Programs to Spot Painkiller Abuse Work, But Are Underused

TUESDAY, June 28, 2016 (HealthDay News) — Programs to reduce prescription painkiller abuse are effective but underused, a new study suggests.

Misuse of prescription pain medicines such as hydrocodone (Vicodin), oxycodone (OxyContin, Percocet), codeine and morphine is a major public health problem in the United States. An estimated 52 million Americans have abused a prescription drug at some point in their life, according to the U.S. National Institute on Drug Abuse.

“We have resources to help tackle the opioid epidemic, but we’re underusing them,” said researcher Stephanie Nichols, who’s with the Husson University School of Pharmacy, in Bangor, Maine.

For instance, many states have created prescription drug monitoring programs, which help identify possible cases of prescription drug misuse and help patients get addiction treatment if needed.

But one study found that even though Maine has had a prescription drug monitoring program since 2004, it was used by only 56 percent of 275 pharmacists surveyed by the researchers in 2014.

While doctors and other health care providers use the system, it’s also important for pharmacists to use it, said the authors of the study in the July issue of the Journal of Studies on Alcohol and Drugs.

“Often, the pharmacist is the ‘last line of defense,’ for patient safety,” Nichols said in a journal news release.

She and her colleagues also found that opioid painkillers were prescribed to 22 percent of Maine residents in 2014, enough to provide every person in the state with a 16-day supply. While that percentage is down slightly from 2010, “it’s still a very large number,” Nichols said.

Prescriptions for oxycodone and hydrocodone were lower in 2014, but there was a sharp rise in buprenorphine prescriptions. Buprenorphine is an opioid, but it’s typically used to treat opioid addiction.

“I think that’s a positive trend, because we interpret that as an increase in treatment of people with an opioid use disorder,” Nichols said.

Along with a prescription drug monitoring program, Maine also has a program that enables health care providers to find out if a patient has a history of drug-related arrests.

A second study in the same issue of the journal examined drug take-back events in which people can drop off their unneeded prescription drugs for safe disposal.

Researchers surveyed more than 900 adults in New Jersey and found that efforts to raise public awareness about take-back programs seemed effective. People who’d seen media stories on drug take-backs or signs at their local drugstore were twice as likely to have used the programs in the past 30 days than other people.

The findings suggest that when people are aware of drug take-back programs, they will use them, concluded Itzhak Yanovitzky, of Rutgers University in New Brunswick, N.J.

More information

The U.S. National Institute on Drug Abuse has more on opioid abuse.

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Old Drug Boosts Brain’s Memory Centers

By Amy Norton
HealthDay Reporter

TUESDAY, June 28, 2016 (HealthDay News) — A long-used drug called methylene blue may rev up activity in brain regions involved in short-term memory and attention, a small study suggests.

Methylene blue has been used in medicine for more than a century, said Timothy Duong, the senior researcher on the study and a professor at the University of Texas Health Science Center at San Antonio.

These days, he said, it’s used to manage a condition called methemoglobinemia, where the blood cannot deliver enough oxygen to the body’s tissues. It’s also used to treat poisoning by cyanide or carbon monoxide.

But evidence dating back to the 1970s suggests the drug may also enhance memory, in animals and humans, Duong said.

In the new study, his team found that a single dose of methylene blue improved memory test performances by 13 healthy adults in a small, placebo-based clinical trial. Based on MRI brain scans, the medication worked by stimulating brain structures involved in processing memories as well as visual and sensory information.

Methylene blue is readily available and cheap, Duong said. But at this point no one is suggesting it’s ready to be used for preventing or treating memory decline.

“Clearly, this is early research,” said Dr. Ezriel Kornel, an assistant clinical professor of neurological surgery at Weill Cornell Medical College in New York City.

For one, it’s not known whether the drug’s effects diminish over repeated doses, said Kornel, who wasn’t involved in the study. What’s more, he said, the study included only people with intact memories and not those with impairments.

Still, Kornel called the findings “fascinating.” He said larger, longer-term studies should dig deeper into the drug’s potential.

According to Duong, methylene blue acts as “an antioxidant and an energy enhancer.” In simple terms, it can allow brain cells to receive more energy.

While there was already evidence that methylene blue can boost short-term memory, Duong said his team wanted to know how the drug affects the brain.

To do that, the researchers used functional MRI, which tracks blood flow in the brain as a person performs mental tasks.

The study group included 26 healthy men and women, ages 22 to 62. Each underwent fMRI before and one hour after receiving either a single low-dose methylene blue pill or a placebo (an inactive treatment).

Overall, the researchers found, people given the drug showed an increase in brain activity during their mental tasks. That included changes in brain areas related to emotional responses, memory, and the ability to process visual and sensory information.

The drug also improved test scores a bit. On average, people had a 7 percent increase in correct responses related to memory “retrieval.”

“The next step is to see if this works in patients with memory problems,” Duong said. “We have a similar study underway that includes people with mild cognitive impairment.”

According to Kornel, the “beauty” of methylene blue is that side effects are “minimal” at low doses. He cautioned, however, that if the drug were to become widely used, new safety issues could crop up.

The findings were published online June 28 in the journal Radiology.

More information

The Alzheimer’s Association has more on memory decline.

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Walking: The Cheap, Easy Workout

MONDAY, June 27, 2016 (HealthDay News) — Walking is a simple and inexpensive exercise that has been shown to offer numerous benefits for bones, muscles and joints.

“Sometimes the hardest part of working out is getting started,” Dr. Carolyn Hettrich, a spokesperson for the American Academy of Orthopaedic Surgeons, said in an academy news release.

“Walking requires minimal preparation, but yields significant benefits. Establish a routine by incorporating at least 30 minutes a day for five days a week,” she advised.

Hettrich also offered these suggestions:

• Wear shoes that support the arch and elevate the heel slightly. There should be stiff material surrounding the heel to prevent your foot from wobbling. The toe area should be roomy but not too long.
• Warm up by walking at a normal pace for 5 minutes, then boost your pace so your heart beats faster and your lungs breathe deeper. Keep up the faster pace for about 15 minutes.
• While walking: swing your arms; keep your head up, back straight, and abdomen flat; point your toes straight ahead; and take long strides, but do not strain. Cool down by walking at your warm-up speed again for 5 more minutes, and do gentle stretching after your walk.
• Start off by doing this type of walking three or four days a week, with days for rest in between. After two weeks, add 5 minutes to the strenuous part of your walk. Keep adding 5 minutes every two weeks as you gradually build strength and endurance.
• You can give your upper body a workout while walking by carrying one to five pound weights in each hand. Using walking sticks or poles can improve lower body stability, and reduce the stress on your legs, knees, ankles and feet.
• Be sure to drink enough water to prevent dehydration. Drink one pint of water 15 minutes before you start your walk, and another pint after you cool down. Have a drink of water every 20 minutes or as needed while you exercise.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about walking for health.

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Giving OD Antidote to Those Using Powerful Painkillers Might Save Lives

By Randy Dotinga
HealthDay Reporter

MONDAY, June 27, 2016 (HealthDay News) — In the wake of the musician Prince’s death from a painkiller overdose, a new study suggests some opioid-related deaths could be prevented by routinely prescribing an antidote for certain patients who take the medications.

Researchers found that those who received prescriptions for the antidote naloxone (Evzio) were less likely to return for emergency care related to their painkiller use.

“The study should encourage primary-care providers to prescribe naloxone to their patients on chronic opioid therapy,” said Dr. Alexander Walley. He’s an addiction specialist and assistant professor of medicine at Boston University School of Medicine. He was not involved in the study.

According to a federal report released earlier this month, an estimated 2 million people in the United States were addicted to prescription opioid painkillers like OxyContin and Vicodin in 2012-2013. Misuse of the drugs has skyrocketed over the past decade, the U.S. study found, and local officials are seeing high numbers of overdose deaths.

The new study examined the use of naloxone, a drug that’s used to reverse the effects of opioid painkillers.

Study author Dr. Phillip Coffin, director of Substance Use Research with the San Francisco Department of Public Health, said, “Since the mid-1990s, programs have been dispensing naloxone directly to people who use [illegal] drugs, as they are the most likely people to be present when an overdose occurs.” These programs have had a “remarkable” impact on overdose death rates and are cost-effective, he added.

In the new study, researchers tracked what happened after 38 percent of nearly 2,000 opioid painkiller patients at San Francisco clinics received prescriptions for naloxone. All of the patients took the opioid for chronic pain, such as pain related to cancer, Coffin said.

The idea was that these patients would have the antidote on hand if they overdosed. The “rescue kits” require a witness to respond and administer the drug to the person who overdoses, said Walley.

“Naloxone blocks the effects of opioids and will cause a person who is overdosing to be able to breathe again and wake up,” he explained. “It has no effect on people who are not using opioids and therefore is very safe.”

The researchers found that those who received naloxone prescriptions had 47 percent fewer opioid-related emergency room visits per month over the following six months, and 63 percent fewer over a year, compared to opioid patients who didn’t receive naloxone.

However, only about 12 percent of all patients went to the emergency room for opioid-related issues during the study period. Overall, the findings suggested that naloxone prescriptions for 30 patients would translate to one averted ER visit, Coffin said.

In a related study, Coffin said, researchers found that the antidote saved 5 percent of a randomly selected group of patients.

As for cost, Coffin said insurance companies generally paid for the antidote medication without a struggle. The retail price for the drug is about $15 to $30 per dose, he said.

But shouldn’t these patients not be taking opioids at all if they’re at risk for overdose?

Some patients require opioid treatment for their pain despite the risk of overdose, Coffin explained, and some are at risk of an overdose because there’s such “a narrow window” between taking enough and taking too much.

Walley praised the study and said he doesn’t see any downsides to offering the overdose antidote.

“Friends and family of people at risk for overdose should also be included in efforts to implement overdose prevention education and naloxone rescue kits,” Walley said. And emergency training in first aid and CPR should include education in how to use the rescue kits, he said.

Coffin said it’s especially important for certain painkiller patients to have the antidote on hand.

“The [U.S.] Centers for Disease Control and Prevention now recommends offering naloxone to patients on long-term opioid therapy who are taking more than 50 morphine-equivalent milligrams daily, who have a history of overdose or substance-use disorder, or who are also taking medications such as benzodiazepines [a class of tranquilizers],” he said.

Coffin urges steps beyond those recommendations: “Even for patients who are unlikely to overdose, it may be important to have naloxone in the house in case of accidental exposures or unintentional diversion of medications,” he said.

The study appears in the Aug. 16 issue of Annals of Internal Medicine.

More information

For more about opioid addiction, try the U.S. National Institute on Drug Abuse.

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Donated Blood Won’t Transmit Alzheimer’s, Parkinson’s Disease

MONDAY, June 27, 2016 (HealthDay News) — People who’ve received a blood transfusion can breathe a bit easier: A new study finds no evidence that degenerative brain disorders can be transmitted via donated blood.

“This study provides reassurance to individuals who have received blood transfusions from patients with Alzheimer’s or Parkinson’s disease,” said Dr. Irving Gomolin, a geriatrician who reviewed the Swedish study findings.

“It demonstrates that the transmission of these diseases via blood either is not biologically possible or, at worst, must be exceedingly rare,” said Gomolin. He is chief of geriatric medicine at Winthrop-University Hospital in Mineola, N.Y.

In the study, a team led by Dr. Gustaf Edgren, of the Karolinska Institute in Stockholm, tracked data on more than 40,000 patients in Denmark and Sweden. All of the patients had received blood transfusions between 1968 and 2012 from people who were later diagnosed with any form of dementia or Parkinson’s disease.

These patients were compared with over 1.4 million patients who did not receive blood from donors later diagnosed with these illnesses.

Patients in both groups had exactly the same chance of developing a neurodegenerative disorder, which clearly shows that these diseases cannot be transmitted through blood transfusion, the researchers said.

The study, “eliminates significant anxiety that a patient may have after receiving a transfusion,” said another neurologist, Dr. Paul Wright.

“If indeed someone develops Alzheimer’s disease or Parkinson’s disease and they had received a transfusion at some point, then based on this study, we can reassure them that it was not from the transfusion,” said Wright, chair of neurology at Long Island Jewish Medical Center in New Hyde Park, NY.

Gomolin believes the news is good for blood donors, too.

“Patients with Alzheimer’s or Parkinson’s disease need not be disqualified as potential blood donors (all other considerations having been addressed),” he noted.

The study was published online June 27 in the journal Annals of Internal Medicine.

More information

The U.S. National Heart, Lung, and Blood Institute has more on blood transfusion.

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The $9 Beauty Product That Kim Kardashian Swears By

Photo: Getty Images

Earlier this month when Kim K. took to Snapchat to walk us through her morning beauty routine, things got a little pricey.

The reality star first snapped a photo of four products from the high-end French beauty brand La Mer—including The Perfecting Treatment, The Concentrate, The Renewal Oil, and Crème de la Mer. But unfortunately for anyone seeking to mimic the Kardashian’s regime, it’ll cost you: Those items add up to more than $900.

RELATED: Here’s How Khloe Kardashian Works Out

But Kim isn’t all about luxury brands: The mom of two also revealed that she’s “obsessed” with Kiko Pure Clean Scrub & Peel wipes, which ring up at just $9 per package. Fans couldn’t get too excited though, as the Kardashian-approved wipes were only sold overseas—until now. Kiko’s just announced that the wipes are currently available for purchase online in the United States, and will be rolling out in stores across the country next month.

If you’re interested, act fast. If Kim’s recommendation is as powerful as Kylie’s, they’ll be sold out before you know it.

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Want to Stay Mobile as You Age? A Healthy Diet May Do the Trick

MONDAY, June 27, 2016 (HealthDay News) — Healthy eating may help reduce a woman’s risk of physical disability as she grows older, a new study suggests.

“Little research has been done on how diet impacts physical function later in life. We study the connection between diet and many other aspects of health, but we don’t know much about diet and mobility,” said study senior author Francine Grodstein, from Brigham and Women’s Hospital in Boston.

“We wanted to look at diet patterns and try to learn how our overall diet impacts our physical function as we get older,” she explained in a hospital news release.

Grodstein and her colleagues analyzed data from almost 55,000 women in the national Nurses’ Health Study who had their physical function assessed every four years from 1992 to 2008. The participants had also completed questionnaires about their eating habits.

Those who ate healthier diets were less likely to develop mobility problems than those with less healthy diets. The researchers also found that high consumption of vegetables and fruits, moderate alcohol intake, and low consumption of sugar-sweetened beverages, trans fats and salt were each associated with a reduced risk of physical impairment.

Although the study wasn’t designed to show cause and effect, specific foods most strongly linked with a lower risk of physical disability included oranges, orange juice, apples, pears, romaine or leaf lettuce, and walnuts.

The study appears in the July issue of the Journal of Nutrition.

“We think a lot about chronic diseases, cancer, heart disease, and tend not to think of physical function,” said study first author Kaitlin Hagan, a postdoctoral fellow at Brigham and Women’s. “Physical function is crucial as you age; it includes being able to get yourself dressed, walk around the block, and could impact your ability to live independently.”

More information

The U.S. Office of Disease Prevention and Health Promotion outlines how to protect your health as you age.

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Blood Pressure Problems During Pregnancy, Heart Trouble Later?

MONDAY, June 27, 2016 (HealthDay News) — Pregnant women who have blood pressure in the high-normal range may have an increased risk for metabolic syndrome after they give birth, a new study indicates.

Metabolic syndrome — which increases the risk of heart disease — is defined as having three or more of the following conditions: abdominal obesity; high triglyceride levels; low levels of “good” HDL cholesterol; high blood pressure (hypertension); and high blood sugar.

The study included 507 pregnant women in China with no history of high blood pressure. Thirty-four percent had blood pressure in the low-normal range throughout pregnancy, 52 percent had mid-normal range readings, and 13 percent had high-normal (pre-hypertension) readings.

Those with high-normal blood pressure throughout pregnancy were 6.5 times more likely to develop metabolic syndrome after giving birth than those with blood pressure in the low-normal range, the study found.

It’s the first study to show that high-normal blood pressure over time during pregnancy is associated with increased risk of later development of metabolic syndrome, the study authors said. However, the study wasn’t designed to prove a cause-and-effect connection.

The study was published June 27 in the journal Hypertension.

“Our findings underscore an important issue that has been long ignored in clinical practice — the fact that criteria for hypertension in pregnancy are derived from the general population,” said lead investigator Dr. Jian-Min Niu, at Guangdong Women and Children Hospital in China.

“We anticipate that if reaffirmed in further research, our study could spark a change in what we currently deem healthy blood pressure in pregnant women,” Niu added in a journal news release.

Niu pointed out that blood pressure measurements are commonly done as part of routine pregnancy check-ups. So, it would be easy and cost-effective to use this information to assess a woman’s risk of later heart disease and stroke.

“Early identification of metabolic risk factors and implementation of lifestyle modifications may help delay the onset of cardiovascular disease that would present itself 20 to 30 years after delivery,” the researcher concluded.

More information

The American Academy of Family Physicians has more about metabolic syndrome.

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Elderly Patients Get Unnecessary End-of-Life Treatments

MONDAY, June 27, 2016 (HealthDay News) — People dying naturally of old age often receive unnecessary end-of-life medical treatments in hospitals, a new global study finds.

The Australian-based research found that one-third of patients with advanced, irreversible chronic conditions were given treatments that didn’t necessarily benefit them — including admission to intensive care or chemotherapy — in the last two weeks of their life. The study also revealed that one-quarter of older patients who had Do-Not-Resuscitate orders were still given cardiopulmonary resuscitation (CPR).

People with serious conditions were subjected to invasive procedures, unnecessary scans and blood tests, intensive heart monitoring and other treatments that did little to alter their outcomes, sometimes against their wishes, the researchers found.

“It is not unusual for family members to refuse to accept the fact that their loved one is naturally dying of old age and its associated complications, and so they pressure doctors to attempt heroic interventions,” said study leader Dr. Magnolia Cardona-Morrell. She is with the University of New South Wales’ Simpson Centre for Health Services Research.

“Doctors also struggle with the uncertainty of the duration of the dying trajectory and are torn by the ethical dilemma of delivering what they were trained to do, save lives, versus respecting the patient’s right to die with dignity,” she said in a university news release.

The new research involved a large analysis of 38 studies done in 10 countries during the past 20 years. The review included 1.2 million doctors, patients and their relatives.

“Our findings indicate the persistent ambiguity or conflict about what treatment is deemed beneficial and a culture of ‘doing everything possible,’ ” Cardona-Morrell said.

One possible explanation for the excess tests and treatments is that significant medical advancements have led to unrealistic expectations about the ability of doctors and treatments to ensure patients’ survival, the researchers noted.

As the population of older and frail people grows, doctors and caregivers must be able to better recognize when death is imminent and unavoidable, the researchers suggested. More training will help doctors lose their fear of a wrong prognosis and identify patients near the end of their lives, they added.

“More importantly, we have identified measurable indicators and strategies to minimize this type of intervention. An honest and open discussion with patients or their families is a good start to avoid non-beneficial treatments. We hope hospitals can monitor these indicators during their quality improvement activities,” Cardona-Morrell said.

The review was published June 27 in the International Journal for Quality in Health Care.

More information

The U.S. National Institute on Aging provides more information on end-of-life care.

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Elderly Patients Get Unnecessary End-of-Life Treatments

MONDAY, June 27, 2016 (HealthDay News) — People dying naturally of old age often receive unnecessary end-of-life medical treatments in hospitals, a new global study finds.

The Australian-based research found that one-third of patients with advanced, irreversible chronic conditions were given treatments that didn’t necessarily benefit them — including admission to intensive care or chemotherapy — in the last two weeks of their life. The study also revealed that one-quarter of older patients who had Do-Not-Resuscitate orders were still given cardiopulmonary resuscitation (CPR).

People with serious conditions were subjected to invasive procedures, unnecessary scans and blood tests, intensive heart monitoring and other treatments that did little to alter their outcomes, sometimes against their wishes, the researchers found.

“It is not unusual for family members to refuse to accept the fact that their loved one is naturally dying of old age and its associated complications, and so they pressure doctors to attempt heroic interventions,” said study leader Dr. Magnolia Cardona-Morrell. She is with the University of New South Wales’ Simpson Centre for Health Services Research.

“Doctors also struggle with the uncertainty of the duration of the dying trajectory and are torn by the ethical dilemma of delivering what they were trained to do, save lives, versus respecting the patient’s right to die with dignity,” she said in a university news release.

The new research involved a large analysis of 38 studies done in 10 countries during the past 20 years. The review included 1.2 million doctors, patients and their relatives.

“Our findings indicate the persistent ambiguity or conflict about what treatment is deemed beneficial and a culture of ‘doing everything possible,’ ” Cardona-Morrell said.

One possible explanation for the excess tests and treatments is that significant medical advancements have led to unrealistic expectations about the ability of doctors and treatments to ensure patients’ survival, the researchers noted.

As the population of older and frail people grows, doctors and caregivers must be able to better recognize when death is imminent and unavoidable, the researchers suggested. More training will help doctors lose their fear of a wrong prognosis and identify patients near the end of their lives, they added.

“More importantly, we have identified measurable indicators and strategies to minimize this type of intervention. An honest and open discussion with patients or their families is a good start to avoid non-beneficial treatments. We hope hospitals can monitor these indicators during their quality improvement activities,” Cardona-Morrell said.

The review was published June 27 in the International Journal for Quality in Health Care.

More information

The U.S. National Institute on Aging provides more information on end-of-life care.

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