Officials said the formal designation was a sign of the grave danger posed by xylazine, which can cause horrific wounds and, when mixed with fentanyl, increase the likelihood of overdose.
By Jan Hoffman April 12, 2023 New York Times The White House on Wednesday designated a common animal tranquilizer that is increasingly mixed into street fentanyl as an “emerging drug threat,” a formal move that requires the administration to create strategies to enhance law enforcement efforts, health interventions and data collection to combat it. This is the first time that the White House’s Office of National Drug Control Policy has ever identified a substance for that designation, a mark of the gravity of the danger that it considers to be posed by the drug, xylazine. Xylazine was approved for veterinary procedures, primarily in cattle and horses, 50 years ago but has never been sanctioned for medical use in humans. Known popularly as tranq or tranq dope, it is a powerful and addictive sedative that slows breathing and heart rate, increases the risk of fatal overdose and often produces severe skin ulcers and abscesses that have led to amputations. “Many communities are not even aware of the threat in their backyard,” Dr. Rahul Gupta, the head of the drug control office, who is often referred to as the national drug czar, said in a briefing with reporters. TO CONTINUE READING: https://www.nytimes.com/2023/04/12/health/tranq-dope-xylazine.html
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Agency Continues to Take Critical Steps to Reduce Drug Overdose Deaths Being Driven Primarily by Illicit Opioids
For Immediate Release: March 29, 2023 FDA News Release Today, the U.S. Food and Drug Administration approved Narcan, 4 milligram (mg) naloxone hydrochloride nasal spray for over-the-counter (OTC), nonprescription, use – the first naloxone product approved for use without a prescription. Naloxone is a medication that rapidly reverses the effects of opioid overdose and is the standard treatment for opioid overdose. Today’s action paves the way for the life-saving medication to reverse an opioid overdose to be sold directly to consumers in places like drug stores, convenience stores, grocery stores and gas stations, as well as online. The timeline for availability and price of this OTC product is determined by the manufacturer. The FDA will work with all stakeholders to help facilitate the continued availability of naloxone nasal spray products during the time needed to implement the Narcan switch from prescription to OTC status, which may take months. Other formulations and dosages of naloxone will remain available by prescription only. Drug overdose persists as a major public health issue in the United States, with more than 101,750 reported fatal overdoses occurring in the 12-month period ending in October 2022, primarily driven by synthetic opioids like illicit fentanyl. “The FDA remains committed to addressing the evolving complexities of the overdose crisis. As part of this work, the agency has used its regulatory authority to facilitate greater access to naloxone by encouraging the development of and approving an over-the-counter naloxone product to address the dire public health need,” said FDA Commissioner Robert M. Califf, M.D. “Today’s approval of OTC naloxone nasal spray will help improve access to naloxone, increase the number of locations where it’s available and help reduce opioid overdose deaths throughout the country. We encourage the manufacturer to make accessibility to the product a priority by making it available as soon as possible and at an affordable price.” TO CONTINUE READING: https://www.fda.gov/news-events/press-announcements/fda-approves-first-over-counter-naloxone-nasal-spray BY EMILY ALPERT REYESSTAFF WRITER
MARCH 9, 2023 1:14 PM PT LA Times The Biden administration is seeking billions of dollars for a new push to wipe out hepatitis C, a virus that has continued to kill thousands of people annually in the U.S. despite the existence of extremely effective medications that can cure the infection within months. The five-year program, outlined as part of a broader budget proposal Thursday by White House officials, has been estimated to have a net cost of $5 billion over a decade, said Dr. Francis Collins, a special advisor to the president for special projects. It would require an upfront investment now estimated at more than $11 billion over five years, which Collins said would be offset by government savings from preventing liver failure and other conditions that result from hepatitis C — and therefore avoiding the costs of treating them. The exact costs would hinge on negotiations with drugmakers, who would be paid a lump sum to make an unlimited supply of direct-acting antiviral pills available to patients on Medicaid, as well as those who are uninsured, incarcerated or treated through the Indian Health Service, said Collins, the former director of the National Institutes of Health. Such “subscription” deals have already been tested in some states in an effort to expand access to the lifesaving medication. White House officials said the medicines can now cost roughly $20,000 per patient, but researchers have found curing patients can ultimately save money that would later be spent treating liver ailments. TO CONTINUE READING: https://www.latimes.com/world-nation/story/2023-03-09/biden-seeks-billions-to-wipe-out-a-hepatitis-c WASHINGTON — The Biden administration will request “significant investments” to help eliminate hepatitis C in the United States in its forthcoming budget proposal, according to Francis Collins, the former NIH director leading the project.
Collins declined to provide too many further details before the official budget request later this week, but Rep. Hank Johnson, (D-Ga.), who joined Collins at a STAT event on the subject Tuesday, suggested the request could potentially be as big as $10 billion over five years. Collins also pointed out that the plan “fits nicely” with President Biden’s broader cancer moonshot, an initiative aimed at halving the cancer rate in 25 years, since hepatitis C is one of the leading causes of liver cancer. “I would like, if it’s possible, to be as bold as possible, and contemplate not just an effort that would improve the situation, but that would eliminate hepatitis C in the United States,” Collins said at the event. “That’s a scary word, and obviously would require a huge investment, to try to reach everybody.” He also said he’s hoping the initiative would be funded as “mandatory” spending, which would ensure it would not need to be renewed each year by Congress. Johnson, too, referenced a potential request for mandatory spending. The Biden administration is expected to release more details about its federal budget later this week. TO CONTINUE READING: https://www.statnews.com/2023/03/07/francis-collins-budget-eliminating-hep-c/ Key Takeaways
Xylazine’s impact in recent years is undeniable. For example, deaths related to xylazine in Pennsylvania jumped from 2 percent to 26 percent from 2015 to 2020, while xylazine was involved in 19 percent of all overdose deaths in Maryland in 2021.[2] Deaths related to xylazine may also be underreported, as many forensic labs and toxicology tests do not test for xylazine. Its popularity comes down to how cheap it is to access and how strong its effects are. According to Abid Nazeer, MD, a psychiatrist and senior medical advisor for Symetria Recovery, “Xylazine’s popularity is connected to its ability to potentially extend the effect of other drugs, such as heroin and fentanyl.” Xylazine can also be bought very cheaply by dealers, who can order it online, Nazeer tells MDlinx. TO CONTINUE READING: https://www.mdlinx.com/article/lethal-street-drug-resistant-to-naloxone-gains-popularity/6Sl08mQtC5IoZK7QjkqjSA? Feb. 10, 2023 -By Jamelle Bouie, New York Times Over the past year, we have seen a sweeping and ferocious attack on the rights and dignity of transgender people across the country.
In states led by Republicans, conservative lawmakers have introduced or passed dozens of laws that would give religious exemptions for discrimination against transgender people, prohibit the use of bathrooms consistent with their gender identity and limit access to gender-affirming care. In lashing out against L.G.B.T.Q. people, lawmakers in at least eight states have even gone as far as to introduce bans on “drag” performance that are so broad as to threaten the ability of gender-nonconforming people simply to exist in public. Some of the most powerful Republicans in the country want to go even further. Donald Trump has promised to radically limit transgender rights if he is returned to the White House in 2024. In a video address to supporters, he said he would push Congress to pass a national ban on gender-affirming care for transgender youth and restrict Medicare and Medicaid funding for hospitals and medical professionals providing that care. TO CONTINUE READING: https://www.nytimes.com/2023/02/10/opinion/trump-desantis-transgender-rights.html?auth=login-google1tap&login=google1tap By Noah Weiland, NY Times Feb. 10, 2023, 5:00 a.m. ET
President Biden has endorsed “harm reduction,” which aims to cut down on overdoses by encouraging safer drug use. But the organizations carrying out that strategy are severely underfunded. OSCEOLA, Iowa — So many of Deborah Krauss’s friends and neighbors have died of drug overdoses during the pandemic that she said she felt as if she had been living inside of a dream. The longest she has gone without someone dying, she noted, is three weeks. Her calendar grew cluttered with funerals. “I lost count at 40,” she recalled on a recent evening in a Des Moines office as she organized supplies to help people consume drugs more safely. “And it just keeps happening.” The next day, Ms. Krauss was on the road, parked outside a Walmart in the small Iowa town of Osceola, her trunk brimming with boxes of syringes, fentanyl test strips and overdose-reversing medication. A former hair stylist, she recalled the stress of grooming an ex-boyfriend’s facial hair to make him presentable at his funeral after he died from an overdose in 2018. Ms. Krauss, 38, is one of the few practitioners in Iowa of a public health strategy known as “harm reduction,” a wide-ranging set of policies that President Biden and many federal and local health officials and physicians have made central to their efforts to curtail record-breaking overdose deaths. The strategy does not seek to cut people off from drug use. Instead, it aims to give them tools to use drugs in a safer manner, like the supplies in Ms. Krauss’s trunk. In his State of the Union address on Tuesday, Mr. Biden, the first president to endorse the strategy, highlighted the federal government’s attention to some of the core features of harm reduction work, including a provision in a recently enacted spending package that makes it easier for doctors to prescribe buprenorphine, an effective addiction medication that Ms. Krauss works to get to drug users. During his speech, Mr. Biden recognized the father of a 20-year-old from New Hampshire who died from a fentanyl overdose, citing the more than 70,000 Americans dying each year from the potent synthetic . TO CONTINUE: https://www-nytimes-com.cdn.ampproject.org/c/s/www.nytimes.com/2023/02/10/us/politics/harm-reduction-overdoses-iowa.amp.html Less than one third of infants born to mothers with the virus were screened for HCV. January 26, 2023 • By Sukanya Charuchandra Active hepatitis C virus (HCV) infection during pregnancy is associated with premature birth, and a high viral load increases the risk of vertical transmission, according to findings published in the Journal of Hepatology. However, only a minority of infants born to mothers with HCV are screened for the infection, as is recommended by treatment guidelines.
Previous studies have shown that the mother-to-child HCV transmission rate is around 6%. But the viral load level needed for transmission and the impact of hepatitis C on pregnancy outcomes are not well understood. Tatyana Kushner, MD, of the Icahn School of Medicine at Mount Sinai in New York City, and colleagues conducted a retrospective study to better understand vertical transmission of hepatitis C and its impact on pregnancy outcomes. Using administrative healthcare data, the team identified 2,170 pregnancies among 1,636 women in Ontario who acquired hepatitis C before pregnancy. In 1,780 of these cases (82%), the women continued to test positive for HCV RNA during their pregnancies, indicating active infection. Women who tested positive for HCV RNA during pregnancy were more likely to deliver their babies prematurely than those who did not have active HCV infection (18% versus 12%, respectively). The former group was also at greater risk for intrahepatic cholestasis of pregnancy (blocked bile flow) and postpartum hemorrhage. However, women with active HCV infection during pregnancy were less likely to develop gestational diabetes than those who had cleared the virus. Less than a third (29%) of the newborns born to women with hepatitis C were screened for HCV after birth. Of those who were screened, the mother-to-child transmission rate was 3.5%. Women with an HCV RNA level of at least 6.0 log, or about 1,000,000 copies, had more than a threefold greater likelihood of vertical transmission. TO CONTINUE READING: https://www.hepmag.com/article/hepatitis-c-pregnancy-linked-worse-outcomes By Jules Murtha | Fact-checked by Barbara Bekiesz MD Linx
| Updated December 20, 2022 Key Takeaways
“The only constant in life is change.” This quote from Heraclitus didn’t specifically refer to the evolving nature of medical terminology, or the consequences of stigmatizing language. Yet, it perfectly applies to research on the language of addiction, which urges clinicians to rethink how they speak about the disease. The link between language and stigmaThe US government has recognized the harsh effects of stigmatizing language on patients with substance use disorders. A 2017 memo written by Michael P. Botticelli, the former director of the White House Office of National Drug Control Policy, recognized how stigmatizing language may negatively alter societal perceptions of people with substance use disorders.[1] According to Botticelli, although people with substance use disorders are capable of recovery, “sometimes the terminology used in the discussion of substance use can suggest that problematic use of substances and substance use disorders are the result of a personal failing; that people choose the disorder, or they lack the willpower or character to control their substance use.” This, along with the perception that those who use substances are dangerous, could converge to create a stigma associated with substance use that can do real damage. This is especially true for women and mothers, who often have poor self-esteem, depression, fear, and anxiety as a result of addiction-related stigma. A 2021 article published by the NIH stated that stigma has the power to prevent patients with substance use disorders from seeking proper treatment, as well as negatively affecting physicians’ understanding of them.[2] This may ultimately influence the quality of care they receive. Person-first languageResearchers urge doctors to adapt their terminology by using person-first language. Person-first language is defined by the NIH as language that “maintains the integrity of individuals as whole human beings by removing language that equates people to their condition or has negative connotations.”[3] But what does person-first language sound like? What vocabulary should be used in the hallways and the exam room, when referring to substance use disorders and the patients who struggle with them? Read Next: Identifying drug-seeking behaviors in your patients Different ways to describe substance useWhen it comes to changing the language of addiction, there are a few concrete terms and phrases to use in place of potentially stigmatizing ones. According to the NIH and an article published by StatNews.com, this list of revised, person-first terms is as follows:[4]
Too many Americans are missing out on a cure for hepatitis C
ByLAURAN NEERGAARD AP Medical Writer ABC News- December 20, 2022, 12:35 PM WASHINGTON -- Too many Americans are missing out on a cure for hepatitis C, and a study underway in a hard-hit corner of Kentucky is exploring a simple way to start changing that. The key: On-the-spot diagnosis to replace today's multiple-step testing. In about an hour and with just a finger-prick of blood, researchers can tell some of the toughest-to-treat patients — people who inject drugs — they have hepatitis C and hand over potentially life-saving medication. Waiting for standard tests “even one or two days for someone who’s actively using drugs, we can lose touch with them,” said Jennifer Havens of the University of Kentucky, who's leading the study in rural Perry County. To start treatment right away "that’s huge, absolutely huge.” Single-visit hepatitis C diagnosis already is offered in other countries, and now the White House wants to make it a priority here. “It’s frankly an embarrassment” that the U.S. doesn’t have such an option, said Jeffrey Weiss of New York’s Mount Sinai health system, who works with a community hepatitis C outreach program. “We have many people we’ve tested and want to give their results to and can’t find them.” At least 2.4 million Americans are estimated to have hepatitis C, a virus that silently attacks the liver, leading to cancer or the need for an organ transplant. It leads to more than 14,000 deaths a year. That's even though a daily pill taken for two to three months could cure nearly everyone with few side effects. Yet in the U.S., more than 40% of people with hepatitis C don't know they're infected. Fewer than 1 in 3 insured patients who are diagnosed go on to get timely treatment. And new infections are surging among younger adults who share drug needles. “This is a travesty,” said Dr. Francis Collins, the former National Institutes of Health director who’s now a White House adviser devising a new national strategy to tackle hepatitis C. Most likely to fall through the cracks are “people in tough times” -- those who inject drugs, are uninsured or on Medicaid, or are homeless or incarcerated -- who can’t navigate what Collins calls the “clunky” diagnosis process and other barriers to the pricey pills. “It’s frankly an embarrassment” that the U.S. doesn’t have such an option, said Jeffrey Weiss of New York’s Mount Sinai health system, who works with a community hepatitis C outreach program. “We have many people we’ve tested and want to give their results to and can’t find them.” At least 2.4 million Americans are estimated to have hepatitis C, a virus that silently attacks the liver, leading to cancer or the need for an organ transplant. It leads to more than 14,000 deaths a year. That's even though a daily pill taken for two to three months could cure nearly everyone with few side effects. Yet in the U.S., more than 40% of people with hepatitis C don't know they're infected. Fewer than 1 in 3 insured patients who are diagnosed go on to get timely treatment. And new infections are surging among younger adults who share drug needles. “This is a travesty,” said Dr. Francis Collins, the former National Institutes of Health director who’s now a White House adviser devising a new national strategy to tackle hepatitis C. Most likely to fall through the cracks are “people in tough times” -- those who inject drugs, are uninsured or on Medicaid, or are homeless or incarcerated -- who can’t navigate what Collins calls the “clunky” diagnosis process and other barriers to the pricey pills. TO CONTINUE STORY: https://abcnews.go.com/Health/wireStory/us-starts-grappling-travesty-untreated-hepatitis-95611164 |
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