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At some point in their lives, 80 percent of adults will experience lower back pain. It’s the second most common reason that adults see a doctor and the most common reason for disability. It’s also a microcosm of all the things that are wrong with the U.S. health care system, including its contribution to the opioid crisis.Having experienced lower back pain myself, I know that it can be truly debilitating. I would have done almost anything to rid myself of it. Lower back pain puts people in desperate and vulnerable positions, and it puts doctors under pressure to Do Something Now. From such a confluence arise many poor and potentially devastating treatments and choices. Among the worst is doctors’ decisions to write opioid prescriptions as a treatment for lower back pain and their patients taking these drugs. (Dave Chase, 3/27)

The federal government released a report last week that came to a striking conclusion: More than 80 percent of the roughly two million people struggling with opioid addiction in the United States are not being treated with the medications most likely to nudge them into remission or prevent them from overdosing. This denial of care is so pervasive and egregious, the report’s authors found, that it amounts to a serious ethical breach on the part of both health care providers and the criminal justice system. (3/26)

In the past week, three people, who were closely affected by mass shootings in this country, are believed to have died by suicide. First, it was two teens who were students at Marjory Stoneman Douglas High School in Parkland, Fla. when a gunman opened fire last year killing 17 students and staff and injuring others. Yesterday it was Jeremy Richman, whose 6-year-old daughter, Avielle, was killed in the 2012 Sandy Hook Elementary School shootings in Newtown, Conn. What I’m about to say is in no way intended to minimize the traumas these three individuals experienced or to diminish their emotional pain. These losses are heart-breaking; tragic. And, it didn’t need to be this way. (Joan Cook, 3/26)

After a stretch of disastrous years that included a recession, a debt crisis, bankruptcy, a hurricane and the exodus of thousands of residents from the island, 2019 is shaping up to be a good year for Puerto Rico — or at least for Puerto Rican morale. Several things came together, mostly by chance, to lift the island’s spirits and give Puerto Ricans a sense of hope. That is due, in important measure, to two New York Puerto Ricans, Lin-Manuel Miranda and Alexandria Ocasio-Cortez, who have brought the world’s attention to the island. (Luisita Lopez Torregrosa, 3/27)

President Trump is frustrated by two numbers that emerged after Hurricane Maria laid waste to Puerto Rico in 2017. The first is 2,975, the number of people estimated to have died as a result of the storm, according to analysis conducted by George Washington University. This number, Trump has insisted, is far higher than reality. When he visited the island shortly after the storm struck, the death toll was only 16 — though that number had more than doubled by the time Air Force One began heading back to the mainland. As weeks passed and recovery efforts continued, the toll increased dramatically. (Philip Bump, 3/26)

African-Americans have historically received less-than-optimal medical care, in part because they don’t trust physicians or the health care system. They come by this distrust honestly: think of the exploitation of African-American men in the Tuskegee experiment, or the unauthorized use of Henrietta Lacks’s cells for scientific discovery and monetary gain.I’m trying to change this dynamic one patient and one blood drive at a time. As a pediatric hematologist, I treat children with blood disorders like anemia, leukemia, thalassemia, and sickle cell disease. The latter affects about 100,000 Americans, most of whom are African-American. (A. Kyle Mack, 3/27)

The usual tactic for law enforcement officers when we detect signs of illegal brothel activity is to go in with a couple of undercover agents, arrest the women, shut down the operation, and move on. But when a health department inspector noticed suspicious activity in a massage parlor last July in Martin County, Fla., we sensed a chance to go beyond a storefront bust and find out who else was involved upstream. (William Snyder, 3/26)

The rhetoric of rage and division continues. As a physician I can tell you that fear and hatred lead to an outpouring of stress hormones which causes health problems, including high blood pressure, heart disease, strokes, as well as anxiety and depression. The entire Trump presidency has been shrouded in special counsel Mueller’s report and now that it is over, it is time to heal the public psyche. Debate is one thing, but the constant climate of threat, name calling and back and forth accusations is unhealthy. (Marc Siegel, 3/26)

Wondrous are the ways of Washington. In a single day, the federal government officially reduced the number of people with schizophrenia in the United States from 2.8 million to 750,000. With a change of the National Institute of Mental Health website in 2017, two million people with schizophrenia simply disappeared. The 2.8 million estimate, or 1.1% of the adult population, had been the official standard for the U.S. since the 1980s, when the last major prevalence survey was carried out. The figure was provided to Congress in 1993 and used for national estimates such as the cost of schizophrenia. (E. Fuller Torrey and Wendy Simmons, 3/26)