Morning Rounds Megan Thielking

Tonight's State of the Union comes amid abortion policy debate

President Trump is expected to touch on a handful of health care issues in his State of the Union speech tonight, including drug pricing, HIV, and abortion. The speech comes amid a fierce debate around a Virginia bill that would loosen some restrictions on abortions in the third trimester. New York also recently passed a law that, among other steps, legalizes abortion after 24 weeks for medical reasons.

The speech also comes as the Supreme Court weighs whether a Louisiana law — which requires abortion providers to have admitting privileges at a hospital within 30 miles — should be allowed to take effect. It's similar to a Texas policy struck down by the Supreme Court in 2016 because it posed an undue burden on a woman's right to abortion and provided "few, if any, health benefits for women." The law was supposed to take effect Monday, but the court has blocked it until Thursday.

What conditions are patients using medical marijuana to treat? 


(health affairs)

People with medical cannabis licenses are most often using marijuana to treat chronic pain. That's according to a new analysis of data on medical marijuana use in 20 states and D.C. Here's a quick look at the findings, which will be published in Health Affairs:

  • The conditions: The study looked specifically at the conditions that qualify people for a medical marijuana license in a given state. Just over 62 percent of medical cannabis users reported using the drug for chronic pain. Spasms associated with multiple sclerosis were the second most common qualifying condition, followed by chemo-induced nausea and vomiting, PTSD, and cancer.

  • The evidence: Nearly 86 percent of people with licenses reported using cannabis for a condition for which there’s conclusive or substantial evidence that it can help. That includes multiple sclerosis, chronic pain, and chemo-induced nausea and vomiting, according to a National Academies report on medical marijuana research.

  • The data: The study also turned up wild variations in the data that states collect about medical marijuana use. Streamlining that data would make it easier to use it to inform both research and policy, the authors say.

Rural health providers urge policymakers to address hospital and clinic closings

Hundreds of rural health care providers, patients, and advocates are in D.C. today to press lawmakers to prevent more rural hospital closures. The National Rural Health Association — which is bringing together the advocates at its annual meeting — says 94 rural hospitals have closed since 2010, and many more are at risk of shuttering. And hundreds of rural health clinics have also closed their doors since 2012, according to the association. The group is also calling on policymakers to address the mortality gap between rural and urban Americans. This morning, they’ll hear from HHS Secretary Alex Azar, who’s speaking about his “vision for rural health care” at the conference.

Inside STAT: Clinicians race to save newborn twins from the disease that took their brother


Charlie and Kolton Martin, Iowa twins who are now 7 weeks old, have a neurodegenerative disorder called Menkes disease. (Courtesy Alyssa Martin)

A decade ago, Alyssa Martin’s son Dylan died just after his second birthday. Last year, at 21 weeks pregnant with twin boys, she found out they, too, had inherited the same mutated gene that killed their older brother. The twins and Dylan had inherited a rare neurodegenerative disorder called Menkes disease. Martin and a team of doctors devised a plan to try to save the twins. Their best hope was an experimental drug — but getting that medicine to Charlie and Kolton Martin proved harder than anyone imagined. A team of clinicians went to extraordinary lengths as they raced to obtain the treatment. STAT’s Rebecca Robbins interviewed those involved to piece together the saga. Read here.

Goop is getting a 'wellness' show on Netflix

Goop is coming to Netflix. Variety reports that the lifestyle and wellness giant, founded by Gwyneth Paltrow, is launching a new docuseries this fall. Goop's chief content officer Elise Loehnen tells Variety the 30-minute episodes will "dial up the aesthetics and quality of storytelling surrounding issues like mental, physical and sexual health." Paltrow, Loehnen, and Goop's editors will host the show, which will reportedly tap into insights from doctors, researchers, and other experts. It's not clear yet who those experts will be, but it's worth noting that some of Goop's go-to experts on its website have been criticized for touting practices and products that aren't supported by science.

After 2016 election, long-acting contraceptive use jumped among privately insured women

In the days after the 2016 election, news outlets picked up on an apparent trend: Women, fearing new restrictions on birth control access or changes to the Affordable Care Act, were rushing to get IUDs and other contraceptive implants. Now, a new study backs those anecdotes up with evidence. Researchers looked at data from 3 million women in a commercial health insurance claims database and found that the number of women who received long-acting, reversible contraceptives, or LARCs, jumped in the month after the 2016 election. There were roughly 16.3 LARC insertions per 100,000 women in the study each weekday in the month after the 2016 election, compared to 13.7 each day during that same time frame in 2015.

What to read around the web today

  • She struggled for years to help her mentally ill son. Was criminal court the only option? San Francisco Chronicle 
  • Doctors surprised by scope of adult-onset food allergies. Wall Street Journal
  • Study shows Purdue’s switch to ‘abuse-deterrent’ OxyContin helped drive a spike in hepatitis C infections. STAT
  • Texas optometrists "just roll our eyes" over treatment restrictions in the state. Texas Tribune
  • As price hikes ease, storm clouds are gathering over pharma companies. STAT Plus

Thanks for reading! More tomorrow,


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Tuesday, February 5, 2019


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