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Saturday, 7 May 2016

Princess Health and In many people, OxyContin doesn't give 12-hour pain relief as advertised, and that can cause an addiction problem. Princessiccia

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Oxycontin tablets (Los Angeles Times photo by Liz Baylen)
Why have so many people become addicted to the painkiller OxyContin? We know about the overselling of the drug by its manufacturer, Purdue Pharma, which cost the company $635 million in 2007 to settle an investigation by the Department of Justice. Now the Los Angeles Times reports on another big reason, which the settlement didn't address: In many people, OxyContin doesn't last as long as advertised, and "Patients can experience excruciating symptoms of withdrawal, including an intense craving for the drug," Harriet Ryan, Lisa Girion and Scott Glover report.

Purdue Pharma "launched OxyContin two decades ago with a bold marketing claim: One dose relieves pain for 12 hours, more than twice as long as generic medications," the writers report. "On the strength of that promise, OxyContin became America�s bestselling painkiller, and Purdue reaped $31 billion in revenue."

However, the Times reports, "Even before OxyContin went on the market, clinical trials showed many patients weren�t getting 12 hours of relief," as the company claimed. "Since the drug�s debut in 1996, the company has been confronted with additional evidence, including complaints from doctors, reports from its own sales reps and independent research. The company has held fast to the claim of 12-hour relief, in part to protect its revenue. OxyContin�s market dominance and its high price � up to hundreds of dollars per bottle � hinge on its 12-hour duration. Without that, it offers little advantage over less expensive painkillers."

In the late 1990s, when doctors began telling patients to take OxyContin at shorter intervals, "Purdue executives mobilized hundreds of sales reps to [refocus' physicians on 12-hour dosing. Anything shorter 'needs to be nipped in the bud. NOW!!' one manager wrote to her staff," the Times reports. "Purdue tells doctors to prescribe stronger doses, not more frequent ones, when patients complain that OxyContin doesn�t last 12 hours. That approach creates risks of its own. Research shows that the more potent the dose of an opioid such as OxyContin, the greater the possibility of overdose and death. More than half of long-term OxyContin users are on doses that public-health officials consider dangerously high, according to an analysis of nationwide prescription data conducted for The Times."

More than 7 million Americans have abused OxyContin in the last 20 years, according to the National Survey on Drug Use and Health, and a disproportionate number have been in Appalachia and Eastern Kentucky, where the drug has been called "hillbilly heroin." OxyContin "is widely blamed for setting off the nation�s prescription opioid epidemic, which has claimed more than 190,000 lives from overdoses involving OxyContin and other painkillers since 1999," the Times reports.

Purdue Pharma issued statement calling the Times story �long on anecdotes and short on facts� and said it was based on a �long-discredited theory.� Times spokeswoman Hillary Manning replied, �Our editors see nothing in Purdue�s statement that casts doubt on our reporting or our findings.� For details, click here.

Friday, 6 May 2016

Princess Health and May 6th, 2016 I'm Sleeping In. Princessiccia

Princess Health and May 6th, 2016 I'm Sleeping In. Princessiccia

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May 6th, 2016 I'm Sleeping In

I haven't had a true "tweets only" post in quite some time! I'm over-due for one. I'll take it, tonight.

But before I go...

I maintained the integrity of my maintenance calorie budget, I remained abstinent from refined sugar and I met my water goal for the day!

Plus, I enjoyed preparing a really nice dinner over at Kristin's place this evening (see dinner Tweet below).

It was a great day all the way around. I'm looking forward to a restful weekend. No alarm set for in the morning. I'm sleeping in on my Saturday!

Today's Live-Tweet Stream:


































Thank you for reading and your continued support,
Strength,
Sean

Princess Health and Childhood obesity rates continue to rise nationally while Ky.'s rate has leveled off, but 1/3 of kids are still overweight or obese. Princessiccia

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By Melissa Patrick
Kentucky Health News

Nationally, childhood obesity rates are not declining and severe obesity rates are still rising, especially among minority children. However, in Kentucky, child obesity rates have remained stable and the rates of obesity for minority children are not rising.

�Understanding the ongoing trends in obesity is important for public health and policymakers,� lead researcher Asheley Skinner, who is with the Duke Clinical Research Institute, said in a news release. �Our study suggests that more than 4.5 million children and adolescents in the U.S. have severe obesity."

The study, published in the journal Obesity, examined data from the National Health and Nutrition Examination Survey between 1999 and 2014 and found that 33.4 percent of children in the U.S. were overweight, meaning their body mass index (BMI) was above the 85th percentile for children their age. BMI levels estimate body fat based on height and weight.

In 2013-14, the study found that nearly 24 percent were obese, or above the 95th percentile, and that 2.4 percent were severely obese, or more than 140 percent of the 95th percentile.

The authors noted that the only statistical increase in child obesity since 2011 was found in those who were severely obese, which went up 2.1 percent, and this increase was most prevalent among African American and Latino children. The report also said that while there has been an increase in obesity in all age groups over the past 30 years, it "may be leveling off."

It could be that this "leveling off" effect is happening in Kentucky, where more than one-third of children are either overweight or obese.

The State of Obesity report found that 18 percent of Kentucky's high school students are obese, almost 20 percent of its 10- to 17- year olds are obese and 15.5 percent of its 2- to 4- year-olds from low-income families are obese. The report also shows that these rates have remained consistent for high school obesity since 2003, 10- to 17- year-olds since 2004 and the 2- to 4- year-olds since 2003.

The Kentucky Youth Risk Behavioral Survey also shows no overall statistical changes in obesity rates among  Kentucky's high-school students, including the state's African American high school students, whose rates range from from 15.5 percent obese in 2005 to 19.1 percent in 2013, or its Hispanic high school students, whose obesity rates were 15.5 percent in 2007 and 18.8 percent in 2013, the only two years with available data.

These reports did not break down the different levels of obesity.

Studies have shown that children with severe obesity are at an increased risk for heart disease, Type 2 Diabetes and even cancer when compared to children who are only considered overweight or mildly obese, says the release.

Skinner said it is time to expand local interventions and to find new treatment approaches.

"Addressing obesity in children is going to require a true population health approach, combining efforts at individual, healthcare, community and policy levels," she said in the release.

What is Kentucky doing about childhood obesity?

Kentucky's schools, as community partners in the battle against childhood obesity, are working to combat it through both nutrition and movement initiatives.

For example, most public Kentucky schools participate in the 2010 Healthy, Hunger-Free Kids Act that requires schools to provide healthier foods for their students; many schools participate in the Fresh Fruit and Vegetable Program, which provides a daily fruit or vegetable snacks to every student in participating schools; and more than 80 Kentucky school districts participate in the National Farm-to-School program.

Jamie Sparks, the school health and physical education director for the Kentucky Department of Education, said in an e-mail to Kentucky Health News that Kentucky schools are working to get students more active through several initiatives.

Sparks pointed out several successes, including school partnerships with the Alliance for a Healthier Generation initiative; a partnership with Humana Vitality called Students with Active Role Models, which encourages teachers and school staff to earn Vitality points by leading physical activity with their students; and partnerships with an online program called GoNoodle, which increases physical activity time in the classroom.

In addition, Sparks said, "Kentucky ranks second in the percentage of public schools enrolled with Let�s Move Active Schools. We have hosted 10 Physical Activity Leader trainings in the past three years."

But is that enough to make a difference?

Dr. Willian Dietz, author of an accompanying journal editorial, said there is a shortage of care-givers to treat obesity, noting that every primary care provider who takes care of children is likely to have about 50 pediatric patients with severe obesity in their practice. He also said that most of these providers aren't trained to treat childhood obesity, nor are they compensated appropriately, if at all, to treat it.

"We need more effective, cost-efficient and standardized approaches and services to manage children with the most severe obesity. This research emphasizes the urgency with which we must develop and validate a reimbursable standard of care for severe obesity in children and adolescents,"Elsie Taveras, spokesperson for The Obesity Society, said in the release.

It should be noted that Dietz, who is the director of the Global Center for Prevention and Wellness at George Washington University, said in his editorial that other data shows obesity rates have declined in two- to five- year olds. He said that this doesn't mean this study is incorrect because different time frames were used. "It all depends on how you look at it," he said. He did, however, acknowledge that severe obesity is increasing among adolescents.

He said, �The authors� observation that severe obesity has increased is of great concern, especially because children with severe obesity become adults with severe obesity.�
Princess Health and Three more Kentucky counties get needle exchanges; several others discussing, some debating; most are in early stages. Princessiccia

Princess Health and Three more Kentucky counties get needle exchanges; several others discussing, some debating; most are in early stages. Princessiccia

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By Melissa Patrick
Kentucky Health News

Harrison, Pike and Knox counties are the latest in Kentucky to approve a needle-exchange program, bringing the total number of counties to 14, and several more are getting close.

Needle exchanges were authorized by the 2015 anti-heroin bill in an effort to decrease the spread of HIV and hepatitis C, which are commonly spread by the sharing of needles among intravenous drug users. They require both local approval and funding.

The other counties that have either approved or are operating needle exchanges are Jefferson, Fayette, Pendleton, Carter, Grant, Jessamine, Franklin, Clark, Boyd, Kenton and Elliott.

Campbell County close, could have domino effect

The Campbell County Fiscal Court voted 3-1 May 4 to approve a needle exchange and now awaits the support of the City of Newport, Mark Collier of Fort Thomas Matters reports for WCPO-TV, its news partner.

If approved, the exchange will be be operated by the Northern Kentucky Health Department and paid for by a grant from the R.C. Durr Foundation. It also has a a sunset provision that would make it expire Dec. 31, 2018.

Commissioner Charlie Coleman, the only dissenter, said he opposed the exchange because Campbell County residents told him "overwhelmingly" that they didn't want one, Collier reports. He was also not comfortable with the proposed location in the Fiscal Court building.

While Kenton County has approved a mobile needle exchange and the City of Covington has also approved one, both programs are contingent on Boone or Campbell counties to join the effort.

The Fort Mitchell City Council passed a resolution April 18 supporting a needle exchange, making it the second Kenton County city to do so. Independence passed a similar resolution earlier this year, Melissa Stewart reports for The Cincinnati Enquirer.

Some counties in very early stages

The Whitley County Board of Health has unanimously voted in support of a needle exchange program, Mark White reports for the Corbin-Whitley News Journal. The county health department and the Whitley County UNITE Coalition, which works toward reversing the country's opioid epidemic, have held a public meeting to discuss the topic.

Mercer County will hold a community forum May 16 from 6 to 8 p.m. at the county Extension office to discuss a needle exchange, Kendra Peek reports for The Advocate-Messenger in Danville. Their program has been prompted by reports of two people stuck by discarded needles in public places in the county. County Judge Executive Milward Dedman told Peek he was "leaning in favor of it."

Nelson County is also considering a needle exchange, Randy Patrick reports for The Kentucky Standard in Bardstown. The public-health director for the Lincoln Trail District Health Department, Sara Jo Best, gave a presentation in support of the program April 19 at the Nelson County Fiscal Court meeting.

The Laurel County Board of Health is considering a needle exchange and will further discuss it at its June 9 meeting, Kelly McKinney reports for The Sentinel-Echo.

Ben Carlson of The Anderson News recently told what now reads like a familiar story about the exchange that occurs in an early needle exchange educational meetings. The Anderson County Health Department held such a meeting April 25.

At the meeting, health officials shared research showing that needle exchanges decrease the rates of HIV and hepatitis C caused by shared needle use; do not increase drug use; help connect users with counseling and treatment; and get dirty needles off the street.

It also included complaints from opponents who say that needle exchanges are "tacit approval of IV drug abuse." The foes included peace officers.

�The sheriff and I have over six decades of law-enforcement experience combined, and we�ve used those to teach children about the dangers of drugs,� said Chief Deputy Sheriff Joe Milam. �We�re not going to say don�t use drugs, but if you do, use this. We are not in favor of this.�

Exchanges get use, award

Lexington's needle exchange program is adding on-site referrals to rehabilitation programs to its needle exchange, which has been operating since September, reports the Lexington Herald-Leader. Since its opening, the program has received 10,297 used needles and given out 10,803 clean ones.

The Little Sandy District Health Department, which runs needle exchanges in Olive Hill and Grayson, recently received the Kentucky Public Health Association Commissioner's Award for its needle exchange. Since Feb. 4, more than 500 dirty needles have been exchanged in both Carter County locations, Joe Lewis reports for the local weekly, the Journal-Times.

Thursday, 5 May 2016

Princess Health and May 5th, 2016 Last Night. Princessiccia

Princess Health and May 5th, 2016 Last Night. Princessiccia

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May 5th, 2016 Last Night

It was a rough night. I'm pretty sure the combination of perhaps too much coffee, the Mexican restaurant, the pineapple last food of day and general stress, combined to create a painful stomach issue that woke me before 1am. It wasn't pleasant. I finally made it back to sleep around 3am or so--but by work time, I wasn't anywhere near ready to go. I called a colleague to cover my radio show and took a 1/2 sick day. I felt much better by mid-morning.
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A while back, someone mentioned how I only allow the most flattering current pictures to make it on this blog or my facebook page. Never mind that I once published an entire post all about loose skin--complete with my personal loose skin pictures. I'm not confirming or denying, but let's say I'm particular--how does that make me different than anyone else who takes an average of thirteen selfies before finding the one? I'm almost 85% past the point of caring about pictures and whether or not they're flattering. To counter this pointless suggestion--every day, my first tweet of the day is my #morningdeal tweet, a selfie--fresh out of bed, drinking the two cups of water right before a light body weight strength training routine--it's a self-imposed required routine before I allow myself a cup of coffee. The craziness level of my hair is a fairly accurate indicator of that night's quality of sleep. Last night wasn't good.
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#TBT Today's Throwback Thursday photo is one that's likely at my all-time heaviest. I really believe this was closer to 510-515, than 505.

I had a little twitter fun tonight and apparently it alarmed at least one person. "Sean, are you feeling okay?" was a message I received in the middle of my dinner play. You can read the series of dinner Tweets below starting with the premise tweet of how I like to pretend my kitchen is a restaurant, just for me. 

The point of it was a few laughs. The bigger point was having fun while honoring the integrity of my plan. When we take exceptional care and we do these things for ourselves--and our plan--we're practicing a different perspective. I spent many years not giving myself this level of care--and now, when I invest time in the weighing and measuring--the preparing and cooking--the planning and eating, I'm giving me what I need and what I deserve. And really--it's a way to take myself seriously--and not take myself too seriously, all at the same time. It's healthy, in my opinion, to be able to laugh at ourselves, occasionally. It's a balance. Am I feeling okay? Except for the middle of last night, never better!

Today was another day of maintaining the integrity of my maintenance calorie budget, remaining abstinent from refined sugar, drinking a minimum 64oz water (exceeded by 16oz) and I got in a nice workout, too! I'll aim for the same tomorrow!

I'll let the Tweets take it the rest of the way. Goodnight!

Today's Live-Tweet Stream:
















































Thank you for reading and your continued support,
Strength,
Sean

Princess Health and Study says intravenous drug users in almost half of Kentucky's counties are at high risk of getting hepatitis C or HIV. Princessiccia

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By Melissa Patrick
Kentucky Health News

A preliminary report by the federal Centers for Disease Control and Prevention has identified 220 counties in the United States as being most vulnerable to outbreaks of HIV and hepatitis C among those who inject drugs in those communities, and 54 of those counties are in Kentucky.

Most are in Appalachia, but the list includes the non-Appalachian counties of Hickman, Breckinridge, Grayson, Allen, Taylor, Boyle, Mercer, Carroll, Gallatin Grant and Campbell.
Counties deemed most vulnerable to outbreaks are green; top 25 of 220 in U.S. are numbered on map.
Kentucky leads the nation in the rate of acute hepatitis C, with 4.1 cases for every 100,000 residents, more than six times the national average, according to the CDC.

�Both HIV and hepatitis C can be transmitted when people who inject drugs share their needles," Doug Hogan, acting communications director for the Cabinet for Health and Family Services, said in an e-mail to Kentucky Health News. "Many of Kentucky�s HCV cases are among rural youth, ages 12-29, who have been sharing needles."

Clark County Health Director Scott Lockard called the CDC report a "wake-up call."

"We are potentially on the leading edge of one of the biggest public-health crises to hit our state," Lockard said in an e-mail to Kentucky Health News. "It will take a combined effort across sectors to prevent an HIV outbreak in the SOAR region such as the one that occurred in Scott County, Indiana," north of Louisville.

Lockard made these comments in April after attending a Shaping Our Appalachian Region roundtable that focused on substance abuse and intravenous drug use in the region. More than half (56 percent) of the 220 counties identified as most vulnerable for HIV or hepatitis C were located in the Appalachian regions of Kentucky, Tennessee and West Virginia.

"About 25 percent of our state�s population lives in these 54 counties," Hogan said.

The CDC began this study after an unprecedented outbreak of HIV infections occurred in Scott County, Indiana, in 2014 among its intravenous drug users to see what other counties might be vulnerable to such an outbreak.

Researchers looked at all 3,143 U.S. counties and based their rankings on six variables, including: the number of overdose deaths, per-capita-income data, unemployment data, population studies, prescription opioid sales, and prescription sales for opioid treatments such as buprenorphine.

The report points out that this does not mean that HIV or hepatitis C outbreaks are inevitable in these counties, or that there is a current problem with intravenous drug users in these counties, but says that intravenous drug users in these counties are at a higher risk.

One way to slow down the spread of HIV and hepatitis C is through needle exchanges, where intravenous drug users trade dirty needles for clean ones. Needle exchanges were authorized in Kentucky under a 2015 anti-heroin law but also require local approval.

So far, only Louisville and Lexington and the counties of Boyd, Carter, Clark, Elliott, Franklin, Grant, Harrison, Jessamine, Kenton, Knox, Pendleton and Pike are either operating or have approved such programs. Of the 54 high-risk counties, only Boyd, Carter, Clark, Knox and Pike counties have operating needle exchanges.

Hogan said, "The Kentucky Department for Public Health is working closely with (the) CDC and at-risk communities to increase HIV and hepatitis C testing, and is assisting counties in their processes of establishing syringe exchange programs."

Here's a list of Kentucky counties and their national rankings for vulnerability to the rapid spread of HIV and hepatitis C among people who inject drugs: Wolfe, 1st; Breathitt, 3rd; Perry, 4th; Clay, 5th; Bell, 6th; Leslie, 8th; Knox, 9th; Floyd, 10th: Clinton, 11th; Owsley, 12th; Whitley, 14th; Powell, 15th; Knott, 17th; Pike, 21st; Magoffin, 23rd; Estill, 25th; Lee, 30th; Menifee, 31st; Martin, 34th; Boyle, 35th; Lawrence, 39th; Rockcastle, 40th; Harlan, 45th; McCreary, 48th; Letcher, 50th; Johnson, 53rd; Russell, 54th; Elliott, 56th; Laurel, 65th; Carroll, 67th; Taylor, 75th; Grant, 77th; Adair, 93rd; Lincoln, 97th; Wayne, 99th; Cumberland, 101st; Gallatin, 108th; Bath, 125th; Grayson, 126th; Greenup, 129th; Green, 132d; Casey, 153d; Carter, 154th; Monroe, 163d; Garrard, 167th; Robertson, 175th; Lewis, 178th; Edmonson, 179th; Allen, 180th; Boyd, 187th; Hickman, 191st; Breckinridge, 202d; Campbell, 212th; and Mercer, 214th.
Princess Health and FDA to regulate e-cigs: ban sales to minors, require warning signs, require federal approval; did not address advertising issues. Princessiccia

Princess Health and FDA to regulate e-cigs: ban sales to minors, require warning signs, require federal approval; did not address advertising issues. Princessiccia

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In a long-anticipated move, the U.S. Food and Drug Administration announced May 5 that it is assuming regulatory authority over all tobacco products, including electronic cigarettes, cigars, hookah, tobacco and pipe tobacco that include banning sales to anyone under 18.

�Today�s announcement is an important step in the fight for a tobacco-free generation � it will help us catch up with changes in the marketplace, put into place rules that protect our kids and give adults information they need to make informed decisions," Health and Human Services Secretary Sylvia Burwell said in a news release.

FDA's new tobacco regulations will prohibit sales of e-cigarettes and all tobacco products to anyone under 18, both in person and online, and buyers must now show photo ID.

Health warnings will also be placed on packages and in advertisements, saying, �WARNING: This product contains nicotine. Nicotine is an addictive chemical.� It also bans free samples and the sale of covered products in vending machines not located in adult-only facilities.

The regulation also requires manufacturers of all newly-regulated products introduced to the market after Feb. 15, 2007, a date that is set by the Tobacco Control Act of 2009, to require federal approval. An amendment to the legislation has been submitted to change the date so more e-cigarettes would be grandfathered in, Jayne O'Donnell and Laura Ungar report for USA Today.

The e-cigarette industry is pushing back on these regulations.

"Industry experts say treating e-cigarettes, which don't contain tobacco, the same as cigarettes could lead to such onerous and costly approval that all but the largest tobacco companies would be forced out of the market � and possibly those companies, too," USA Today writes. Jeff Stier, an e-cigarette advocate with the National Center for Public Policy Research and industry officials, told USA Today that it could cost $1 million or more per application.

Vapers also argue that e-cigs help people quit, but studies on that conflict.

Ellen Hahn, a professor at the University of Kentucky College of Nursing and co-chair of the UK Tobacco-free Task Force, told USA Today that the new rule is a good first step toward controlling e-cigarettes, noting "vaping" can get youth addicted to nicotine and threatens to prolong "the tobacco epidemic."

"From a health perspective, to reduce the social acceptance of them is good because frankly, it's the wild, wild West out there," she told the newspaper. "Vape stores are everywhere."

The Robert Wood Johnson Foundation commended the FDA for these regulations, noting the use among high school students has "rocketed from 1.5 percent in 2011 to 16 percent in 2015, an increase of more than 900 percent." But it also said the regulation did not go far enough.

"Studies have proven that tobacco advertising directly influences youth, and that such sweet e-cigarette flavors as gummy bear and cotton candy play a role in children trying these products," Dr. Risa Lavizzo-Mourey, CEO of the RWJF, said in the statement "Today's final rule did not address these issues, and we strongly urge the FDA to take aggressive regulatory and enforcement actions to prevent and reduce youth tobacco use, in any form it takes."

The regulation goes into effect Aug. 8, and gives affected industries two years to comply. The original proposal was introduced in 2014.
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