Patients Legally Using Cannabis Stopped Or Used Less Opioids & Dangerous Prescription Drugs

Our elected officials and health care providers may hope to curb the opioid epidemic through traditional addiction recovery programs and criminalization, but it’s time for them to consider the potential that medical cannabis has to offer in this effort.

All year, researchers from all over the country have been publishing concrete evidence proving that the legalization of medical marijuana leads to happier, healthier patients. Another study, released this week, has found that patients are replacing their prescription drugs with medical marijuana.

Published in the Journal of the American Medical Directors Association, the study concluded that chronic pain sufferers who were legally able to use medical cannabis eventually ended up using fewer opioids and other dangerous prescription drugs.

By the 10-month mark of being enrolled in the New Mexico Medical Cannabis Program (MCP), patients with chronic back pain, arthritis, chronic headaches, fibromyalgia, and other chronic musculoskeletal conditions significantly reduced their prescription drug use. Over a third of the patients enrolled in the MCP stopped using prescription drugs altogether, compared to only two percent of the non-enrolled participants.

Booming Boise Picks a Fight With CVS

CVS Health, the largest retail pharmacy chain in America, announced early this month that it planned to purchase Aetna, one of the largest health insurance companies. It was a move analysts say was meant to keep the brick-and-mortar pharmacy juggernaut competitive as e-tailer Amazon moves in to disrupt the prescription drug industry.

Over the last few years, CVS has become all-but-synonymous with “drug store” for much of the U.S., wiping out independent pharmacists as its outlets have marched through cities coast-to-coast. CVS has been on a tear during the last decade, with stores in 49 states, Washington, D.C., Puerto Rico, and Brazil. The number of CVS storesgrew more than 30 percent to more than 9,700 from 2012 to 2017. More than 1,600 are located inside Target stores, which in 2015 sold its pharmacies to CVS for $1.9 billion.

The state of Idaho, however, has only two lonely CVS outposts. Both are inside Targets, and neither is in Boise, the fast-growing high-desert capital city of 223,000. The company has been trying to remedy that situation: In October, a developer filed an application to build a single-floor 12,000-square-foot CVS retail pharmacy on Boise’s West State Street, an urban gateway that links multiple neighborhoods to the city’s downtown.

To make space for the store and its parking lot—which would have occupied nearly a city block—the developer planned to demolish three homes and a building with 23 low-income residences, at a time when the city’s downtown is quickly gentrifying and concerns about low-income residents being pushed out are intensifying.

But CVS ran into a chorus of community opposition, triggering a land-use battle that pits the pharmacy chain against a cadre of spirited smart-growth advocates who say that the drug goliath threatens the town’s essential character. Boise has been welcoming an influx of new residents lately—many from high-cost cities in California and the Pacific Northwest—drawn by the relatively inexpensive housing and laid-back outdoorsy vibe. (Boise’s local ski hill, Bogus Basin, is a nonprofit.) Longtime Boise residents don’t want the development that’s coming along with these newcomers to turn Boise into a city indistinguishable from the places they left.

Net neutrality repeal may diminish telemedicine access, harm small practices

“If I can do that, that would be a very healing experience,” he said. “Well, repealing net neutrality may screw that up. They may charge those patients a zillion dollars for the necessary bandwidth I need to communicate and to do my job better.”

Cyber protection, competition

Another hurdle to telemedicine if net neutrality is repealed involves encryption. Everything that is transmitted through telemedicine portals has tomust be encrypted to meet HIPAA laws.

“Say an ISP decides they no longer want encrypted traffic to go across their network because they want visibility into everything that goes across their line. At that point we’re just hoping that they’re going to continue to pass that traffic,” Greg Hall, IT director for the Center for Telehealth at the University of Mississippi Medical Center, told “If they decide they don't want to or want us to pay them additional fees to have the traffic that is encrypted then suddenly we’re stuck. They could very easily block it all and we can no longer do a telehealth encounter because we can’t pass our traffic over our networks. Our business is completely stopped because one ISP somewhere on the chain has decided that they don't like that kind of traffic.”

Even if major ISP providers such as AT&T, Verizon and Sprint continue to operate under the guidelines of net neutrality and do not restrict access, there still could be hurdles to telemedicine, Hall said.

“You have a small rural ISP that decides, ‘Hey, no we don’t want to play all those games, we want to charge a certain fee for certain traffic’ and say that happens to be the video traffic that we push across the internet at some point. All of the sudden, that small little provider, just because we happen to pass some traffic across their network, could very easily cripple access at that point.

“The main concern is not even just, ‘Hey, our bill comes from AT&T every month.’ It doesn't always just go over AT&T lines, so we have to worry about every ISP that our traffic happens to go across to get from one location to another.”

And although major ISPs might say there will be no changes, Hall said there are examples where that has not been the case. Previously, he said, larger providers blocked video applications from going across their network because they competed with another service the provider already offered.

A Milestone for CAR T Cells

More than 7 years have passed since the regression of advanced lymphoma was first reported in a patient who had undergone the infusion of T cells engineered to express a chimeric antigen receptor (CAR) targeting the CD19 antigen expressed on the surface of both normal and malignant B cells.1Subsequent trials of CD19-targeted CAR T-cell therapy showed a complete response in some patients with relapsed or chemotherapy-refractory hematologic cancers for which there were no effective therapies.2-5

The recent approval of anti-CD19 CAR T-cell therapy for the treatment of relapsed or refractory acute lymphoblastic leukemia and large B-cell lymphomas by the Food and Drug Administration sets a new standard of care for the patients who receive these therapies. However, the approval also comes with substantial economic challenges because of the high cost of care, a challenge that will grow as the indications for these therapies expand in the future. Policies will need to be developed to ensure that eligible patients receive these potentially curative therapies.

Groundbreaking New Drug Successfully Suppresses Huntington's Protein In Human Trial

In what is thought to be one of the biggest breakthroughs in the treatment of neurodegenerative diseases in the last 50 years, researchers have created a drug that may one day slow the progression of Huntington's disease

A tragic neurodegenerative disease, Huntington's is caused in most people by a single genetic mutation, although a small number of others do develop the genetic fault through random mutation. The gene in question codes for a protein known as huntingtin that builds up in the brain, causing the progressive degeneration of the nervous system and significantly harming movement, learning, thinking, and emotions.

The new drug is designed to disrupt the expression of this faulty gene, preventing the production of huntingtin and thus hopefully slowing the onset of the disease.

Known as IONIS-HTTRx, the drug does not target the gene itself, but is instead a piece of synthesized genetic code that binds to the piece of messenger RNA that transports the information needed to build huntingtin around the cell. By doing this, the drug destroys the messenger molecule before the damaged proteins form. The researchers were able to dramatically cut the levels of this protein found in the brain.

It is important to stress that the trials carried out so far were not looking at whether or not the new treatment prevented the symptoms of the disease from progressing, so the researchers cannot say unequivocally that it works. Instead, they were looking at the level of the toxic protein found in the nervous system.

They found that the level of the toxic protein in the brain was linked to the dose of the medicine, suggesting that the new drug does indeed target the manufacturing of the protein as expected. This is coupled with the fact that the drug had no adverse effects and was seemingly safe.

Traveling With Chronic Pain? Tips From a Spoonie

Last January, I had a terrible flare of what I soon learned was psoriatic arthritis. I had to learn how to travel across the country by myself with an uncontrolled autoimmune disorder. I had to adjust my daily life to being a spoonie. (“Spoons” are finite units of measurement that those of us with chronic illnesses use to budget our energy throughout the day – more explanation here.)  But how could I adjust my travel plans?

Airports Are Big. Flights Are Long. Plan Ahead.

• Purchase your tickets well in advance so you can select your seat – and buy as much comfort as you can afford. Take Business class if you can swing it. If you’re in economy, try to get a seat with extra leg room. And take the window seat. If I can avoid basic economy center seats for the rest of my life, I will.

• Get to the airport early and check your luggage. Even if it’s a carry-on size roller-bag. When I fly by myself, I only carry on the backpack that I can put under the seat in front of me. Managing extra luggage just means additional pain for my hands and wrists.

• Use a wheelchair. When I asked for travel tips, one of the things my friends and family repeatedly advised was “swallow your pride.” I have a hard time with this. I want to muscle through. But, even in small airports, I find it’s a mistake to think I can muscle through and go without a wheelchair. (And even if I can, I’ve then spent a spoon or two that I might want to save for after I land at my destination!)

You can reserve a free wheelchair service when you buy your ticket. But whether you reserved it ahead of time or not, when you arrive at the ticketing counter to check that luggage, let the agent know that you need a wheelchair. Usually, someone wheels a chair out for me to sit in while they dispatch a “pusher” out to me. Again, planning well in advance is necessary, because this can take a while if it’s a smaller airline and has a shared pool of wheelchair attendants. The service is always free, but it is customary to tip your wheelchair attendants. They are so nice and friendly, it’s hard not to overflow with gratitude.

The wheelchair attendant will scan your boarding pass – this is very important, because for some airlines, that’s the only way to ensure you’ll have one waiting on the ramp upon arrival at your destination. (Yes, you added it to your ticket when you bought it, but that doesn’t guarantee someone will be waiting. Also, just because you added it to your ticket doesn’t mean anyone will notice until you say something at check-in.)

CVS is buying Aetna in massive deal that could transform health care

If approved, the $69 billion acquisition -- $77 billion including debt -- would drastically remap the healthcare industry. CVS Health (CVS)is a massive drugstore chain and prescription drug insurer, while Aetna (AET) is one of the nation's largest health insurers.

It would also go down as the largest health insurance deal in history, far exceeding Express Scripts (ESRX)' $29 billion acquisition of Medco in 2012, the last record-holder.

The acquisition is not a done deal. It will have to be approved by antitrust regulators, who have been skeptical of similar health care mergers.

Buying Aetna puts CVS in a better position to compete with other integrated health care providers, such as UnitedHealthcare (UNH) and pharmacy benefits manager Optum. PBMs like Optum and CVS's Caremark help manage prescription drug plans for commercial health insurers.

Normalizing Feeding Tubes

A lot of the heavy duty stuff that comes with being an old cripple kind of scares me some, but not a lot. Like for instance, being on a ventilator. I can’t deny that I think being on a ventilator would be a real drag, mostly for the pain in the ass of it all. Being hooked up to this blinking, beeping thing all day? Having somebody constantly follow you around in case you need them to stick a tube down your throat via your trach to suction out mucous? It seems like that would add a lot to the daily routine.

A lot of people are so scared about being on a ventilator that they say they’d rather be dead. Come on, really? Dead? Once you make a decision like that there’s no taking it back. You can’t try it for 30 days and return it free if you’re not completely satisfied, paying only shipping and handling. Maybe people wouldn’t be so freaked out about being on a ventilator if somebody did something to normalize the experience. The way that we normalize something in the U.S. is to make a TV show about it. There ought to be a show about a crime-solving dude who’s on a ventilator. He’s crippled as all hell but he’s a crime solving genius so whenever the police have a stumper of a crime that really busts their balls they turn to him and he solves it every time. He has a nurse who follows him around and suctions him every now and then and she’s also his wise-cracking sidekick. A show like that would convince a lot of people that being on a ventilator is not just okay, it can even be cool.

Hacking Health Care: Silicon Valley’s Solutions To Elderly Care, Diabetes And More

While Silicon Valley’s technological breakthroughs have transformed the way people live, work, and play, health care remains an arena bogged down by archaic technology and inefficient paperwork. At the 2017 Forbes Healthcare Summit, executives from startups Color, Virta Health, Honor and Collective Health gather to discuss how they apply the hallmarks of their industry — user-friendliness, big data, virtual communication — to everything from caring for elderly parents to managing your employees’ health insurance plans.

Seth Sternberg, who cofounded non-medical homecare company Honor, recalls getting the idea for the startup during a visit with his mother. The California transplant, whose mom lives in Connecticut, noticed that she was driving much slower than he’s used to. “Mom, why are you driving so slowly?” Seth remembered asking. “Well, driving is harder than it used to be,” his mom replied.

The incident got him thinking about his mother’s future, when she may not be able to drive at all. “I don’t want to be the kid that says, mom, sorry, you now have to move to California to be with me,” Sternberg says. As it stands, if a person loses the ability to perform a few necessary tasks — such as cooking, bathing or getting groceries — they will no longer be able to live independently in their homes. Sternberg started to look into non-medical homecare for seniors — services that provide caretakers who help with daily activities — and found an extremely fragmented industry that has over 30,000 players but no one owning more than 0.5% of the market.

The serial entrepreneur, who cofounded web messenger Meebo before selling the app to Google in 2012, decided to start Honor. Unlike traditional homecare services that require advance booking and minimum number of hours per visit, care professionals booked through Honor’s app can show up in as little as two hours, and stay for only an hour. Some people use it for just a couple weeks — say, right after a knee surgery — while others use it to find long term, around-the-clock care. The app is easy to navigate and allows caretakers to quickly view allergies, favorite activities, medications and more, while children can see who’s coming to the house and when they arrive and depart.

Here's a New Reason You Should Worry About Antibiotics

There’s a global push for doctors and patients to use antibiotics more judiciously, largely because overusing them is contributing to growing resistance—meaning that some infections that were previously treatable no longer respond well to medications. Now, a new study in mice suggests that antibiotics may come with another potential health consequence. They could be interfering with the microbiome—a community of bacteria that live in the gut and elsewhere—and these changes may be passed down through generations and may cause disease.

In the study, published Monday in the journal Nature Microbiology, researchers gave healthy pregnant mice either a normal microbiome or one that had been exposed to antibiotics. Once the mice pups were born, the researchers found that the microbiome changes in the mothers had been passed on to their offspring.

The researchers also looked at a group of mice that were engineered to be at a higher risk for developing colitis, a type of inflammatory bowel disease (IBD). The researchers followed the offspring of these mice for five months and discovered that the pups who had been born to a mother with a microbiome perturbed by antibiotics had substantially worse colitis than the mice that inherited a normal microbiome.

Prior studies in humans have linked antibiotic exposure to a higher risk for IBD, which is thought to affect about 1.3 million Americans. Blaser says that the new study’s findings add to the evidence that antibiotic overuse may cause health complications even beyond antibiotic resistance.

“A lot of pregnant women are taking antibiotics, and a lot of teen girls are taking antibiotics,” says Blaser. “We are concerned that it could have an effect on the next generation.”

They hypothesized that the exposed microbiomes would impact the disease risk of the mice pups, but Blaser says the researchers were surprised by how substantial the effect was.