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The number of opioid pills prescribed peaked in 2011 and has since declined by 29 percent, according to a new report from the Iqvia Institute...The number of prescriptions accelerated its decline in 2017, with an even faster drop for high doses...More patients appear to be starting on medication-assisted therapies to treat opioid addiction...decline accelerated...helped by changes in regulation of opioid prescribing and in reimbursement policies from insurers...many of the programs that have been put into place in the past year or two seem to be having an impact...increased use of nonopioid pain treatments, like ibuprofen and other nonsteroidal anti-inflammatory drugs...as well as public awareness about overuse and misuse of opioids...

The Washoe County Health District has released the “2018 Washoe County Chronic Disease Report Card,” the most current and available information about chronic disease and their risk factors for Washoe County...“The intent of this report is to provide a summary of chronic diseases and their risk factors in Washoe County and to serve as a source of currently-available chronic disease data. It is also intended to provide local health care providers, chronic disease practitioners, and other interested persons and programs with data they may use in their work to improve the health of Washoe County,” says District Health Officer Kevin Dick...

Senator’s investigation found a “lack of transparency” surrounding the donations...A new report from Senator Claire McCaskill found that five opioid manufacturers paid nearly $9 million to 14 outside groups between 2012 and 2017, alleging that the advocacy groups often “amplified messages favorable to increased opioid use.”...The groups—many of which work on chronic pain and other opioid-related issues—lobbied to defeat prescriber limits on opioids...and many criticized facets of 2016 guidelines from the Centers for Disease Control and Prevention that limited the prescribing of painkillers...“The financial relationships between these groups and opioid manufacturers should be clear to the general public,” McCaskill said. “We passed a law ensuring the public had information on payments to doctors by pharmaceutical companies, and I can’t imagine why the same shouldn’t be done in this space.”...

Quest Analysis of 3.4 million tests shows evidence of dangerous drug combinations...A majority of test results from patients taking prescription medications show signs of drug misuse—including potentially dangerous drug combinations...The Quest Diagnostics Health Trends study is based on analysis of the company's de-identified laboratory data, believed to be one of the largest nationally representative datasets of objective laboratory information of patients prescribed opioids and other commonly abused medications. Physicians order laboratory services to aid their ability to monitor patients for signs of prescription or illicit drug misuse or abuse...(The report, "Prescription Drug Misuse in America: Diagnostic Insights in the Growing Drug Epidemic")

• evidence of misuse has declined in recent years, 52% of test results showed evidence of potential misuse in 2016, suggesting a majority of patients took their prescribed drugs in ways that were inconsistent with their physician's instruction...
• disturbing patterns of concurrent drug use. Among more than 33,000 specimens tested for opioids, benzodiazepines, and alcohol in 2016, more than 20% were positive for both opioids and benzodiazepines, more than 10% were positive for both opioids and alcohol, and 3% were positive for all three...
• 19% of specimens positive for heroin in 2016 were also positive for nonprescribed fentanyl...
• drug misuse rates were high among most age groups and both genders. However, adolescents (10 to 17 years of age) showed a striking improvement, with the rate dropping from 70% to 29% between 2011 and 2016...
• Misuse rates were higher for men and women of reproductive age (58%) than in the general study population (52%)

Nevada’s amphetamine death rate is highest in the nation and will soon eclipse the state’s prescription opioid death rate if current trends continue, according to a new report from the Centers for Disease Control and Prevention...The death rate in Nevada attributed to “psychostimulants” — a class of drugs that includes methamphetamine, ecstasy and ADHD prescription drugs like Adderall and Ritalin — hit 7.5 per 100,00 in 2016, up nearly 32 percent from 2015. Prescription opioid deaths fell about 9 percent in the same time period, from 9.8 per 100,000 to 8.9 per 100,000...unlike opioids, there’s no overdose antidote...if prevention resources were devoted equally to opioid and amphetamine overdose, that could cut down on abuse and, ultimately, death...What’s needed...is public education that stresses that using amphetamines can be lethal, not just from overdose but because they can impact organ function and can be laced with opioids like synthetic fentanyl, a deadly substance...

The Food and Drug Administration is planning to survey 2,000 healthcare professionals to better understand how prescription drug promotion affects the decisions they make...Promotional activities include meetings with pharmaceutical sales representatives, presentations given at industry-sponsored events, and journal or direct mail advertisements. In 2012, drugmakers spent north of $24 billion marketing their products to physicians, according to data cited by the FDA..."Although HCPs (healthcare professionals) are learned intermediaries, like most people, they may rely on heuristics in making decisions and may have cognitive biases in the type of information they attend to at any given time. They may be persuaded by strong statements and may not have the time to ascertain accuracy of such information," the FDA wrote in a notice posted on the Federal Register on March 15..."There is little qualitative research on people’s attitudes to promotion, and this is a major gap," the organization said. "In order to understand people’s perspectives and values more clearly, in‐depth interviews are needed...

When pharmacy professionals, rather than doctors or nurses, take medication histories of patients in emergency departments, mistakes in drug orders can be reduced by more than 80 percent, according to a study led by Cedars-Sinai...Cedars-Sinai now assigns pharmacy staff members to take medication histories for high-risk patients admitted to the hospital through the emergency department...Injuries resulting from medication use are among the most common types of inpatient injuries at U.S. hospitals, affecting hundreds of thousands of patients every year. Errors in medication histories contribute significantly to such problems, and those errors can lead physicians to order the wrong drug, dose or frequency.

Researchers propose that pharmacists can help improve medication-related care and lower costs...the actual cost of prescription medications is more than just the dollars and cents on the bill, according to a recent study. Researchers...estimate that illness and death resulting from nonoptimized medication therapy costs $528.4 billion annually...when you’re sick, a health care professional prescribes you a medication, you take it as directed, and you get better...But what happens a lot of the time is the medication regimen is not optimized...the prescription may not be exactly appropriate for your indication—not quite the right medication or dose—or you just don’t take the medication for whatever reason, don’t take them as directed, or the medication causes an adverse event or a new health problem...the current cost of each possible consequence...illnesses and deaths that result from nonoptimized medication therapy to be $528.4 billion...Nonoptimized medication therapy is a massive avoidable cost. If medications were prescribed, monitored, and taken properly, we wouldn’t face this cost, and patients would be healthier...To improve medication-related care...authors...would like to see a systematic and coordinated effort to break down prescriber–pharmacist silos and expand comprehensive medication management programs, in which clinical pharmacists have access to complete medical records, improved dialogue with other members of a patient’s health care team, and input as a medication is prescribed—similar to what is now taking place at many U.S. Veterans Affairs clinics.

Governor Brian Sandoval announced...that the second meeting of his Opioid State Action Accountability Task Force will take place April 18th in Carson City...The 1 p.m. meeting will be held in the Old Assembly Chambers at the state Capitol Building...the Task Force will hear a status report of crosscutting initiatives and status reports on track one – prescriber education and guidelines; track two – treatment options and third-party payers; track three – data collection and intelligence sharing; and track four – criminal justice investigations...“This Task Force has the specific task of reviewing the policies and programs that have been put into place to address the opioid epidemic in our state,” Sandoval added. “I am looking forward to hearing reports on the progress being made to combat this epidemic.”...

During a session at the American Society of Health System Pharmacists Midyear Clinical Meeting and Exhibition, Christina Michalek, PharmD, of the ISMP presented the organizations’ annual review of the year’s biggest medication safety issues...From January 2017 to September 2017, the drug classes most often involved medication errors events included:

1. Narcotics/Opioids (10%)
2. Antimicrobial agents (10%)
3. Antihypertensive agents (6%)
4. Antithrombotic agents (6%)
5. Anticonvulsant agents (4%)
6. Insulin and antidiabetic agents (4%)
7. Central nervous system stimulants (4%)

Of these, narcotics/opioids, antithrombotic agents, and insulin and antidiabetic agents are listed as “high alert” drugs by the ISMP, indicating that they are associated with a high risk of harm when used in error.