Showing posts with label Medical Law. Show all posts
Showing posts with label Medical Law. Show all posts

Friday, June 14, 2019

Pharmacies may not stock naloxone, despite statewide orders

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(Reuters Health) - More than three years after Pennsylvania issued a statewide order expanding access to the life-saving opioid antidote naloxone, the product was still hard to purchase in Philadelphia pharmacies, researchers found.

In 2017, two-thirds of pharmacies in Philadelphia either did not stock naloxone, or they still insisted on a physician’s prescription, which the law said was no longer required.

In the wake of the opioid addiction crisis that has claimed thousands of lives, many U.S. states have passed laws like Pennsylvania’s, which allow the drug to be dispensed without a prescription and mandate that every drugstore carry it.

Laws that let pharmacists sell naloxone without prescription have been associated with a nearly 30% drop in the number of opioid overdose deaths, a separate team of researchers reported last month. (reut.rs/2WM3qMa)

Yet this study is not the first to find that drugstores are slow to comply. Research has shown that most pharmacies in California and Texas, for example, do not carry the drug or make it readily available.

The new results add to the growing body of evidence that these laws are not being enforced, experts said.

“While policy can be put in place, it’s not sufficient and has to be followed up with education, and reinforcement at the county and pharmacy level, and not just assume that the policy itself will ensure access to anyone who needs it,” Dr. Michael Lynch, a toxicologist and emergency medicine physician who was not involved in the study, told Reuters Health.

For the current study, Dima Qato of the University of Illinois, Chicago and colleagues contacted 418 drugstores in Philadelphia between February and August 2017 and found that only about 34% had naloxone in stock - and 38.5% of those drugstores required a physician’s prescription to dispense the drug.

People living in communities with elevated rates of opioid overdose deaths were the least likely to have access to naloxone without a prescription and had to pay more to buy the drug, the researchers wrote in JAMA Network Open.

“Areas that need this policy enforced the most are areas that lack it and that’s a concern,” Qato told Reuters Health by phone.

An overdose of opioids like morphine or heroin slows breathing, reducing the supply of oxygen to the body. Naloxone helps reverse the effects of an overdose and saves lives.

Lynch, who is also the medical director of the Pittsburgh Poison Center at the University of Pittsburgh Medical Center, notes that the high importance of naloxone may not necessarily translate to high demand.

“If patients or individuals are not coming in and asking for it, pharmacies, especially a local independent pharmacy with pretty narrow margins, may not continue to stock a medication that isn’t being dispensed,” he added.

However, Mel Brodsky, executive director of PARD, an association of community pharmacies in Philadelphia, disputes the study’s findings.

“It is from 2 years ago - a lot has changed. Philadelphia mandates that every pharmacy have 2 doses of naloxone in stock. As I travel to my stores, I see 95% having naloxone in stock,” he told Reuters Health by email.

Dr. Michael Fingerhood, of Johns Hopkins Bayview Medical Center in Baltimore, Maryland, told Reuters Health that the low numbers in the study may be partly due to a shortage of naloxone in 2017.

“I would do a similar study now, (when) we don’t have a shortage of naloxone, and see if there has been any difference, two years later,” he said.

SOURCE: bit.ly/2IEd5LZ JAMA Network Open, online June 7, 2019

Our Standards:The Thomson Reuters Trust Principles.


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Thursday, June 13, 2019

Prosecutors drop Flint, Michigan water charges over 'flawed' probe

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(Reuters) - Michigan prosecutors on Thursday dropped all criminal charges over the deadly contamination of the city of Flint’s water, saying a more thorough investigation was needed before they could proceed with the case.

FILE PHOTO: Volunteers distribute bottled water to help combat the effects of the crisis when the city's drinking water became contaminated with dangerously high levels of lead in Flint, Michigan, March 5, 2016. REUTERS/Jim Young/File Photo

The charges were brought by the Office of Special Counsel (OSC), a federal prosecutorial agency, and were based on an investigation that state prosecutors described as “flawed.”

“Dismissing these cases allows us to move forward according to the non-negotiable requirements of a thorough, methodical and ethical investigation,” Michigan’s Solicitor General Fadwa Hammoud and Wayne County Prosecutor Kym Worthy said in a statement.

Eight former state and city officials, including Michigan’s chief medical officer Eden Wells, faced criminal charges for their roles in the water crisis which killed 12 people and sickened over 70, one of the worst man-made environmental disasters in U.S. history.

According to the prosecutors, the OSC made agreements that gave law firms representing state agencies and officials a role in deciding what information would be turned over to law enforcement during their investigation. As a result, not all evidence was pursued, they said.

Additional investigation by the prosecution team has already identified more individuals of interest in the case, they said.

Flint’s troubles began in 2014 after the city switched its water supply to the Flint River from Lake Huron to cut costs. Corrosive river water caused lead to leach from pipes, contaminating the drinking water and causing an outbreak of Legionnaires’ disease.

Prosecutors said they dropped charges “without prejudice,” meaning they could be brought again once a new investigation is completed.

“Justice delayed is not always justice denied,” Michigan Attorney General Dana Nessel said in a statement.

But Michigan Senate Minority Leader Jim Ananich, a Democrat who represents Flint, expressed his disappointment.

“Months of investigation have turned into years, and the only thing to show for it is a bunch of lawyers who have gotten rich off the taxpayers’ dime,” he said in a statement. “The people of Flint believe that they will never see justice, and sadly, so far they’ve been proven right.”

The U.S. Supreme Court in March allowed two class-action lawsuits filed by Flint residents, who are pursuing civil rights claims against local and state officials.

Reporting by Andrew Hay in Taos, New Mexico; Editing by Bill Tarrant and James Dalgleish

Our Standards:The Thomson Reuters Trust Principles.


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