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Morning Rounds Shraddha Chakradhar

Prescriptions for opioids far outnumber those for naloxone

Despite the increased need for the opioid overdose antidote naloxone, a new CDC report indicates that overall prescriptions for the drug are still low. Naloxone prescriptions doubled between 2017 and 2018, but that translates to only one such prescription for every 69 high-dose opioid prescriptions. “We may never get to 1-to-1 … but we think that ratio of 1-to-70 is too low,” Anne Schucat, the CDC’s principal deputy director, told STAT’s Andrew Joseph. Data from 2012-2018 showed there was a wide geographic variation in naloxone prescriptions rates: They were highest in small cities and in the South, but lowest in rural counties and in the Midwest. Counties with higher drug overdose death rates also had increased rates of naloxone prescriptions, suggesting that more awareness about overdoses could also increase naloxone availability.  

Louisiana becomes latest state to offer medical marijuana

Louisiana just began dispensing medical marijuana to patients who need it, four years after state lawmakers initially approved the measure. Louisiana is also the first of the five Deep South states to do so, and joins a list of more than 30 states to offer the substance in some form. Nine pharmacies in the state have been licensed to dispense marijuana, which they can get from two state-sanctioned growers. The law allows physicians to “recommend” marijuana for the treatment for a range of diseases including cancer, epilepsy, and Parkinson’s disease as federal law prohibits physicians from prescribing the drug. Insurance companies won’t be covering the cost of medical marijuana, so patients will have to pay out of pocket for the products, which could cost upward of $99. 

Eating more plant-based foods may be linked to better heart health

A study of more than 12,000 adults finds that eating a diet that’s rich in plant-based foods may be better for heart health than an animal-based diet or one that doesn’t have many servings of fruits and vegetables. Researchers surveyed the adults periodically between 1987 and 2017 about their food habits and recorded any cardiovascular-related incidents. People who ate a plant-heavy diet — where they consumed between four and five servings of fruits and vegetables and less than a serving of red and processed meat daily — had a 16% lower risk of cardiovascular disease and about a 30% lower risk of cardiovascular-related mortality compared to those who didn’t eat as many plant-based foods. More research is needed to better understand how plant-based diets that are either high or low in key nutrients influence disease. 

Inside STAT: 5 burning questions about mental health technology

(ALEX HOGAN/STAT; ADOBE)

From tools to track insomnia to voice detection software that can help diagnose depression, mental health apps are ubiquitous. And these apps are helping address a crucial need for more accessible mental health care, which is normally expensive and for which there’s a shortage of specialists. Even still, existing treatments don’t always work. But before these apps can be recommended and relied upon to provide care regularly, there are still unanswered questions about whether they have actually been tested in clinical populations and whether clinicians will want to use them to keep track of their patients. STAT’s Megan Thielking looks into these and other questions for STAT Plus subscribers here

Majority of charity drug assistance programs require patients to be insured

Charity programs meant to help patients access medicines often exclude the uninsured, a new study finds. Researchers looked at six charity organizations that had nearly 275 drug assistance programs and found that 97% of them required that patients have insurance. The amount of assistance offered to patients wasn’t consistent even when accounting for family income. For instance, families with a household income of around $100,000 could get assistance from one foundation of up to $25,000, or about 25% of the income. But families of the same size with a household income of around $125,000 were eligible for about 2%, or up to $2,500, of the income. The study authors call for more transparency in how charities operate to get a better sense of how patients benefit from these programs.

Philippines declares dengue epidemic

The Philippines Department of Health yesterday declared the number of dengue cases recorded so far this year a national epidemic. Already, the country has seen more than 146,000 cases beginning in January until late July, a 98% increase in cases over the same period last year. More than 600 people have died as a result. The health department said it was launching a campaign to find and destroy mosquito breeding sites, and is asking other organizations including schools and local communities to aid in the effort. Other Southeast Asian countries have also reported an uptick in dengue cases this year: Malaysia has seen twice as many cases this year than it did over the same period last year, and Vietnam has seen more than three times as many cases this year. 

Correction: Yesterday’s item on the Autism Self Advocacy Network incorrectly stated who was behind the PSAs that ASAN took issue with. The Ad Council and Autism Speaks borrowed the “Sesame Street” autistic character Julia to air PSAs, and ASAN took issue with some of the resources linked to in these PSAs. 

What to read around the web today

  • Novartis faces another crisis. And for CEO Vas Narasimhan, this time is different. STAT Plus
  • War is the enemy of breastfeeding. NPR
  • U.S. senator calls Texas Medicaid contractor callous, orders more oversight to protect vulnerable patients. The Dallas Morning News
  • When my favorite patient turned on me, I learned a lesson in the emotional work of doctoring. STAT
  • A model hospital where the devices get hacked—on purpose. Wired

Thanks for reading! More tomorrow,

Shraddha

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Wednesday, August 7, 2019

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