Children Often Prescribed Potentially Dangerous Codeine in the ER: Study

By Join Together Staff | April 22, 2014 | Leave a comment | Filed in Parenting,Prescription Drugs, Research & Youth

Children treated in the emergency room for pain or coughs are often prescribed codeine, a potentially dangerous opioid, a new study finds.

Organizations including the American Academy of Pediatrics and American College of Chest Physicians recommend against using codeine for coughs or upper respiratory infections in children, according to Reuters.

While codeine prescription rates decreased from 3.7 percent to 2.9 percent between 2001 and 2010, many children still received the drug. Between 559,000 and 877,000 children were prescribed codeine in the emergency room each year during that time, the researchers report in Pediatrics. Codeine can be dangerous because it slows breathing. Up to one-third of people break down the drug much faster than usual, which can lead to an overdose, the article notes. About one-third of children who take codeine have no relief from symptoms, while one in 12 can accumulate toxic amounts of the drug, causing slowed breathing and possible death.

Dr. Alan D. Woolf, a pediatrician at Boston Children’s Hospital who wrote an editorial that accompanied the study, told Reuters that parents whose children are prescribed codeine can ask the doctor if there is an alternative treatment. “At Boston’s Children Hospital, we’ve taken it off the formulary so you can no longer easily prescribe it,” he said.

Study author Dr. Sunitha Kaiser of the University of California, San Francisco said codeine prescriptions for children are an issue outside of the ER. “Despite strong evidence against the use of codeine in children, the drug continues to be prescribed to large numbers of them each year,” she said in a news release. “It can be prescribed in any clinical setting, so it is important to decrease codeine prescription to children in other settings such as clinics and hospitals, in addition to emergency rooms.”

She noted ibuprofen is equal to or better than codeine for treating injury pain.

New Clemency Rules Aimed at Inmates Serving Time for Nonviolent Drug Offenses

By Join Together Staff | April 22, 2014 | Leave a comment | Filed in Drugs &Legal

The Justice Department on Monday announced new clemency criteria, aimed at inmates who are serving time for nonviolent drug offenses. The goal is to reduce the nation’s federal prison population, the Associated Press reports.

Attorney General Eric Holder described the new criteria for evaluating clemency petitions in a video message. The new rules are expected to result in thousands of new clemency applications, he said. Clemency applications take into account the seriousness of the crime, whether the person accepts responsibility for the crime, and their behavior since they were convicted. The Justice Department also considers input from the prosecuting office.

Traditionally, most requests for pardons and sentence commutations have not been granted. President Obama only commuted one sentence during his first term. That would change under the new criteria.

“The White House has indicated it wants to consider additional clemency applications, to restore a degree of justice, fairness and proportionality for deserving individuals who do not pose a threat to public safety,” Holder said. “The Justice Department is committed to recommending as many qualified applicants as possible for reduced sentences.”

Earlier this month, the U.S. Sentencing Commission, which advises federal judges, recommended shorter prison sentences for most federal drug trafficking offenders. Up to 70 percent of these offenders would receive shorter prison sentences if the commission’s recommendations are not opposed by Congress.

APRIL 22 v 10 TWELVE STEPPING WITH POWER IN THE PROVERB

Throw out the mocker, and fighting goes, too.

Quarrels and insults will disappear.

STEP 1 - We admitted we were powerless over our addictions—that our lives had become unmanageable. 

Whats it gonna take for you to realize that addiction is the cause of all this sadness and anger . Your loved ones cant keep taking your insanity what you are doing is wrong to them , God and yourself . We understand you maybe hurting and all we want is you to find a way to feel better get sober and find peace . TOUGH LOVE IS JUST THAT AND IT IS TOUGHER ON THE ONES WHO HAVE TO USE IT . TOUGH LOVE IT IS NOT THERE WAY OF TRYING TO CONTROL YOU SO TELL YOUR PRIDE TOO SHUT UP. It is killing them a little each day being helpless unable to stop you from killing yourself over and over again that's what you do every time you use. Consider your loved ones just for a moment ,and reflect on all the pain you have caused them and yourself. All the stuff mentioned in the Proverb will keep you separated and isolated from the only people on this planet who truly love you but your addiction has convinced you that love is something you don't deserve. Addiction is the biggest lie in the world and it steals everything from you and if you let it you will lose your life and soul . Sincerely commit step one ,realize enough is enough and you want to live . Reach out and ask for help ! Recovery is possible ! 

John 14 -6 - Jesus answered, “I am the way and the truth and the life. No one comes to the Father except through me.

By - Joseph Dickerson

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"There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle." - Albert Einstein

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APRIL 21 v 16 TWELVE STEPPING WITH POWER IN THE PROVERB

The person who strays from common sense

will end up in the company of the dead.

STEP 3 -Made a decision to turn our will and our lives over to the care of God .

In my active addiction I was a dead man walking , A zombie , lifeless no purpose just one focus ! Picture a zombie from the movies  , head forward arms out mouth open  grrrr druuuggggsssss   druel running down the lip. Living a life of addiction is no life at all . The control addiction has is mind boggling and the destruction it causes is indescribable . Step one and two are only the beginning but step three is a must if you don't want to be a drug zombie anymore in the company of the dead . God also has given us an instruction manual (Bible) it is the cure for Zombizm in addiction along with the steps of course. Foolishness , addiction , and pride will keep you in zombie state , Surrender , humility and God in control along with right living , working the steps , and common sense will keep you sober.  

Galatians 5 v 1

It is for freedom that Christ has set us free. Stand firm, then, and do not let yourselves be burdened again by a yoke of slavery.

By : Joseph Dickerson

Let’s Get Serious About Treating Addiction

By Dr. David Rosenbloom | April 9, 2014 | 4 Comments | Filed in Addiction,Drugs, Insurance, Mental Health & Treatment

Every few years the media report an epidemic of heroin overdose deaths; often after a celebrity like Phillip Seymour Hoffman dies to set off the spark. This time the spike in deaths—which is real– is being attributed to heroin mixed with fentanyl. Attention will fade but the deaths will continue. We wring our hands about overdoses, but do little to make effective treatment widely available. Our continuing refusal to prevent and treat addiction is a medical and social scandal.

Here are the policy changes I believe we must make to end this scandal:

1) Complete the transition to individual health insurance with complete coverage for addiction treatment. The bulk of addiction treatment today is provided by small free standing programs that depend on contracts with public entities for treatment “slots” or individual out of pocket payment. The programs with contracts are responsive to their funders, not to the patients who may be filling a slot at the moment. The organization and funding of our treatment system works against developing a long term relationship between patient and provider that is key to successful long-term recovery. When a patient leaves, the treatment entity has no continuing contact with that person. Obamacare can cover almost all the people with addiction in the country if states, employers and insurers implement it properly. Sadly, some existing treatment programs are dragging their heels or opposed to getting their patients covered because they find it easier to bill the state or because they cannot meet the administrative and clinical requirements for accepting insurance payments.

2) Integrate addiction, mental illness and medical treatment around individuals with severe addiction. Telling a patient who is unemployed, homeless, addicted and mentally ill to go someplace different for each service or to wait weeks for an appointment is malpractice because the providers know it will not happen. We should force consolidation of addiction treatment, mental illness and medical care providers to coordinate and take care of the most severely ill patients in one place. The few places where this kind of care is provided now get much better results for their patients.

3) Increase insurance payment rates for addiction treatment to a level that meets providers’ costs, draws in new responsible providers, and pays for the required coordination. Very low Medicaid and private insurance payment rates create and perpetuate the shortage of quality treatment. Appropriate payment rates will attract higher quality providers.

4) Reward longer stays in treatment and stop using providers that are unable to successfully retain patients in treatment long enough for it to be effective. Longer time in treatment, inpatient or outpatient, improves outcomes. Research shows that drug treatment for less than 90 days is generally not effective, but very few public or private insurance programs authorize that much treatment now. It is shocking that some treatment programs still throw a patient out if he relapses during treatment. Relapse is part of the disease and a signal for more treatment, not a reason to end it.

5) Require hospitals, health centers, HMO’s and other primary providers, as a condition of their participation in Medicaid, Medicare, and public employee health programs, to demonstrate that they diagnose all patients with alcohol and drug disease and that they have a clinically sound program that gets individuals the care they need. Today, most hospitals refuse to provide addiction treatment at any appropriate scale even though many of their patients would have better clinical outcomes if they got brief interventions or treatment.

6) Stop the revolving door at detoxification programs. Current policy and reimbursement get the patient out the door as soon as he or she is “medically stable,” whether or not the person is connected or ready to enter real addiction treatment. The vast majority of people who leave detox without directly entering and staying in treatment quickly relapse. Many think they “failed” treatment but the truth is they never had any treatment, just detoxification.

7) Stop arresting people for non-violent drug offenses. And stop putting people back in jail or prison for non-violent addiction related probation violations. Our current policies ruin thousands of young lives. Addiction is a disease, not a crime. Drug court programs are fine, but they touch only a tiny proportion of the people in the criminal justice system who need treatment.

David L. Rosenbloom, PhD, is Professor, Boston University School of Public Health and former Director of Join Together.

This feature was originally published on the BU Today website.