The insurance provider is replacing Oxycontin with Xtampza and Morphabond, whose formulas make them more difficult to crush and delay the high.
Although the replacement drugs cost more, BCBS will keep member co-pays the same as they were for Oxycontin.
BCBS is also lowering the daily maximum morphine milligram equivalent (MME) of any opioid, patch, pill or syrup, to 120 ml.
“We feel that’s still too high, but that’s where Medicare will be,” Willis said. “Higher doses overtime have not been shown to reduce pain anymore.”
As an alternative to opioids, BCBS will now cover acupuncture, a traditional Chinese medicine practice in which thin needles are inserted in key points of the body to relieve pain and treat other conditions.
Acupuncture has been shown to have a relevant effect on chronic pain that persists over time that cannot be solely explained by placebo effects, according to research by the Acupuncture Trialists’ Collaboration, published in the May 2018 edition of The Journal of Pain, the official journal of the American Pain Society.
BCBS is encouraging providers to ask questions such as — have you ever been diagnosed with addiction? does addiction run in your family? have you ever had a problem getting off of a substance? — to identify members who could be at risk of opioid addiction.
“The beauty of all these efforts is to let everyone know they can be at risk,” Willis said. “People may not know they have a predisposition until asked.”
Confidential, evidence-based, digital programs help individuals consider their drinking and/or drug use and decide what, if anything, to do about it. Our programs then help these same individuals develop the skills to be successful if they decide to change, at Check up & Choices
Let me know if you make use of this and how you like it and how it helps.
Here’s to change! Durga
Doctors in Scotland can now prescribe nature to their patients
There is a whole leaflet of nature prescription suggestions that accompanies the program, filled with amusing, charming, sometimes seemingly off-kilter suggestions:
February, you can make a windsock from a hoop and material to “appreciate the speed of the wind”;
March, you can make beach art from natural materials or “borrow a dog and take it for a walk”;
April, you can “touch the sea” and “make a bug hotel”;
May, you can “bury your face in the grass”;
July, you can “pick two different kinds of grass and really look at them”;
August, you can summon a worm out of the ground without digging or using water;
September, you can help clean the beach and prepare a meal outdoors;
October, you can “appreciate a cloud”;
“feed the birds in your garden” in December, and do so much more. All on doctor’s orders. Read more here
Up until the early ’70’s, people on the native reservation at Alkali Lake were 100% alcoholic. This drama/documentary explores the alcoholic poisoning of a once proud people, followed by a story of hope, how that condition can be changed and by those who are the victims themselves.
Choctaw filmmaker Phil Lucas created this film with Peter von Puttkamer, Gryphon Productions. Executive Producers were Phil Laine of Four Worlds and Leonard George, son of famed Hollywood actor Chief Dan George. Hollywood actor Will Sampson (One Flew Over the Cuckoo’s Nest) did an intro for this film.
It’s perhaps the most important production produced for aboriginal peoples on drug and alcohol prevention– and the Alkali Lake Band traveled far and wide- Andy, Freddy, Charlene, Phyllis all took part in presenting the film to communities across North America and around the world. It was widely used by the Betty Ford Clinic- and Alkali Lake members were invited back for an anniversary celebration there. It’s legacy has been phenomenal – all due to the amazingly courageous and loving Alkali Lake Band members- many of them survivors of abuse at Missionary Schools.
I love her actions at 17 minutes in when she throws the boozing men off her porch then it’s heartbreaking to hear that “it’s pretty damn lonely” not to be drinking anymore. Then she goes to the store and tells him “to get your hand out of there, I’m not buying your thumb” – and she starts her own store : ) Reminds me of my mum and granny and how they called the “weights and measures” department to investigate a store in our town that was cheating people in the same way : )
In the US, federally approved pharmacotherapies include methadone, buprenorphine (e.g., suboxone), and naltrexone. While evidence supports their ability to help individuals recover from opioid use disorder (i.e. reduce opioid use), a common concern is whether medications improve other areas of function too.
While important in their own right, improvements in these non-substance use domains of psychosocial functioning and resources, often called recovery capital, may help sustain recovery over the long-term. Thus, there is a need to better understand how these lifesaving treatments affect everyday functions like social relationships and cognitive skills, that might play an important role in longterm recovery. This review evaluates the research conducted to-date that examines the effects of opioid use disorder pharmacotherapies on functioning in various aspects of one’s life, including physical, social, occupational (i.e. work-related functioning), and neurocognitive outcomes.
It suggests a need for high quality controlled investigations that further explore the cognitive deficits seen in patients, assess the potential benefits of pharmacotherapy on criminal activity and legal problems, and address occupational function in more detail. There is a huge gap in the scientific literature that demands immediate attention. With so few investigations of functional outcomes in pharmacotherapy patients, addressing this area of study offers tremendous benefit not only to the scientific community, but also to opioid use disorder patients, clinicians, and society at large.
Despite weight being the number one reason children are bullied at school, America’s institutions of public health continue to pursue policies perfectly designed to inflame the cruelty. TV and billboard campaigns still use slogans like “Too much screen time, too much kid” and “Being fat takes the fun out of being a kid.”
Perhaps the most unique aspect of weight stigma is how it isolates its victims from one another. For most minority groups, discrimination contributes to a sense of belongingness, a community in opposition to a majority. Gay people like other gay people; Mormons root for other Mormons. Surveys of higher-weight people, however, reveal that they hold many of the same biases as the people discriminating against them. In a 2005 study, the words obese participants used to classify other obese people included gluttonous, unclean and sluggish.
Fat people never get a moment of declaring their identity, of marking themselves as part of a distinct group. They still live in a society that believes weight is temporary, that losing it is urgent and achievable, that being comfortable in their bodies is merely “glorifying obesity.” This limbo, this lie, is why it’s so hard for fat people to discover one another or even themselves. “No one believes our It Gets Better story,” says Tigress Osborn, the director of community outreach for the National Association to Advance Fat Acceptance. “You can’t claim an identity if everyone around you is saying it doesn’t or shouldn’t exist.”
The problem is that in America, like everywhere else, our institutions of public health have become so obsessed with body weight that they have overlooked what is really killing us: our food supply. Diet is the leading cause of death in the United States, responsible for more than five times the fatalities of gun violence and car accidents combined. But it’s not how much we’re eating—Americans actually consume fewer calories now than we did in 2003. It’s what we’re eating.
For more than a decade now, researchers have found that the quality of our food affects disease risk independently of its effect on weight. Fructose, for example, appears to damage insulin sensitivity and liver function more than other sweeteners with the same number of calories. People who eat nuts four times a week have 12 percent lower diabetes incidence and a 13 percent lower mortality rate regardless of their weight. All of our biological systems for regulating energy, hunger and satiety get thrown off by eating foods that are high in sugar, low in fiber and injected with additives. And which now, shockingly, make up 60 percent of the calories we eat.
The United States spends $1.5 billion on nutrition research every year compared to around $60 billion on drug research. Just 4 percent of agricultural subsidies go to fruits and vegetables. No wonder that the healthiest foods can cost up to eight times more, calorie for calorie, than the unhealthiest—or that the gap gets wider every year.
For 40 years, as politicians have told us to eat more vegetables and take the stairs instead of the elevator, they have presided over a country where daily exercise has become a luxury and eating well has become extortionate.
While procedures like blood tests and CT scans command reimbursement rates from hundreds to thousands of dollars, doctors receive as little as $24 to provide a session of diet and nutrition counseling.
Every day in California friends, family and co-workers struggle with emotional pain. And, for some, it’s too difficult to talk about the pain, thoughts of suicide and the need for help. Though the warning signs can be subtle, they are there. By recognizing these signs, knowing how to start a conversation and where to turn for help, you have the power to make a difference – the power to save a life.
“gaming disorder” included in WHO’s 11th International Classification of Diseases (ICD)
The last version of the ICD was completed in 1992, with the new guide due to be published in 2018.
It will suggest that abnormal gaming behaviour should be in evidence over a period of at least 12 months “for a diagnosis to be assigned” but added that period might be shortened “if symptoms are severe”.
impaired control over gaming (frequency, intensity, duration)
increased priority given to gaming
continuation or escalation of gaming despite negative consequences
Many psychiatrists refer to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the fifth edition of which was published in 2013.
In that, internet gaming disorder is listed as a “condition for further study”, meaning it is not officially recognised.