "Some of the foundation's board members have extensive financial ties to drug makers ... and the group has lobbied against federal and state proposals to limited opioid use. Painkiller sales have increased fourfold since 1999, but the foundation argues that pain remains widely undertreated."

The problem is not the drugs, but doctors who prescribe them too easily, contends Will Rowe, the foundation's chief executive. "I'm convinced with every shred of my body that our interest is improving the lives of people affected by pain," he said, "and we want to do that the best way we can."

Last year, $8.5 billion in narcotic painkillers were sold in the United States, IMS Health found. The CDC reported enough drugs were prescribed last year to "medicate every American adult around the clock for a month." OxyContin alone accounted for $3.1 billion in sales in 2010, up from $752 million in 2006. Last summer, the Institute of Medicine found 116 million American adults suffer from chronic pain.

The American Pain Foundation's website lists several publications for patients, policymakers and journalists. "Each depicts the benefits of opioids, and each is underwritten by the makers of those drugs," Ornstein and Weber report. Dr. Lewis Nelson, chairman of the federal Food and Drug Administration's Drug Safety and Risk Management Advisory Committee, said the funding behind these guides, by its very nature, slants them. "If you're taking drug-company money and you're working as an advocacy group for patients, I think by definition you're biased," he said. "I take everything they say with a grain of salt." (Read more)

Pain clinics in Texas skirting law by calling themselves 'wellness' or 'rehab' facilities

Calling themselves rehabilitation or wellness clinics is the latest way operators of pill mills are skirting the law in Texas, which requires pain management clinics to register and be inspected by the state medical board. The issue is one to consider as legislators look at ways to curb prescription pill abuse in Kentucky in the 2012 legislative session, which started today.

One doctor in Santa Fe, Tex., labeled his facility a "family practice" instead of a pain clinic. "But investigators said his office had no stethoscopes or blood pressure cuffs and only a single thermometer," reports Cindy Horswell of the Houston Chronicle. "His records indicated he dispensed hundreds of thousands of highly addictive pills to known drug abusers, the Texas Medical Board said before suspending the doctor's medical license in March."

In Kentucky, Sen. Jimmy Higdon, R-Lebanon, has pre-filed a bill that would require background checks for people planning to open pain clinics, prohibit convicted felons from running them, and require that a physician in such a clinic own part of it. (Read more)

Doctor report cards will be as big a failure as No Child Left Behind, physician contends in op-ed piece

Tying physicians' reimbursements to how well they score on a Medicare report card is akin to the federal government having schools submit to No Child Left Behind, asserts Dr. Barry Schumer, a Lexington-based internal medicine physician. As the federal education-reform effort resulted in teachers "teaching to the test," the Physician Quality Reporting Initiative will only result in doctors treating to one, Schumer's op-ed piece in the Lexington Herald-Leader reads.

"The idea that a check-list of dos, don'ts and test scores will result in an upgrade of care delivery is reminiscent of the government supposition that it alone could legislate the teacher-student relationship in the interest of improving education outcomes," Schumer writes. "It didn't work in education, and it won't work in health care."

Schumer contends the program "did not ask patients what they believe are the key elements of a high-quality doctor-patient relationship, nor was their input or opinion sought on whether they want their physician financially penalized for non-compliance with these mandates." Also ignored, he says, were primary-care providers, "any of whom could easily describe how increasing government regulations, mandating the purchase and use of expensive technology, and the threat of stiff financial penalties will not only detract from the care of patients but, worse yet, will drive already overwhelmed providers out of practice altogether." (Read more)

Smoking hookahs can cause carbon monoxide poisoning

Though they're often viewed as just cool and unusual, hookahs, exotic-looking water pipes that can be smoked at several restaurants and bars in Lexington and Louisville, can cause carbon-monoxide poisoning.

That was the case with a young man who was brought to Jewish Hospital in Louisville last fall after passing out, reports Joseph Lord of The Courier-Journal. His symptoms indicated carbon monoxide poisoning, but doctors were confused by its source. After more research, they determined it was from a hookah. His monoxide level was tested at about 29 percent. A cigarette smoker can have a level of about 5 percent. (Photo of Amanda Steinhauer and Don Moore by Aaron Borton) "They're the levels we're used to seeing when you have furnace issues, house fires, car in the garage — the really significant carbon-monoxide poisonings," said Henry Spiller, director of the Kentucky Regional Poison Center.

The increased level is not entirely surprising, given that research shows the average cigarette smoker takes about 10 puffs per cigarette, while a hookah session might involve 100 puffs. Data from the Centers for Disease Control and Prevention show a one-hour hookah session involves the user inhaling 100 to 200 times the volume of smoke than would be inhaled from one cigarette.

Symptoms of carbon-monoxide poisoning include nausea and fatigue. Long-term health problems can include neurological damage. (Read more)

Evidence grows of links between oral health and overall health

"The eyes may be the window to the soul, but the mouth provides an even better view of the body as a whole," The Wall Street Journal's Melinda Beck writes in her Health Journal column. "Some of the earliest signs of diabetes, cancer, pregnancy, immune disorders, hormone imbalances and drug issues show up in the gums, teeth and tongue—sometimes long before a patient knows anything is wrong. There's also growing evidence that oral health problems, particularly gum disease, can harm a patient's general health as well, raising the risk of diabetes, heart disease, stroke, pneumonia and pregnancy complications." (WSJ graphic; click on it for larger version)

Beck adds, "Such findings are fueling a push for dentists to play a greater role in patients' overall health. Some 20 million Americans — including 6 percent of children and 9 percent of adults — saw a dentist but not a doctor in 2008, according to a study in the American Journal of Public Health this month."

Beck urges her readers not to be fooled by shiny white teeth. "In fact, many dentists worry that people who whiten their teeth may have a false sense of complacency, since their teeth can still be harboring tooth decay and serious gum disease," she writs. "Even people who have no cavities can still have inflamed and infected gums." She quotes Mark Wolff, an associate dean at the New York University College of Dentistry: "Whiteness and the health of your teeth are totally unrelated." (Read more)

Pure hydrocodone pain pill in testing; critics worry about abuse

A new pain pill, one more powerful than OxyContin and 10 times stronger than Vicodin, is being tested on patients by four drug companies and could be out as early as 2013. The new medicine, which is a pure form of hydrocodone, has law enforcement in Eastern Kentucky worried, reports Ralph B. Davis of the Floyd County Times.

"In my personal opinion, a drug like that shouldn't be a prescription medication," Floyd County Coroner Greg Nelson told the Times. "It should strictly be an in-house medication."

Drug maker Zogenix of San Diego plans to apply early next year to begin marketing Zohydro, a time-released drug intended to manage moderate to severe pain, reports Chris Hawley of The Associated Press. The drug has completed three rounds of testing.

Critics worry abusers will simply crush the pill to get an intense, immediate high. "I have a big concern that this could be the next OxyContin," said April Rovero, president of the National Coalition Against Prescription Drug Abuse.

The companies defend the drug by saying pure hydrocodone "would avoid liver problems linked to high doses of acetaminophen, an ingredient in products like Vicodin," Hawley reports. "They also say patients will be more closely supervised because, by law, they will have to return to their doctors each time they need more pills."

But critics remain unconvinced and are worried about the larger ramifications of the pills being on the market. "Hydrocodone abuse is already a tremendous problem in Southern and Eastern Kentucky," Karen Kelly, executive director of the government-funded anti-drug program UNITE, told Davis. "When used properly, these medications help many who are experiencing moderate to severe pain. Unfortunately, we have seen how easily the system can be abused."

Davis expressed his own views in an editorial that ran earlier this week. "The pharmaceutical companies developing Zohydro and other copycat drugs clearly must know that their products will kill people," he wrote. "They see it happening every single day. And they have been warned that the problem is growing worse."

Davis referred to a report by the Centers for Disease Control and Prevention, which found that in 2008, an average of 40 people a day in the United States died as a result of prescription painkiller overdoses, a 400 percent increase over 10 years. "Meanwhile, the pharmaceutical companies raked in billions in profits, and financial speculators are taking note," Davis writes. "Since stories about concerns over Zohydro first began appearing over the weekend, Zogenix's stock has skyrocketing nearly 70 percent ... To put it bluntly, this is horrifying." (Read more)