U.S. Surgeon General: Addiction a disease, not a moral failing

In an interview with Health News Florida, U.S. Surgeon General Dr. Vivek Murthy emphasized that the disease of addiction – be it alcoholism or heroin dependence – is a disease of addiction and is not a moral failing.

The news collective out of Tampa caught up with Murphy in Cleveland earlier this mother where he gave the keynote speech at the annual Association of Health Care Journalists conference.

Murthy said  wants to help change the way people look at addiction and the current heroin epidemic.

“We have to be sure that people see it for what it is, which is a chronic illness, that we have to treat it with the same urgency and the same skill the same compassion we would diabetes or heart disease,” he told Health News Florida.

He said the government and the private sector must ensure that not only are prescribing practices changing in regards to opioid medications but that first-responders have overdose antidotes like Nalaxone, also known as a “save shot.”

The disease may have taken one of our most beloved musicians.  Supposedly, Prince received a save shot the week before his death.

Addiction is hitting South Florida hard. It is home to unprecedented numbers of heroin overdoses.

Those overdoses reflect the large  numbers of people coming to Palm Beach County to recover from heroin- and the numbers of unscrupulous businesses exploiting them.  Read more about addiction in our series Addiction Treatment: Inside the Gold Rush.

US Surgeon General Vice Admiral (VADM) Vivek H. Murthy, M.D., M.B.A., center, tours FoundCare in West Palm Beach on February 6, 2015. (Thomas Cordy / The Palm Beach Post)
US Surgeon General  Vivek H. Murthy , tours FoundCare in West Palm Beach on February 6, 2015. He says its time addiction is treated as an illness, not a moral failing.

Murthy said that because society didn’t address addiction as an illness for decades, many people have gone without treatment, missing out on living fulfilling lives and contributing to society. He is forming the first-ever Surgeon General’s Report on Substance Use, Addiction and Health.

“It’s there not only to bring together the best science and how to prevent and treat substance abuse disorders, but it’s also there to move the country toward a new way of thinking about addiction,” Murthy said.

To read all of Health News Florida’s report click here.

 

The good news and bad news on Zika in the U.S.

So the bad news on the Zika virus is that that the United States is likely to see an outbreak. But Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, tells the news service Reuters it will be limited to perhaps dozens of people

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The bad news is that health officials do expect some native cases of Zika in the United States. The good news the cases might be a few dozen.

So far the U.S. has about  350 cases of people who were infected abroad and then returned to the country. There has not been a native case of the disease carried by the Aedes aegypti mosquito in North America yet.

For most people with Zika experience fever, rash, joint pain and red eyes. But when the outbreak was first detected in Brazil last year, the concern has been with thousands of cases of microcephaly, a typically rare birth defect marked by unusually small head size which often indicates poor brain development.

The World Health Organization declared a global health emergency in February.

“It is likely we will have what is called a local outbreak,” Fauci said on Fox News Sunday with Chris Wallace.

Some Florida counties are gearing up by adding staff to mosquito control staff, Health News Florida

Orange County, for instance, wants to add 10 seasonal full-time workers to respond to calls, according to Health News Florida.

Fauci had more bad news for us by saying that other neurological ailments could be eventually linked to Zika, which he called “disturbing.”

“There are only individual case reports of significant neurological damage to people not just the fetuses but an adult that would get infected. Things that they call meningoencephalitis, which is an inflammation of the brain and the covering around the brain, spinal cord damage due to what we call myelitis,” he said. “So far they look unusual, but at least we’ve seen them and that’s concerning.”

So, whether it’s just a few cases or not, get ready dear readers for the Summer of Zika.

New law allows nurse practitioners to prescribe narcotics

The Florida Nurse Practitioner Network hailed the governor signing into law new legislation that allows their members to prescribe painkillers to patients.

This is landmark legislation,” said Janet DuBois, president of the network. “This legislation ensures that nurse practitioners can prescribe a variety of controlled substances and pain-relieving drugs to alleviate severe pain for patients, especially patients in emergency or palliative care situations.

View of seven hydrocodone pills Wednesday Nov 20, 2013 in West Palm Beach. (Bill Ingram/Palm Beach Post)
Under a new state law, nurse practitioners can now prescribe painkillers to patients. (Bill Ingram/Palm Beach Post)

The bill expands the categories of health providers who may prescribe controlled substances for various illnesses, including cough relief, anxiety, neurological conditions and general pain, to include advanced registered nurse practitioners.

“We are proud that our legislative efforts were instrumental in the passage of this bill,” DuBois said.

A nurse practitioner is a registered nurse who has acquired the expert knowledge base, complex decision-making skills, and clinical competencies necessary for expanded practice. Nurse practitioners are required to have national certification and must hold a master’s of science degree in nursing.

What a long, strange trip it’s been: Scientists map brain on LSD

In what is being called a scientific breakthrough, scientists for the first time have mapped the effect of LSD on the brain.

CNN reports that brain scans were taken from volunteers who agreed to take the drug associated with hallucinations and a feeling of oneness with the universe. The drug also can induce paranoia – or what is known among recreational users as a bad trip.

The findings have given researchers an unprecedented insight into the neural basis for effects produced by one of the most powerful drugs ever created.

 

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A new study shows what happens to brain when it takes LSD. Scientists feel the drug may have medicinal benefits. (Image: Imperial College London)

As a result, LSD is getting mad respect in scientific circles these days.

The Post reported in February about another study that found that long-term use of the drug could lead to improved psychological well-being. The Imperial College London study found that the use of the  creates “cognitive looseness” and leads to “highly enhanced mental flexibility.”

Imperial was at it again by taking these brain scans that revealed subjects experienced images through information drawn from many parts of their brains. Usually, it is just the visual cortex at the back of the head that normally processes visual information

In an even more intriguing finding, scientists learned the drug allowed regions of the brain once segregated to speak one another.

David Nutt, a professor of neuropsychopharmacology at Imperial, was ecstatic.

“This is to neuroscience what the Higgs boson was to particle physics,” he said. “We didn’t know how these profound effects were produced. It was too difficult to do. Scientists were either scared or couldn’t be bothered to overcome the enormous hurdles to get this done.”

LSD, or lysergic acid diethylamide, was first synthesized in 1938 and was part of extensive research until the 1960s when the drug started being used for recreation and led to it being banned.

In a story on the brain scan study in The Guardian, researchers said their findings  could pave the way for LSD or related chemicals to be used to treat psychiatric disorders.

Nutt said the drug could pull the brain out of thought patterns seen in depression and addiction through its effects on brain networks.

Amanda Feilding, director of the Beckley Foundation that helped fund the study said, said: “We are finally unveiling the brain mechanisms underlying the potential of LSD, not only to heal but also to deepen our understanding of consciousness itself.”

Florida Auditor General releases report on Health Care District

The state Auditor General released the much-anticipated report on the Health Care District of Palm Beach County — and despite resurrecting some ghosts of scandals past — this latest in a long line of audits found little new.

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New CEO of the Health Care District Darcy Davis says taxpayers should be thrilled with the recent report from the State Auditor General that resurrected some old scandals but found little new.

The audit recommended the district get reimbursed for using the air ambulance Trauma Hawk out of county and put in conflict of interest safeguards when purchasing land or giving money away to outreach organizations. It also recommended increased independence when it comes to its internal audits.

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Rep. Dave Kerner of Lake Worth – and county commission candidate – wanted Trauma Hawk placed under the power of the Sheriff’s Office.

The district has undergone a series of audits in about a year and this latest one was a political animal stemming from a takeover attempt last year by the Sheriff’s Office of Trauma Hawk. That coup failed, but one of its most ardent supporters, Lake Worth state Rep. Dave Kerner, called for an audit.

For Darcy Davis, the newly enthroned CEO of the district, the Auditor General’s report was a good start to her tenure. It is especially good news when compared to what has happen to the south with scandal-plagued Broward Health where the chair was removed by Gov. Rick Scott last month and then ordered reinstated by a judge on Monday.

“The taxpayers should be pleased that this is all the Auditor General would find,” she said. “Not to minimize their efforts, but seriously this gives me reassurance that the tax dollars are being used wisely.”

The report alludes to a scandal five years ago when the district spurned free county land to rebuild the Edward J. Healey Rehabilitation and Nursing Center at its existing – but problematic – site. Instead, the district purchased land for $4 million in which the family of the real estate broker for the district had an interest.

On Trauma Hawk, the report did say that not all out-of-county services were trauma-related, and thus were not reimbursed. The county footed about $452,500 for counties that called in for help.

Davis said that the District will renew negotiations with other counties, but it is a tough task since withholding such services could cost lives.

 

Doctor implicated in hyperbaric deaths loses medical license

An 85-year-old Florida doctor held responsible for the deaths of a child and his grandmother in a hyperbaric chamber seven years ago in Broward County has lost his medical license.

The Florida Board of Medicine revoked the medical license of Dr. George Daviglus on Friday, according to Health News Florida.

The news consortium reported the Altamonte Springs chest surgeon worked as the medical director for Ocean Hyperbaric Neurologic Center in 2009 in Lauderdale-by-the-Sea when a spark caused a fire in the pressurized oxygen chamber.

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A doctor has lost his license for a fire in a hyperbaric chamber like this one. (Photo: Creative Commons)

The fire killed Vicenza Pesce immediately and severely injured her grandson, 4-year-old Francesco Martinisi of Italy. The child suffered severe burns and died one month later.

Hyperbaric oxygen treatment is sometimes used for chronic neurological diseases and other intractable ailments, but the devices are known usually for treating decompression illness in divers or carbon monoxide poisoning.

The Board of Medicine noted in striping Daviglus of his license that treatment for neurological conditions remains controversial with little evidence to support its use. Investigations found the chamber had faulty wiring and a broken intercom switch.

He said the fire was the fault of lax maintenance and that the owner of the center paid a $2 million settlement to the boy’s family, Health News Florida reported.  “I do not feel it was my fault in any way,” he said at a hearing on Friday.

Daviglus said he regrets a guilty plea in which he admitted that he was criminally liable.

To read the whole Health News Florida story click here.

Local mom fought for kids in Medicaid lawsuit

More than a decade ago, Rita Gorenflo of Palm Beach Gardens signed on as a plaintiff in the class-action lawsuit against the state of Florida on behalf of nearly two million poor and disabled children on Medicaid.

Through a lengthy Miami trial and the appeal of the judge’s scathing findings against the state, Gorenflo lost a son, while she raised six other adopted disabled children to adulthood.

Last week, the state and plaintiffs settled the class-action case with Florida agreeing to increase enrollment efforts that have left children off of Medicaid.

“It is, at least, an admission from the state that issues exist and need to be dealt with,” said Gorenflo, her son Thomas’ care becoming a prime example of the state failing disabled children.

One of the biggest victories in the multifaceted settlement is that the state agreed to increase reimbursement rates for doctors and pediatricians – one of the lowest in the country. The aim is that more doctors will now participate in the Medicaid program, increasing care and cutting travel times for families.

“It’s been 30 years since physicians were able to increase their reimbursement,” Gorenflo said. “You want to know why pediatricians were reluctant to take Medicaid patients? It was way beyond pathetic. Hopefully, it will be better.”

Gorenflo’s son, Thomas, died of his birth defects in 2011 at age 12. He became emblematic of the lawsuit. Despite his lungs being crushed by the curvature of his spine due to progressive scoliosis, the child had to wait 18 months for vital surgery while Gorenflo battled the state.

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Les and Rita Gorenflo of Palm Beach Gardens adopted Thomas, 2, in 2001. Thomas’ care became emblematic of the lawsuit against the state of Florida claiming it failed children on Medicaid. He died in 2011. (Photo by Jennifer Podis)

The registered nurse praised the lead attorney Stuart Singer and his firm Boies, Schiller & Flexner, which handled the case pro-bono. The case was settled after a federal judge ruled for the plaintiffs in December 2014, finding the state was low-balling doctors. Florida, however, appealed the decision.

Singer said there is a belief the state agency that administers Medicaid — the Agency for Health Care Administration — will act in good faith. “There is also the ability to go to court and seek injunctive relief if the agreement is materially breached and that is not remedied,” he told The Post.

Dr. Tommy Shechtman, president of the Florida Chapter of the American Academy of Pediatrics, noted that there is still work to be done as there are approximately 377,000 uninsured children in Florida — more than 28,600 living in Palm Beach County.

“We have the unfortunate distinction of being one of the nation’s top 20 counties for having the highest number children without health insurance,” Schechtman said. “This is alarming. However, I remain encouraged that through FCAAP’s collaboration with the state we can and will strive for significant improvement.”

Tallahassee pediatric cardiologist Louis St. Petery, who was highly involved in the lawsuit, said the effects of the settlement will take some time to implement.

“I don’t see any change in access tomorrow compared to today just because the settlement agreement is in place,” he said. “The settlement agreement meters this out over one year, two years, three years, depending on which category of physicians and dentists you’re talking about.”

Blocked! Feds could usurp Florida’s new abortion law

The federal government and Florida may be on a collision course over a new state law seeking to ban Medicaid funding for services at clinics that offer abortions, such as those run by Planned Parenthood, according to a News Service of Florida story.

The federal government has prohibited such bans on Medicaid funding when such laws have been put into place in other states, said Elizabeth Nash of the Guttmacher Institute, which researches abortion issues and supports abortion rights.

With the Capitol dome in the background, Mary Elizabeth Burke, of Washington, participates in a pro choice rally near the Supreme Court, Wednesday, Jan. 22, 2003. Opponents and supporters of abortion rights rallied at the nation's symbols of freedom Wednesday, energized on both sides by Republican hopes of curbing the procedure 30 years after the Supreme Court legalized it. (AP Photo/Susan Walsh) ORG XMIT: SAW101 ORG XMIT: MER0705021207182794

“You cannot exclude a provider from Medicaid because you don’t like the services they provide,” Nash said.

Florida has already been put on notice by the U.S. Centers for Medicare & Medicaid Services, the News Service reports.

The agency notified Gov. Rick Scott administration, “reminding them of the state’s obligation to ensure Medicaid beneficiaries continue to have access to services provided by any willing provider,” according to a CMS spokeswoman.

While only government-funded abortions can be obtained through extreme circumstances, women can obtain other medical services through Medicaid, the News Service reports. Indiana tried to do the same thing in 2011 and found it could not.

One of the sponsors – Rep. Colleen Burton of Lakeland – said they were aware that the state would have to apply to the federal government for a waiver.

“We knew that,” Burton said. “And we’ve said it in committees — I’ve said it on the floor of the House — that we are aware that this portion of the bill requires a waiver from the federal government.”

WASHINGTON, DC - JUNE 26: Pro-life activists gather outside the U.S. Supreme Court June 26, 2014 in Washington, DC. The court overturned today a Massachusetts law barring protests within 35 feet of abortion clinics. (Photo by Win McNamee/Getty Images)

Scott spokeswoman Jackie Schutz would not confirm that the administration was considering requesting  a waiver.

“The bill doesn’t take effect until July 1, and we’re working with our agencies on it, and looking at our options,” Schutz said.

Read the whole News Services story by clicking here.