MMS files amicus brief in potential landmark opioid-related case

Posted in opioids on September 20th, 2017 by MMS Communications – Be the first to comment

A statement from Henry L. Dorkin, M.D., FAAP, President of the Massachusetts Medical Society, on the Society’s filing of an amicus brief in “The Julie Eldred Case.”

During the last several years, I have taken great professional and personal pride in the Massachusetts Medical Society’s public positions on important questions. One of these is acknowledgment of our obligation to take strong and decisive actions that we, as a delegation of physicians calling on our knowledge and ethics, determine will curtail and one day end one of our nation’s most pressing public health crises – the opioid epidemic.

Our advocacy work on this has been relentless and resolute. Therefore, we cannot, in good conscience, remain on the sidelines as a potential landmark case affecting patients who suffer from opioid abuse disorder plays out imminently in the Massachusetts Supreme Judicial Court.

The Supreme Judicial Court will hear the case of Julie Eldred, a Massachusetts woman who suffers from opioid use disorder, and who, as part of her probation for admitting guilt on a larceny charge, was ordered to “remain substance-free and submit to random drug testing.”

Ms. Eldred, having recently started treatment, later tested positive for fentanyl, lighting a legal fuse that could have major implications on the way in which opioid abuse disorder is treated in our legal system.

At stake in this pivotal case is whether an individual can be incarcerated or otherwise sanctioned because of a recurrence of a symptom; in this instance, relapse, a common symptom many with opioid use disorder experience before attaining complete abstinence.

The MMS, along with other organizations, including the Association for Behavioral Medicine, the BMC Grayken Center for Addiction Medicine, the Massachusetts Organization for Addiction Recovery, the Massachusetts Society of Addiction Medicine and the Northeastern University’s Center for Health Policy and Law, was compelled to file with the Massachusetts Supreme Judicial Court an amicus brief (which you can read by clicking here) conveying our position.

It goes without saying that the Society neither condones nor dismisses commission of any crimes; however, we are respectfully urging the Court to recognize that opioid abuse disorder is a medically diagnosed chronic disease. Mandating an individual “guarantee relapse does not occur upon penalty of incarceration” is out of alignment with the scientific evidence that opioid abuse disorder is best addressed (with a greater level of success) as a public health issue rather than as a criminalized behavior.

 

Raw, heartbreaking look at the opioid crisis from the front lines

Posted in Uncategorized on September 13th, 2017 by MMS Communications – Be the first to comment

If you’ve not yet read the incredible piece by the Cincinnati Enquirer about the opioid crisis in an around that city, please take a few moments out of your day to so, by clicking here.

The final tally in one week: 180 reported overdoses, 18 deaths.

While Cincinnati was the setting for this outstanding piece, the location, unfortunately, could’ve been “Anytown, USA.”  One can’t help but wonder if any of the overdoses and deaths depicted in the piece could have been prevented if the users had at their disposal a supervised injection facility, staffed by healthcare professionals, there in case of emergency and to suggest and navigate ways in which help can be received.

 

Massachusetts Medical Society launches Comprehensive Cannabis Curriculum series for doctors, healthcare providers

Posted in Uncategorized on August 28th, 2017 by MMS Communications – Be the first to comment

The Massachusetts Medical Society, together with Dr. Stephen B. Corn and Dr. Meredith Fisher-Corn from medical education website TheAnswerPage.com, has developed a Comprehensive Cannabis Curriculum intended to equip doctors and healthcare providers with a robust training on the medical, legal and social issues regarding marijuana use.

“With legalization of both medical marijuana and recreational marijuana growing in states across the U.S., it is imperative that physicians be prepared to answer questions about marijuana use and to counsel their patients about any potential impact of cannabis,” said Dr. Henry L. Dorkin, FAAP, President of the Massachusetts Medical Society.

 

The online course was reviewed by the Massachusetts Medical Society’s Committee on Sponsored Programs and by Dr. Alan Ehrlich, an assistant clinical professor in Family Medicine at the University of Massachusetts Medical School in Worcester and deputy editor for DynaMed.

“The Comprehensive Cannabis Curriculum is neither an endorsement of the usage of cannabinoid medications by the Massachusetts Medical Society nor a recommendation to impede healthcare professionals from considering utilization of medical cannabis,” Dorkin said.  “We are confident that the curriculum, which was subject to multiple layers of expert review, will provide the data needed to facilitate (between patients and their healthcare providers) informed, balanced, transparent and important conversations, based upon the strongest and most comprehensive research available at present.”

The Comprehensive Cannabis Curriculum expands significantly on the Society’s existing continuing medical education offerings on the medical uses of cannabis.

The course provides details of the endocannabinoid system and its interactions with medical cannabis, cannabis administration, dosing, contraindications, metabolism and drug interactions.  Studies addressing the physiologic, cognitive and mental health effects of cannabis are reviewed in detail.

Additional modules are focused on the medical use of cannabis for 10 distinct disease states, including ALS, cancer, epilepsy, HIV/AIDS, Huntington’s Disease, IBS, multiple sclerosis and spasticity, neuropathic pain and Parkinson’s Disease.

“The course addresses a huge knowledge deficit clinicians have regarding risks and benefits of marijuana and other cannbinoinds,” Dr. Ehrlich said. “The chapters have been written by leading experts and the presentation is very balanced with an emphasis on the best available evidence. This is just what doctors need to be able to have constructive conversations with their patients when the subject of medical marijuana comes up.”

TheAnswerPage has been offering medical educational content worldwide since 1998, providing peer-reviewed content focused on medical cannabis, pain and the opioid epidemic.

 

 

September: Don’t let down guard against Lyme disease

Posted in Lyme disease on August 24th, 2017 by MMS Communications – Comments Off on September: Don’t let down guard against Lyme disease

By Catherine Brown, D.V.M., M.Sc., M.P.H and Allen Steere, MD.

As the summer winds down and our thoughts turn to back-to-school preparation and pumpkin lattes, it’s important to remember that the local threat of Lyme disease doesn’t immediately fade away.

In fact, September is still part of the peak season for ticks, especially the black-legged tick — more commonly referred to as the deer tick — which can transmit Lyme disease (and, less commonly, other diseases) to humans and pets with its bite. This year, as you’ve probably heard, there may have been even more ticks around than usual. Summer and early fall are often when symptoms of Lyme disease tend to show up.

 

Lyme disease is still a risk, even as weather starts to cool in September.

 

Using precautions can help curtail your risk of exposure to Lyme disease. Along with taking precautions, we need to sort out the facts from myths.

Ticks like damp shady areas and they’re also ground dwelling. They live in vegetation, under leaf litter, close to the ground. They move up grass stems and leaves, waiting for a person or animal to brush past. People tend to think of ticks as being solely in forested areas, and that’s a mistake. In Massachusetts, ticks can also be found in suburban areas.

Unfortunately, there isn’t one, single step one could take to completely protect themselves from ticks, but there are two important routines that are proven effective — one before you go outside and the other when you get back inside.

When going into areas of risk, it is advisable to use a tick repellant that includes an EPA-registered ingredient. Those active ingredients will be listed on the packaging of the product, and include DEET and permethrin. DEET should be applied to exposed skin, while permethrin should be used on shoes and clothing.

Upon returning from the outdoors, run your hands over your body, feeling for a little bump that might be an attached tick. Taking a shower within about two hours will rinse off any unattached ticks you may have missed, and a research study concluded that throwing clothes in the dryer on high heat for about 10 minutes will kill ticks that may be on your clothing.

If you discover a tick, don’t panic. If it hasn’t attached to your body, you can simply brush it off and move on.

If a tick has attached, it’s important to remove the tick promptly and properly, since the longer a tick is attached, the more increased its chance to spread disease.

The standard recommendation is to use tweezers that have fine points on them, grasp the tick as close to the skin as possible, then pull straight up firmly — don’t twist — and pull it out. There’s a lot of false information online about tick removal, and some of those methods may irritate the tick or delay complete removal, increasing the risk of disease transmission.

After a tick is removed, check that area of skin for signs of Lyme disease. The most commonly discussed sign is a slowly expanding redness that occurs at the site of the tick bite. The redness can occur a couple days after a bite or up to a month after.  Although the rash is common, it may go unnoticed or be dismissed as being caused by something else.

Typically, flu-like symptoms of Lyme disease will present, including headache, neck stiffness, some joint pain and some muscle pain.

This can be a confusing presentation of the disease, since such symptoms may be caused by viral infection, as well as by Lyme disease or its co-infecting agents. If flu-like symptoms develop during summer and if you have had potential exposure to ticks, visit your physician.

If early Lyme disease is diagnosed, the typical course of treatment is several weeks of antibiotic therapy, which usually is sufficient to treat the infection. If Lyme disease isn’t treated promptly, it can cause more serious symptoms, including neurological or heart problems or arthritis. These manifestations of the illness can still be treated with antibiotic therapy, but the course of therapy may need to be a little longer.

The Massachusetts Department of Public Health has a dedicated website, mass.gov/mosquitoesandticks, with information on protecting yourself from tick-borne illness.

Catherine Brown, D.V.M., M.Sc., M.P.H. is the Deputy State Epidemiologist and State Public Health Veterinarian at the Massachusetts Department of Public Health.

Allen Steere, MD, is principal investigator for the Center for Immunology and Inflammatory Diseases at Massachusetts General Hospital.

 

MA newspaper endorses idea of supervised injection facility study

Posted in opioids on August 14th, 2017 by MMS Communications – Comments Off on MA newspaper endorses idea of supervised injection facility study

The Lowell Sun, a newspaper based in a geography that has been hit hard by the opioid crisis, has published an editorial in which it encourages the idea of studying the effectiveness of a supervised injection facility locally.

“Certainly, those on both sides of this issue make strong arguments. However, the grave consequences of continually fighting a losing battle in the war on drugs demands that we must seriously explore every reasonable alternative,” the editorial read.

Read more: http://www.lowellsun.com/opinion/ci_31206074/editorial-opioid-injection-facilities-worthy-careful-study#ixzz4pk6Lcs8l

The Massachusetts Medical Society is in favor of such sites and earlier this summer testified in front of the Boston City Council on the subject. You can read that testimony by MMS President Henry L. Dorkin, MD, FAAP  here.

Lowell-area officials weigh in on concept of supervised injection facility to combat opioid epidemic

Posted in opioids on August 8th, 2017 by MMS Communications – Comments Off on Lowell-area officials weigh in on concept of supervised injection facility to combat opioid epidemic

The Greater-Lowell area, like so many areas across the state and the country, is facing a serious opioid crisis.  Lowell Sun reporter Rick Sobey spoke with  Henry L. Dorkin, MD, FAAP, President of the Massachusetts Medical Society and officials from the area about the concept of a supervised injection facility in or around Lowell.

Click here to read the piece.

Mass. Medical Society reacts to latest attempt to repeal ACA

Posted in Uncategorized on July 31st, 2017 by MMS Communications – Comments Off on Mass. Medical Society reacts to latest attempt to repeal ACA

Massachusetts Medical Society: MMS Statement on the Affordable Care Act

The following is a statement from Henry L. Dorkin, MD, FAAP, President of the Massachusetts Medical Society, regarding efforts to repeal the Affordable Care Act:

Dr. Henry Dorkin

Dr. Henry Dorkin

“(Last week’s) vote (a demonstration of due democratic process) against a so-called ‘skinny’ repeal of the Affordable Care Act helps protect the health care of millions of America’s patients. From coast to coast, including here in the Commonwealth, Americans have voiced their concern about, and opposition to, outright repeal of the ACA. We are grateful to the majority of U.S. Senators, including Senator Ed Markey and Senator Elizabeth Warren, who demonstrated their commitment to fighting on behalf of their constituents’ access to health care. We also thank Senators Collins, Murkowski and McCain and applaud their efforts to keep any Americans from losing their health care access.

“It is long-standing policy of the Massachusetts Medical Society that we advocate for universal access to insurance coverage. None of the legislative options presented in recent months – neither straightforward repeal, repeal-and-replace nor this ‘skinny’ repeal – would have advanced the mission of promoting reliable, affordable, effective insurance coverage for our patients. A health care bill should actually improve the health of Americans, not worsen it.

“Once again, we urge Congress to join representatives of the medical community in collaborating on legislation that would improve, strengthen and sustain the Affordable Care Act, which has extended health coverage to record numbers of Americans. Now is the time to abandon efforts at repeal and instead focus on how to make the ACA work even better for more of our neighbors and patients.”

Mass. Medical Society: Marijuana bill ‘a significant step forward’

Posted in Uncategorized on July 19th, 2017 by MMS Communications – Comments Off on Mass. Medical Society: Marijuana bill ‘a significant step forward’

Henry L. Dorkin, MD, FAAP, President of the Massachusetts Medical Society, released the following statement regarding the marijuana bill compromise:

 

“The Massachusetts Medical Society commends and thanks the Legislature for its diligence and thoughtful leadership and recommendations toward installing protections for the public’s health. We’re pleased that many facets of the bill are consistent with the advocacy efforts put forth by our membership. From a public health perspective, this compromise bill represents a significant step forward.

 

“Inclusion of public health experts within the Cannabis Control Commission structure and funding earmarked for public and behavioral health, prevention, treatment, intervention and critical research related to marijuana use demonstrate a focus on the health of the people of Massachusetts.

 

“We are encouraged by the labeling and packaging requirements and the incorporation of warnings on marijuana products, as well as marketing and advertising restrictions in place to reduce youth consumption.

 

“We look forward to working in tandem with the Cannabis Control Commission on developing and implementing strategies that will increase protections and safety for all Massachusetts residents.”

Doctor discusses broaching gun safety with patients

Posted in Gun Safety, Public Health, Uncategorized on July 14th, 2017 by MMS Communications – Comments Off on Doctor discusses broaching gun safety with patients

A mistake turned deadly last week when a Chicago-area teenager mishandled a gun in his home, leading to the accidental shooting of his 17-year-old girlfriend.

While child-involved accidental shootings are prominent – a child dies from an accidental shooting every other day in the United States, according to a joint investigation by USA Today Network and the Associated Press – these accidents can be reduced or avoided, and physicians can be a conduit to to a decrease.

According to a recent report, a child is killed accidentally by a gun every other day in the US.

In a recent interview (you can view it here), Dr. Michael Hirsh, a member of the Massachusetts Medical Society’s Committee on Public Health and pediatric surgery chief at UMass Memorial Medical Center, said he believes firearm safety should be part of a larger, honest conversation about health and safety that takes place between a physician and patients.

Dr. Hirsh also suggests physicians make use of the Mass. Medical Society’s resources on gun safety. Developed with the Massachusetts Attorney General’s Office, literature for patients and, for physicians, helpful tips on broaching the subject of gun safety with patients, the materials can be viewed and downloaded here, along with training videos.

The Massachusetts Medical Society is strongly opposed to legislative interference in the right of physicians and patients (or their parents or guardians) to discuss gun ownership, storage, and safety in the home.

 

Mass. Medical Society supports bill that would end discrimination against gay men wishing to donate blood

Posted in discrimination, Health Policy, HIV, Uncategorized on July 13th, 2017 by MMS Communications – Comments Off on Mass. Medical Society supports bill that would end discrimination against gay men wishing to donate blood

 

Earlier this month, Jimmy Kimmel took to Twitter and leveraged his significant social media profile to encourage blood and platelet donation.

Staff and volunteers attached to blood donation centers across the nation have in recent weeks furiously stepped up donor recruiting efforts.

The summer season – and, specifically, the Fourth of July holiday – is a predictable time in which a blood shortage or “summer slump” may occur.  No matter the season, however, blood supply shortage puts patients’ lives at risk, including those who may need blood after an accident or who are facing treatment for cancer and blood diseases.

The media coverage of the nation’s most recent shortage brings to the forefront the fact that an entire segment of the United States is barred from giving blood, and a shift in that policy would increase the pool of potential donors and likely lessen the shortage and save additional lives.

The Massachusetts Medical Society is proud to support Rep. Daniel Cullinane (D – 12th Suffolk) and of HB 3597, An Act relative to eliminating discrimination in blood donations. This bill would require blood donation facilities not to discriminate against prospective donors on the basis of sex, gender, or sexual orientation, while allowing those facilities to require proof of a negative HIV test prior to accepting donated blood.

Currently, FDA regulations recommend that men who have sex with men be deferred from donating blood.

The MMS has a long history of advocating to remove discrimination based on sexual orientation. MMS policy “strongly supports the rights of individuals to health, happiness, and liberty regardless of sexual orientation…and urges all governments to recognize these rights.” Accordingly, MMS policy favors lifting the FDA deferral of blood donation for men who have sex with men: “The MMS supports a federal policy change to ensure blood donation bans or deferrals are applied to donors according to their individual level of risk and are not based on sexual orientation alone.” Accordingly, we recognize the importance of testing donated blood for HIV/AIDs, and we commend this legislation for stipulating that blood donation facilities may require individuals to provide negative HIV test results prior to donating to ensure the safety of our Commonwealth’s blood supply.

We wish to note that, while our policy refers specifically to enacting policy change on a federal level to address this issue, making this change at the state level is consistent with the MMS’s anti-discriminatory stance. Massachusetts has a chance to be a leader on this important shift in policy, and we as a medical society stand proudly with Rep. Cullinane at the forefront of this change.

Furthermore, this bill would not only combat discrimination based on sexual orientation; it would also save lives by increasing the supply of donor blood. The Commonwealth currently faces a shortage of donated blood: the American Red Cross issued an emergency call for blood and platelet donations this year. This bill would add to the pool of potential donors in Massachusetts.

The MMS urges the Committee on Public Health to report H.3597 out of Committee favorably.