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Morning Briefing

Summaries of health policy coverage from major news organizations

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Thursday, Apr 26 2018

Full Issue

Viewpoints: Pro-Work Obsession Of Both Parties Overlooks The Virtue Of Rest; Remove Shame To Help Those Entrapped By The Opioid Crisis

Opinion writers focus on these and other health topics.

Americans love to contemplate 鈥 and legislatively promote, to whatever degree possible 鈥 the virtue of hard work. Here in the United States, we already work more hours per year than our English-speaking counterparts in Britain, Canada and Australia 鈥 not to mention those enviable denizens of European social democracies, who enjoy the kind of leisure time only our highest-paid workers can afford. So perhaps it鈥檚 not surprising that several new pro-work policy ideas are enjoying attention on the left and the right. On the right, work requirements for Medicaid, food stamps and housing assistance represent the latest conservative effort to make sure Americans work for any benefits they receive. Meanwhile, on the left, the idea of a federal job guarantee has gained increasing attention, showing up in statements from the likes of Sen. Bernie Sanders (I-Vt.) and Sen. Cory Booker (D-N.J.). (Elizabeth Bruenig, 4/25)

My sister was not a 鈥渄runk, drugged-up loser.鈥 Yet language like this, used to describe addicts, has consequences in the opioid crisis. I experienced my sister Jenny鈥檚 opioid addiction, her suffering and her death in just six days last July. She was part of the 90 percent of the 21 million Americans struggling with substance use disorder who never seek treatment. Our family鈥檚 story isn鈥檛 unique, and it isn鈥檛 the saddest story. But it鈥檚 a chilling example of how derogatory language, stigma and denial render families helpless in this health crisis. Jenny was a college-educated, middle-class suburban mom. She didn鈥檛 do a single stint in rehab or have any interventions. She died without our family ever having an honest conversation about her illness. She never had a chance, because she was too ashamed to ask for help. (Kelly O'Connor, 4/25)

An examination of data from 10 U.S. states found that more than half the people who died of opioid-related overdoses during the second half of 2016 tested positive for fentanyl. As the United States faces this unprecedented epidemic, there are lessons to be learned from Canada, which has taken bold action on a number of fronts with the aim of reducing deaths related to fentanyl, fentanyl analogues, and other opioids. For instance, in March 2016, the Canadian government made the overdose-reversal drug naloxone available without a prescription. Although naloxone is also increasingly available in many regions of the United States, laws in 14 states provide no immunity from criminal prosecution for health care providers who prescribe or distribute it to laypersons. Furthermore, in 36 states, existing laws make possession of naloxone without a prescription illegal. (Evan Wood, 4/26)

As the toll of opioid-overdose deaths in the United States rises, we face an urgent need for prevention. But preventing such deaths will require a better understanding of the diverse trajectories by which overdoses occur, including the distinction between intentional (suicide) and unintentional (accidental) deaths, be they in patients with chronic pain who overdose on their opioid analgesics or in those with a primary opioid use disorder (OUD). Interventions to prevent overdose deaths in suicidal people will differ from interventions targeted at accidental overdoses. Yet most strategies for reducing opioid-overdose deaths do not include screening for suicide risk, nor do they address the need to tailor interventions for suicidal persons. Moreover, the inaccuracy of available data on the proportion of suicides among opioid-overdose deaths 鈥 which are frequently classified as 鈥渦ndetermined鈥 if there is no documented history of depression or a suicide note 鈥 hinders deployment of appropriate prevention services. (Maria A. Oquendo and Nora D. Volkow, 4/26)

Dr. Ronny L. Jackson, President Trump鈥檚 personal physician and his pick to lead the Veterans Affairs Department, is now alleged to have inappropriately dispensed drugs, including the opioid Percocet, to others, and to have prescribed himself medication. In an interview with CNN, Senator Jon Tester of Montana said Dr. Jackson was known as the 鈥渃andy man鈥 inside the White House. Mr. Tester said a number of sources had told the Senate Veterans鈥 Affairs Committee that, on overseas trips, Dr. Jackson would 鈥済o down the aisle way of the airplane and say, 鈥楢ll right, who wants to go to sleep?鈥 And hand out the prescription drugs like they were candy.鈥 Then, the senator continued, Dr. Jackson would 鈥減ut them to sleep and then give them the drugs to wake them back up again.鈥 (Richard A. Friedman, 4/26)

Advocates for White House鈥揵acked legislation intended to make it easier for sick patients to get access to experimental drugs are frustrated, believing that congressional momentum behind 鈥渞ight to try鈥 has ground to a halt.聽Despite vocal support from President Trump and Vice President Pence, the House and Senate have made little if any progress on bridging differences with each other over separate bills that have passed each chamber. (Rachel Roubein, 4/26)

As a libertarian, I fully accept the motto that what a woman chooses to do with her own body is her business. As someone who can count, I believe that abortion involves two bodies. That鈥檚 what makes it a difficult question. So what would it mean as a practical legal matter to outlaw abortion? That is a question I have been asked frequently since being fired by the Atlantic over a four-year-old, six-word tweet and accompanying podcast in which I was alleged to have voiced an extremist view on the matter of criminalizing abortion 鈥 that it should be punished by hanging. (Kevin Williamson, 4/25)

Fertility treatments are sounding more and more like something out of a science fiction movie. Artificial intelligence and embryonic gene editing pose potential solutions to infertility and disease. Scientists are discovering how to turn human stem cells into sperm and eggs. Slices of ovarian tissue and immature eggs can now develop into mature eggs. And, fertility treatments are being used to save species at risk of extinction like the northern white rhino and coral in the Great Barrier Reef. Recent advances in fertility treatments also allow women to freeze their younger eggs to use at an older age. ...Amidst the glitz and glamor of celebrities and swanky parties, the truth about egg freezing has gotten lost. (Angela Lawson, 4/25)

Every year on World Malaria Day, April 25, the international community reaffirms its commitment to eliminate this treatable and preventable disease. Targeted investments by the U.S. and others drove deaths down 60% between 2000 and 2015鈥攕aving at least six million lives. In 57 countries, malaria cases dropped by 75% or more.But progress appears to have stalled. More than 60 countries have reported that malaria-carrying mosquitoes are becoming resistant to insecticides. In Southeast Asia, the malaria parasite itself is developing resistance to the drug artemisinin, today鈥檚 standard treatment. Africa could be next. Unchecked, drug resistance could cause more than 100,000 new deaths each year. This tragedy can be averted鈥攁nd malaria defeated鈥攚ith decisive action. (Vas Narasimhan, 4/24)

The loud, unwieldy bipap machine seemed to smother Hannah as she was wheeled out of the pediatric ICU for the last time. The apparatus thrust air into her leukemia-riddled lungs with such force it was hard to tell whether she had anything to do with the mechanical, rhythmic rise and fall of her chest. Eight years old, Hannah had relapsed acute myelogenous leukemia. After exhaustive attempts to control her disease and a month of steady decline in the ICU, it was time for her to go home. Her parents held onto hope 鈥 in part for a cure, but in larger part for just getting her home. They simply wanted to take their daughter back to their cozy double-wide trailer that had been lovingly prepared for her arrival. What happened after that, well, the Lord would take it from there. (David N. Korones, 4/25)

Last week, the mayors of 12 cities in South Orange County had the opportunity to cut the Gordian knot that is homelessness. They met at the behest of U.S. District Court Judge David O. Carter, who'd issued them a warning: Step up and help solve this problem, or I'm striking down the HOA-approved hedge of laws you think guard your perimeter. See, for decades cops and sheriff's deputies in South County have picked up the destitute and then dropped them off in blue-collar North County towns including Costa Mesa and Anaheim, but especially Santa Ana, which just happens to be the most Mexican city in Orange County. (Gustavo Arellano, 4/25)

At first glance, it seems a preposterous and careless proposal: Spend $5.4 million to hire 200 unlicensed social workers to investigate reports of child abuse and neglect around Kansas. The Kansas Department for Children and Families, already under heavy criticism for its decisions in the death of 3-year-old Wichita boy Evan Brewer and the disappearance of 5-year-old Wichita boy Lucas Hernandez (and other cases), wants neophytes watching over our state鈥檚 most vulnerable children? It does seem crazy 鈥 until considering the alternative. (4/25)

Students across Iowa walked out of school last week to protest gun violence. Like many adults, they are tired of easy access to firearms resulting in accidents, suicides and murders. Some of these teens will be old enough to vote in November鈥檚 elections, and their concerns about guns are legitimate. Every 39 hours, someone is killed by a firearm in Iowa. Guns are the most common method to commit suicide, and long guns were used in more than 40 percent of domestic violence gun homicides of Iowa women from 2007 to聽2016. These are among the findings in a new report from the Center for American Progress and Progress Iowa. The report also offers some common-sense recommendations Iowa lawmakers should consider to prevent firearm injuries and deaths. (4/25)

Travis Reinking, accused in Sunday鈥檚 shooting rampage at a Nashville Waffle House, makes the perfect case for the Red Flag proposals moving through Congress. ...Clearly, this is a guy who should have never been allowed near a gun. That鈥檚 the sort of intervention Red Flag laws are designed to enable. Proposals in Congress, including one co-sponsored by Michigan Reps. Debbie Dingell, D-Dearborn, and Fred Upton, R-St. Joseph, would give police or family members the ability to petition a court to remove guns from individuals who are determined to be a danger to themselves or others. Reinking certainly fits into that category. He has struggled with mental illness for years. And yet despite his many encounters with law enforcement agencies and concerns expressed by his family about his mental state, he was apparently able to bring a small arsenal to Nashville to carry out a mass shooting. (4/25)

With Gov. Larry Hogan's focus on putting Marylanders to work and ensuring our state is "open for business," worker health and safety should be a top priority. But when it comes to protecting the health and safety of the 2.5 million workers across our state, the main cop on the beat, the Maryland Occupational Safety and Health (MOSH) division, is exhibiting lackluster performance. (4/25)

Ohio is facing the most gripping addiction and mental health crisis in our history, and the Ohio Department of Medicaid is about to make it worse. Policy changes implemented on January 1 slowed resources for the current capacity of addiction and mental health treatment, and additional modifications scheduled for July will negatively exacerbate the situation. (Lori Criss, 4/25)

Assembly Bill 1795, introduced by Assemblyman Mike Gipson, D-Carson, would give counties authority to allow specially trained paramedics to transport intoxicated adults directly to sobering centers when it鈥檚 determined they do not have an underlying medical issue. Sobering centers offer a safe and effective alternative. (Shannon Smith-Bernardin, 4/25)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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