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Tag: Medication

  • Matthew Perry died from acute effects of ketamine, officials rule

    Matthew Perry died from acute effects of ketamine, officials rule

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    Matthew Perry died from acute effects of ketamine, a drug sometimes used to treat depression, officials said.

    The ketamine caused cardiovascular overstimulation and respiratory depression, the Los Angeles County medical examiner said. Other contributing factors in the actor’s death included drowning, coronary artery disease and the effects of buprenorphine, a medication used to treat opioid use disorder.

    Perry’s Oct. 28 death was an accident, according to an autopsy.

    The actor was best known for playing the sarcastic and witty Chandler Bing on NBC’s “Friends” for 10 seasons, from 1994 to 2004. In his 2022 memoir, Perry said he began abusing substances at the age of 14 and landed the role on “Friends” a decade later. Fame increased his dependency on alcohol and drugs. At one point, he said in his book, he took nearly five dozen pills a day.

    Following his death at his home in Pacific Palisades, trace amounts of ketamine were found in Perry’s stomach, the medical examiner noted. The level found in his blood was about the same quantity as would be used during general anesthesia.

    According to the report, Perry had been playing pickleball at about 11 that morning, and his live-in assistant last saw him at 1:37 p.m.

    Upon returning to Perry’s home on Blue Sail Drive, the assistant found him floating face-down in his swimming pool. The assistant jumped in, pulled Perry’s head out of the water and called 911.

    Paramedics arrived and moved Perry onto the grass, where he was pronounced dead.

    The report noted that Perry had no other drugs in his system and had been 19 months sober at the time of his death. There was no evidence of illicit drugs or paraphernalia at Perry’s home.

    Perry was undergoing ketamine infusion therapy every other day for a period of time but had reduced that intake more recently, and his last known infusion was a week and a half before his death.

    The medical examiner noted the ketamine could not have been from that session as it typically disappears from the system in detectable amounts within three to four hours.

    The medical examiner also noted that Perry, 54, had diabetes and suffered from chronic obstructive pulmonary disease, which refers to a group of diseases that cause airflow blockage and breathing-related problems. He also smoked two packs of cigarettes a day.

    A coroner’s investigator interviewed a person close to Perry who described him as in “good spirits” and said he had quit smoking two weeks prior to his death and was weaning himself off ketamine.

    A legal medication commonly used medically as an anesthetic, ketamine has been increasingly offered “off label” at private clinics in an effort to treat depression and other mental health disorders, said Dr. David Goodman-Meza, an addiction medicine and infectious disease specialist at UCLA.

    Some people also snort or inject it recreationally to experience euphoric or “dissociative” effects that cause someone to feel separated from their own body, Goodman-Meza said. At very high doses, it can make people feel immobilized and spur hallucinations, an experience called a “K-hole.”

    The drug can complicate breathing and increase demands on the heart. If someone already has coronary artery disease and is taking high doses of ketamine, “that could then speed up your heart, create more demand, but then your arteries don’t have the ability to supply that demand,” the physician explained.

    Tucker Avra, a UCLA medical student who works with people recovering from ketamine addiction, said that people using ketamine can also be at risk of passing out or falling down. “If you’re in water,” he said, there’s “a risk of drowning by basically putting yourself under anesthesia by using it.”

    Avra said those using ketamine should test their drugs for the synthetic opioid fentanyl, have Narcan on hand to reverse an opioid overdose in case the drug is contaminated with opioids, and avoid using the drug alone. He said he hoped the tragedy of Perry’s death might encourage doctors to learn more about the side effects of recreational use.

    In 2006, the National Institute of Mental Health concluded that an intravenous dose of ketamine had rapid antidepressant effects. About 300 clinical trials have been held, and they have broadly found that ketamine is extremely fast-acting compared with traditional antidepressants and can relieve depression for a period that can last days or weeks.

    A prescription version of ketamine called Spravato, given through a nasal spray, was approved in 2019 by the FDA for treatment-resistant depression. The number of ketamine clinics in the U.S. has risen from a few dozen to several hundred in the last few years.

    “Ketamine overdose by itself is exceedingly rare,” said Dr. Siddarth Puri, associate medical director of prevention for the Substance Abuse Prevention and Control division at L.A. County’s public health department.

    In general, much of the overdose concern around ketamine surrounds mixing it with other substances that can also affect breathing or heart rate, such as alcohol or opioids, he said.

    People are also at higher risk of bad outcomes if they have underlying conditions such as high blood pressure or breathing problems, Puri said. In medical settings, Puri said, “your doctor is making sure your heart can manage and respond to ketamine appropriately, your breathing is OK … you’re not having any kind of allergic reaction,” and other medications will not compound its effects.

    Perry described taking ketamine infusions in his memoir, “Friends, Lovers, and the Big Terrible Thing.”

    “It’s used for two reasons: to ease pain and help with depression. Has my name written all over it — they might as well have called it ‘Matty,’” he wrote. “Ketamine felt like a giant exhale. They’d bring me into a room, sit me down, put headphones on me so I could listen to music, blindfold me, and put an IV in.”

    He wrote that he would “disassociate” while listening to music and “often thought that I was dying during that hour.”

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    Richard Winton, Emily Alpert Reyes

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  • Mexico raids and closes 31 pharmacies in Ensenada that were selling fentanyl-laced pills

    Mexico raids and closes 31 pharmacies in Ensenada that were selling fentanyl-laced pills

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    MEXICO CITY — Mexican authorities said Friday they have raided and closed 31 pharmacies in Baja California’s coastal city of Ensenada, after they were detected selling fake or fentanyl-laced pills.

    Marines and health inspection authorities seized 4,681 boxes of medications that may have been offered for sale without proper safeguards, may have been faked and may contain fentanyl.

    “This measure was taken due to the irregular sales of medications contaminated with fentanyl, which represents a serious public health risk,” the Navy said in a press statement.

    Mexico’s health authorities are conducting tests on the seized merchandise. Ensenada is located about 60 miles (100 kms) south of the border city of Tijuana.

    The announcement represents one of the first times Mexican authorities have acknowledged what U.S. researchers pointed out almost a year ago: that Mexican pharmacies were offering controlled medications like Oxycodone, Xanax or Adderall, but the pills were often fentanyl-laced fakes.

    Authorities inspected a total of 53 pharmacies, and found the suspected fakes in 31 of them. They slapped temporary suspension signs on the doors of those businesses.

    Sales of the pills are apparently aimed at tourists.

    In August, Mexico shuttered 23 pharmacies at Caribbean coast resorts after authorities inspected 55 drug stores in a four-day raid that targeted establishments in Cancun, Playa del Carmen and Tulum.

    The Navy said the pharmacies usually offered the pills only to tourists, advertised them and even offered home-delivery services for them.

    The Navy did not say whether the pills seized in August contained fentanyl, but said it found outdated medications and some for which there was no record of the supplier, as well as blank or unsigned prescription forms.

    In March, the U.S. State Department issued a travel warning about sales of such pills, and the practice appears to be widespread.

    In February, the University of California, Los Angeles, announced that researchers there had found that 68% of the 40 Mexican pharmacies visited in four northern Mexico cities sold Oxycodone, Xanax or Adderall, and that 27% of those pharmacies were selling fake pills.

    UCLA said the study, published in January, found that “brick and mortar pharmacies in Northern Mexican tourist towns are selling counterfeit pills containing fentanyl, heroin, and methamphetamine. These pills are sold mainly to U.S. tourists, and are often passed off as controlled substances such as Oxycodone, Percocet, and Adderall.”

    “These counterfeit pills represent a serious overdose risk to buyers who think they are getting a known quantity of a weaker drug,” Chelsea Shover, assistant professor-in-residence of medicine at the David Geffen School of Medicine at UCLA, said in February.

    The U.S. State Department travel warning in March said the counterfeit pills being sold at pharmacies in Mexico “may contain deadly doses of fentanyl.”

    Fentanyl is a synthetic opioid far more powerful than morphine, and it has been blamed for about 70,000 overdose deaths per year in the United States. Mexican cartels produce it from precursor chemicals smuggled in from China, and then often press it into pills designed to look like other medications.

    ____

    Follow AP’s coverage of Latin America and the Caribbean at https://apnews.com/hub/latin-america

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  • OxyContin maker bankruptcy deal goes before the Supreme Court on Monday, with billions at stake

    OxyContin maker bankruptcy deal goes before the Supreme Court on Monday, with billions at stake

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    WASHINGTON — The Supreme Court is hearing arguments over a nationwide settlement with OxyContin maker Purdue Pharma that would shield members of the Sackler family who own the company from civil lawsuits over the toll of opioids.

    The agreement hammered out with state and local governments and victims would provide billions of dollars to combat the opioid epidemic. The Sacklers would contribute up to $6 billion and give up ownership, and the company would emerge from bankruptcy as a different entity, with its profits used for treatment and prevention.

    But the justices put the settlement on hold during the summer, in response to objections from the Biden administration. Arguments take place Monday.

    The issue for the justices is whether the legal shield that bankruptcy provides can be extended to people such as the Sacklers, who have not declared bankruptcy themselves. Lower courts have issued conflicting decisions over that issue, which also has implications for other major product liability lawsuits settled through the bankruptcy system.

    The U.S. Bankruptcy Trustee, an arm of the Justice Department, contends that the bankruptcy law does not permit protecting the Sackler family from being sued by people who are not part of the settlement. During the Trump administration, the government supported the settlement.

    Proponents of the plan said third-party releases are sometimes necessary to forge an agreement, and federal law imposes no prohibition against them.

    Lawyers for more than 60,000 victims who support the settlement called it “a watershed moment in the opioid crisis,” while recognizing that “no amount of money could fully compensate” victims for the damage caused by the misleading marketing of OxyContin.

    A lawyer for a victim who opposes the settlement calls the provision dealing with the Sacklers “special protection for billionaires.”

    OxyContin first hit the market in 1996, and Purdue Pharma’s aggressive marketing of the powerful prescription painkiller is often cited as a catalyst of the nationwide opioid epidemic, persuading doctors to prescribe painkillers with less regard for addiction dangers.

    The drug and the Stamford, Connecticut-based company became synonymous with the crisis, even though the majority of pills being prescribed and used were generic drugs. Opioid-related overdose deaths have continued to climb, hitting 80,000 in recent years. Most of those are from fentanyl and other synthetic drugs.

    The Purdue Pharma settlement would be among the largest reached by drug companies, wholesalers and pharmacies to resolve epidemic-related lawsuits filed by state, local and Native American tribal governments and others. Those settlements have totaled more than $50 billion.

    But it would be one of only two so far that include direct payments to victims from a $750 million pool. Payouts are expected to range from about $3,500 to $48,000.

    Sackler family members no longer are on the company’s board and they have not received payouts from it since before Purdue Pharma entered bankruptcy. In the decade before that, though, they were paid more than $10 billion, about half of which family members said went to pay taxes.

    A decision in Harrington v. Purdue Pharma, 22-859, is expected by early summer.

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  • Vermont day care provider convicted of causing infant's death with doses of antihistamine

    Vermont day care provider convicted of causing infant's death with doses of antihistamine

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    Vermont child care provider accused of sedating an infant guilty of manslaughter

    ByThe Associated Press

    December 2, 2023, 11:40 AM

    RUTLAND, Vt. — A child care provider accused of sedating an infant with an antihistamine was convicted of manslaughter, and faces up to 25 years in prison when she’s sentenced.

    A jury on Friday convicted of Stacey Vaillancourt of manslaughter and child cruelty in the 2019 death of Harper Rose Briar in Vaillancourt’s home in Rutland.

    The 6-month-old was found unresponsive while in Vaillancourt’s care, and an autopsy determined she had high concentrations of diphenhydramine, the sedating ingredient in some over-the-counter antihistamines including the brand Benadryl. The drug is not recommended for infants without a doctor’s order, and there was no such order for Harper.

    Vaillancourt’s defense attorney said there was no evidence to prove Vaillancourt sedated the infant, but the prosecutor told jurors that no one else could have done it.

    Vaillancourt, who denied giving the infant anything that wasn’t provided by her parents, was released on an unsecured appearance bond. Her attorney didn’t immediately return a message seeking comment on Saturday.

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  • South African company to start making vaginal rings that protect against HIV

    South African company to start making vaginal rings that protect against HIV

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    A South African company will make vaginal rings that protect against HIV, which AIDS experts say should eventually make them cheaper and more readily available.

    The Population Council announced Thursday that Kiara Health of Johannesburg will start making the silicone rings in the next few years, estimating that 1 million could be produced annually. The devices release a drug that helps prevent HIV infections and are authorized by nearly a dozen countries and the World Health Organization.

    The nonprofit council owns the rights to the rings, which are now made by a Swedish company. About 500,00 rings are currently available to women in Africa at no cost, purchased by donors.

    Ben Phillips, a spokesman at the U.N. AIDS agency, said the advantage of the ring is that it gives women the freedom to use it without anyone else’s knowledge or consent.

    “For women whose partners won’t use a condom or allow them to take oral (preventive HIV) medicines, this gives them another option,” he said.

    HIV remains the leading cause of death among women of reproductive age in Africa and 60% of new infections are in women, according to figures from WHO.

    The ring releases the drug dapivirine in slow doses over a month. It currently costs $12 to $16, but experts expect the price to drop once it is widely produced in Africa. Developers are also working on a version that will last up to three months, which should also lower the yearly cost.

    WHO has recommended the ring be used as an additional tool for women at “substantial risk of HIV” and regulators in more than a dozen African countries, including South Africa, Botswana, Malawi, Uganda and Zimbabwe have also given it the green light. WHO cited two advanced studies in its approval, saying the ring reduced women’s chances of getting HIV by about a third, while other research has suggested the risk could be dropped by more than 50%.

    Last year, activists charged the stage in a protest during last year’s biggest AIDS meeting, calling on donors to buy the silicone rings for African women.

    ___

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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  • South Africa, Colombia, others are fighting drugmakers over access to TB, HIV drugs

    South Africa, Colombia, others are fighting drugmakers over access to TB, HIV drugs

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    CAPE TOWN, South Africa — South Africa, Colombia and other countries that lost out in the global race for coronavirus vaccines are taking a more combative approach towards drugmakers and pushing back on policies that deny cheap treatment to millions of people with tuberculosis and HIV.

    Experts see it as a shift in how such countries deal with pharmaceutical behemoths and say it could trigger more efforts to make lifesaving medicines more widely available.

    In the COVID-19 pandemic, rich countries bought most of the world’s vaccines early, leaving few shots for poor countries and creating a disparity the World Health Organization called “a catastrophic moral failure.”

    Now, poorer countries are trying to become more self-reliant “because they’ve realized after COVID they can’t count on anyone else,” said Brook Baker, who studies treatment-access issues at Northeastern University.

    One of the targets is a drug, bedaquiline, that is used for treating people with drug-resistant versions of tuberculosis. The pills are especially important for South Africa, where TB killed more than 50,000 people in 2021, making it the country’s leading cause of death.

    In recent months, activists have protested efforts by Johnson & Johnson to protect its patent on the drug. In March, TB patients petitioned the Indian government, calling for cheaper generics; the government ultimately agreed J&J’s patent could be broken. Belarus and Ukraine then wrote to J&J, also asking it to drop its patents, but with little response.

    In July, J&J’s patent on the drug expired in South Africa, but the company had it extended until 2027, enraging activists who accused it of profiteering.

    The South African government then began investigating the company’s pricing policies. It had been paying about 5,400 rand ($282) per treatment course, more than twice as much as poor countries that got the drug via a global effort called the Stop TB partnership.

    In September, about a week after South Africa’s probe began, J&J announced that it would drop its patent in more than 130 countries, allowing generic-makers to copy the drug.

    “This addresses any misconception that access to our medicines is limited,” the company said.

    Christophe Perrin, a TB expert at Doctors Without Borders, called J&J’s reversal “a big surprise” because aggressive patent protection was typically a “cornerstone” of pharmaceutical companies’ strategy.

    Meanwhile, in Colombia, the government declared last month that it would issue a compulsory license for the HIV drug dolutegravir without permission from the drug’s patent-holder, Viiv Healthcare. The decision came after more than 120 groups asked the Colombian government to expand access to the WHO-recommended drug.

    “This is Colombia taking the reins after the extreme inequity of COVID and challenging a major pharmaceutical to ensure affordable AIDS treatment for its people,” said Peter Maybarduk of the Washington advocacy group Public Citizen. He noted that Brazilian activists are pushing their government to make a similar move.

    Still, some experts said much more needs to change before poorer countries can produce their own medicines and vaccines.

    When the coronavirus pandemic hit, Africa produced fewer than 1% of all vaccines made globally but used more than half of the world’s supply, according to Petro Terblanche, managing director of Afrigen Biologics. The company is part of a WHO-backed effort to produce a COVID vaccine using the same mRNA technology as those made by Pfizer and Moderna.

    Terblanche estimated about 14 million people died of AIDS in Africa in the late 1990s-2000s, when countries couldn’t get the necessary medicines.

    Back then, President Nelson Mandela’s government in South Africa eventually suspended patents to allow wider access to AIDS drugs. That prompted more than 30 drugmakers to take it to court in 1998, in a case dubbed “Mandela vs. Big Pharma.”

    Doctors Without Borders described the episode as “a public relations disaster” for the drug companies, which dropped the lawsuit in 2001.

    Terblanche said that Africa’s past experience during the HIV epidemic has proven instructive.

    “It’s not acceptable for a listed company to hold intellectual property that stands in the way of saving lives and so, we will see more countries fighting back,” she said.

    Challenging pharmaceutical companies is just one piece to ensuring Africa has equal access to treatments and vaccines, Terblanche said. More robust health systems are critical.

    “If we can’t get (vaccines and medicines) to the people who need them, they aren’t useful,” she said.

    Yet some experts pointed out that South Africa’s own intellectual property laws still haven’t been changed sufficiently and make it too easy for pharmaceutical companies to acquire patents and extend their monopolies.

    While many other developing countries allow legal challenges to a patent or a patent extension, South Africa has no clear law that allows it to do that, said Lynette Keneilwe Mabote-Eyde, a health care activist who consults for the nonprofit Treatment Action Group.

    The South African department of health didn’t respond to a request for comment regarding drug procurement and patents.

    Andy Gray, who advises the South African government on essential medicines, said J&J’s recent decision to not enforce its patent may have more to do with the drug’s limited future earnings than caving to pressure from activists.

    “Because bedaquiline is not ever going to sell in huge volumes in high-income countries, it’s the sort of product they would love to offload at some stage and perhaps earn a royalty from,” said Gray, a senior lecturer in pharmacology at the University of KwaZulu-Natal.

    In its annual report on TB released earlier this month, the World Health Organization said there were more than 10 million people sickened by the disease last year and 1.3 million deaths. After COVID-19, tuberculosis is the world’s deadliest infectious disease and it is now the top killer of people with HIV. WHO noted only about 2 in 5 people with drug-resistant TB are being treated.

    Zolelwa Sifumba, a South African doctor, was diagnosed with drug-resistant TB in 2012 when she was a medical student and endured 18 months of treatment taking about 20 pills every day in addition to daily injections, which left her in “immense pain” and resulted in some hearing loss. Bedaquiline was not rolled out as a standard treatment in South Africa until 2018.

    “I wanted to quit (treatment) every single day,” she said. Since her recovery, Sifumba has become an advocate for better TB treatment, saying it makes little sense to charge poor countries high prices for essential medicines.

    “TB is everywhere but the burden of it is in your lower and middle income countries,” she said. “If the lower income countries can’t get it (the drug), then what’s the point? Who are you making it for?”

    ___

    Cheng reported from London.

    ___

    AP health coverage: https://apnews.com/health

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  • South Africa, Colombia and others are fighting drugmakers over access to TB and HIV drugs

    South Africa, Colombia and others are fighting drugmakers over access to TB and HIV drugs

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    CAPE TOWN, South Africa — South Africa, Colombia and other countries that lost out in the global race for coronavirus vaccines are taking a more combative approach towards drugmakers and pushing back on policies that deny cheap treatment to millions of people with tuberculosis and HIV.

    Experts see it as a shift in how such countries deal with pharmaceutical behemoths and say it could trigger more efforts to make lifesaving medicines more widely available.

    In the COVID-19 pandemic, rich countries bought most of the world’s vaccines early, leaving few shots for poor countries and creating a disparity the World Health Organization called “a catastrophic moral failure.”

    Now, poorer countries are trying to become more self-reliant “because they’ve realized after COVID they can’t count on anyone else,” said Brook Baker, who studies treatment-access issues at Northeastern University.

    One of the targets is a drug, bedaquiline, that is used for treating people with drug-resistant versions of tuberculosis. The pills are especially important for South Africa, where TB killed more than 50,000 people in 2021, making it the country’s leading cause of death.

    In recent months, activists have protested efforts by Johnson & Johnson to protect its patent on the drug. In March, TB patients petitioned the Indian government, calling for cheaper generics; the government ultimately agreed J&J’s patent could be broken. Belarus and Ukraine then wrote to J&J, also asking it to drop its patents, but with little response.

    In July, J&J’s patent on the drug expired in South Africa, but the company had it extended until 2027, enraging activists who accused it of profiteering.

    The South African government then began investigating the company’s pricing policies. It had been paying about 5,400 rand ($282) per treatment course, more than twice as much as poor countries that got the drug via a global effort called the Stop TB partnership.

    In September, about a week after South Africa’s probe began, J&J announced that it would drop its patent in more than 130 countries, allowing generic-makers to copy the drug.

    “This addresses any misconception that access to our medicines is limited,” the company said.

    Christophe Perrin, a TB expert at Doctors Without Borders, called J&J’s reversal “a big surprise” because aggressive patent protection was typically a “cornerstone” of pharmaceutical companies’ strategy.

    Meanwhile, in Colombia, the government declared last month that it would issue a compulsory license for the HIV drug dolutegravir without permission from the drug’s patent-holder, Viiv Healthcare. The decision came after more than 120 groups asked the Colombian government to expand access to the WHO-recommended drug.

    “This is Colombia taking the reins after the extreme inequity of COVID and challenging a major pharmaceutical to ensure affordable AIDS treatment for its people,” said Peter Maybarduk of the Washington advocacy group Public Citizen. He noted that Brazilian activists are pushing their government to make a similar move.

    Still, some experts said much more needs to change before poorer countries can produce their own medicines and vaccines.

    When the coronavirus pandemic hit, Africa produced fewer than 1% of all vaccines made globally but used more than half of the world’s supply, according to Petro Terblanche, managing director of Afrigen Biologics. The company is part of a WHO-backed effort to produce a COVID vaccine using the same mRNA technology as those made by Pfizer and Moderna.

    Terblanche estimated about 14 million people died of AIDS in Africa in the late 1990s-2000s, when countries couldn’t get the necessary medicines.

    Back then, President Nelson Mandela’s government in South Africa eventually suspended patents to allow wider access to AIDS drugs. That prompted more than 30 drugmakers to take it to court in 1998, in a case dubbed “Mandela vs. Big Pharma.”

    Doctors Without Borders described the episode as “a public relations disaster” for the drug companies, which dropped the lawsuit in 2001.

    Terblanche said that Africa’s past experience during the HIV epidemic has proven instructive.

    “It’s not acceptable for a listed company to hold intellectual property that stands in the way of saving lives and so, we will see more countries fighting back,” she said.

    Challenging pharmaceutical companies is just one piece to ensuring Africa has equal access to treatments and vaccines, Terblanche said. More robust health systems are critical.

    “If we can’t get (vaccines and medicines) to the people who need them, they aren’t useful,” she said.

    Yet some experts pointed out that South Africa’s own intellectual property laws still haven’t been changed sufficiently and make it too easy for pharmaceutical companies to acquire patents and extend their monopolies.

    While many other developing countries allow legal challenges to a patent or a patent extension, South Africa has no clear law that allows it to do that, said Lynette Keneilwe Mabote-Eyde, a health care activist who consults for the nonprofit Treatment Action Group.

    The South African department of health didn’t respond to a request for comment regarding drug procurement and patents.

    Andy Gray, who advises the South African government on essential medicines, said J&J’s recent decision to not enforce its patent may have more to do with the drug’s limited future earnings than caving to pressure from activists.

    “Because bedaquiline is not ever going to sell in huge volumes in high-income countries, it’s the sort of product they would love to offload at some stage and perhaps earn a royalty from,” said Gray, a senior lecturer in pharmacology at the University of KwaZulu-Natal.

    In its annual report on TB released earlier this month, the World Health Organization said there were more than 10 million people sickened by the disease last year and 1.3 million deaths. After COVID-19, tuberculosis is the world’s deadliest infectious disease and it is now the top killer of people with HIV. WHO noted only about 2 in 5 people with drug-resistant TB are being treated.

    Zolelwa Sifumba, a South African doctor, was diagnosed with drug-resistant TB in 2012 when she was a medical student and endured 18 months of treatment taking about 20 pills every day in addition to daily injections, which left her in “immense pain” and resulted in some hearing loss. Bedaquiline was not rolled out as a standard treatment in South Africa until 2018.

    “I wanted to quit (treatment) every single day,” she said. Since her recovery, Sifumba has become an advocate for better TB treatment, saying it makes little sense to charge poor countries high prices for essential medicines.

    “TB is everywhere but the burden of it is in your lower and middle income countries,” she said. “If the lower income countries can’t get it (the drug), then what’s the point? Who are you making it for?”

    ___

    Cheng reported from London.

    ___

    AP health coverage: https://apnews.com/health

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  • Obesity drug Wegovy cut risk of serious heart problems by 20%, study finds

    Obesity drug Wegovy cut risk of serious heart problems by 20%, study finds

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    The popular weight-loss drug Wegovy reduced the risk of serious heart problems by 20% in a large, international study that experts say could change the way doctors treat certain heart patients.

    The research is the first to document that an obesity medication can not only pare pounds, but also safely prevent a heart attack, stroke or a heart-related death in people who already have heart disease — but not diabetes.

    The findings could shift perceptions that the new class of obesity drugs are cosmetic treatments and put pressure on health insurers to cover them.

    “It moves from a kind of therapy that reduces body weight to a therapy that reduces cardiovascular events,” said Dr. Michael Lincoff, the study’s lead author and a heart expert at the Cleveland Clinic.

    Wegovy is a high-dose version of the diabetes treatment Ozempic, which already has been shown to reduce the risk of serious heart problems in people who have diabetes. The new study looked to see if the same was true in those who don’t have that disease.

    Experts have known for years that losing weight can improve heart health, but there hasn’t been a safe and effective obesity medication proven to reduce specific risks, said Dr. Francisco Lopez-Jimenez, a heart expert at the Mayo Clinic. He expects the new findings to change treatment guidelines and “dominate the conversation” for years to come.

    “This is the population who needs the medicine the most,” said Lopez-Jimenez, who had no role in the study.

    In the U.S., there are about 6.6 million people like those tested in the study, experts said.

    The results were published Saturday in the New England Journal of Medicine and presented at a medical conference in Philadelphia. Novo Nordisk, the maker of Wegovy and Ozempic, has asked the U.S. Food and Drug Administration to include the heart benefits on Wegovy’s label, like on Ozempic’s.

    The new study, paid for by the company, included more than 17,500 people in 41 countries. Participants were age 45 and older, had a body mass index of 27 or higher and were tracked for more than three years on average. They took typical drugs for their heart conditions, but they were also randomly assigned to receive weekly injections of Wegovy or a dummy shot.

    The study found that 569, or 6.5%, of those who got the drug versus 701, or 8%, of those who received the dummy shot had a heart attack or stroke or died from a heart-related cause. That’s an overall reduction of 20% in the risk of those outcomes, the researchers reported.

    The drop appeared to be fueled primarily by the difference in heart attacks, but the number of serious health complications reported were too small to tell whether the individual outcomes were caused by the drug or by chance.

    Study volunteers who took Wegovy lost about 9% of their weight while the placebo group lost less than 1%.

    The Wegovy group also saw drops in key markers of heart disease, including inflammation, cholesterol, blood sugars, blood pressure and waist circumference, noted Dr. Martha Gulati, a heart expert at Cedars-Sinai Medical Center in Los Angeles. Changes in those markers began early in the study, before participants lost much weight.

    “It means to me that it’s more than just weight loss, how this drug works,” said Gulati, who had no role in what she called a landmark study.

    Still, “it remains unclear” how much of the results were a benefit of losing weight or the drug itself, an editorial accompanying the study noted.

    About a third of all study volunteers reported serious side effects. About 17% in the Wegovy group and about 8% in the comparison group left the study, mostly because of nausea, vomiting, diarrhea and other stomach-related problems.

    Nearly three-quarters of participants were men and nearly 84% were white. Gulati and others said future research needs to include more women and racial and ethnic minorities.

    Wegovy is part of a new class of injectable medications for obesity. On Wednesday, the U.S. Food and Drug Administration approved Eli Lilly’s Zepbound, a version of the diabetes drug Mounjaro, for weight control.

    Both carry high price tags — monthly costs are about $1,300 for Wegovy and about $1,000 for Zepbound. And both have been in shortage for months, with manufacturers promising to boost supplies.

    The medications are often not covered by private health insurance or subject to strict preauthorization requirements. Medicare, the government health plan for older Americans, is prohibited from covering drugs for weight loss alone. But drugmakers and obesity treatment advocates have been pushing for broader coverage, including asking Congress to pass legislation to mandate that Medicare pay for the drugs.

    Results from the latest study and others that show the obesity drugs have a direct effect on costly health problems could be a factor in shifting the calculus of coverage, said Dr. Mark McClellan, former chief of the Centers for Medicare and Medicaid Services and the FDA. In 2006, Medicare was allowed to cover weight-loss surgery to treat the complications of severe obesity, if not obesity itself, he noted.

    That approach “may end up being relevant here,” he said.

    ___

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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  • As billions roll in to fight opioid epidemic, one county shows how recovery can work

    As billions roll in to fight opioid epidemic, one county shows how recovery can work

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    FINDLAY, Ohio — Communities ravaged by America’s opioid epidemic are starting to get their share of a $50 billion pie from legal settlements.

    Most of that money comes with a requirement that it be used to address the overdose crisis and prevent more deaths.

    But how?

    It could mean that places look more like the area around Findlay. Here, conservative Hancock County has built a comprehensive system focused on both treatment and recovery.

    “People recover in a community,” said Precia Stuby, the official who heads the county’s addiction and mental health efforts. “We have to build recovery-oriented communities that support individuals.”

    It was 2007 when Stuby began hearing from officials about prescription opioids being misused. That was about the same time Jesse Johnson, then 14, was prescribed the painkiller Percocet.

    The Findlay native was pregnant when she needed stents put into her kidneys as treatment for infections and kidney stones. After seven months on the opioid medication, she gave birth to a healthy daughter. Then she underwent an operation to remove the stents. The prescriptions stopped and she became sick from withdrawal.

    “I remember not even being able to hold my daughter,” said Johnson, now 31. “It just hurt.”

    Alcohol, marijuana and, a few years later, cocaine and opioids from the black market helped Johnson ease the pain.

    By then, county officials were seeing the area’s fatal opioid overdose toll tick up. The recovery system then included only some outpatient services and Alcoholics Anonymous.

    From 1999 through 2020, 131 deaths in the county were attributed to opioids. Across the country, it was more than 500,000. The county’s opioid-linked death rate over that period paralleled the nation’s as the crisis moved from pain pills to heroin to even more potent fentanyl.

    But the county took a path that many places did not.

    Officials created a plan with the help of the federally funded Addiction Technology Transfer Center that stressed recovery and built upon a local recognition that “this is our family, our friends, our brothers, our sisters,” Stuby said.

    The settlement funds from drugmakers, wholesalers and pharmacies will not be enough for every harm reduction, treatment, recovery and prevention program that might be needed to fight the nation’s opioid epidemic.

    But it could be enough to jumpstart major changes to the efforts.

    The county’s approach, which echoes experts’ recommendations for use of the settlement money, is that people with the right support can recover from addiction.

    Since its implementation began a decade ago, Hancock County has brought in more than $19 million in grants, largely from the federal government. Other funding comes from a county tax levy and the state. Health insurance helps pay for treatment.

    Among the steps Hancock County has taken:

      1. Like hundreds of communities, it’s launched a drug court where people can avoid jail if they work on recovery.

      2. The University of Findlay began offering classes on addiction. They can lead to an entry-level certificate for work in the field.

      3. It’s added three recovery homes and a community center where people can attend 12-step meetings, play video games or learn to crochet — and a similar place for teens.

      4. The county launched a needle exchange, providing supplies to reduce needle sharing and the risk of HIV and hepatitis C. These are policy staples in larger cities, but less common in smaller ones.

      5. At the Family Resource Center, the quick response team identifies and reaches out to overdose survivors and people with substance use disorder who are being released from jail or prison.

      6. The county deployed outreach workers to help people who survive overdoses, those who are incarcerated and others navigate the recovery system.

    There’s evidence that the efforts are helping. After 28 overdose deaths from all drugs last year, Hancock County has three confirmed overdose deaths and five suspected ones so far in 2023.

    “It’s not just about how to get people off of opioids, but how do we keep them in remission and increase their stable recovery?” said John F. Kelly, of Harvard Medical School. His research has shown that recovery support services — such as housing, community centers and peer coaching — can help.

    It’s worked for Johnson.

    After she was released from a hospital following an overdose when she was 27, a peer support worker tracked her down in Findlay’s homeless shelter.

    Now 31, she’s still in recovery, has two of her children living with her and regularly sees two others who live with her stepfather.

    Earlier this year, she started a peer support job with the Family Resource Center, the same organization that employed the worker who was so instrumental in her own early recovery.

    “It’s something that I’ve always wanted to do,” she said, “because I wanted to be that person that reached out to me and then found me at one of the worst times in my life and pulled me together somehow.”

    ___

    Johnson reported from Washington state. AP video journalist Patrick Orsagos also contributed to this article.

    ___

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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  • Volunteer medical students are trying to fill the health care gap for migrants in Chicago

    Volunteer medical students are trying to fill the health care gap for migrants in Chicago

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    CHICAGO — Using sidewalks as exam rooms and heavy red duffle bags as medical supply closets, volunteer medics spend their Saturdays caring for the growing number of migrants arriving in Chicago without a place to live.

    Mostly students in training, they go to police stations where migrants are first housed, prescribing antibiotics, distributing prenatal vitamins and assessing for serious health issues. These student doctors, nurses and physician assistants are the front line of health care for asylum-seekers in the nation’s third-largest city, filling a gap in Chicago’s haphazard response.

    “My team is a team that shouldn’t have to exist, but it does out of necessity,” said Sara Izquierdo, a University of Illinois Chicago medical student who helped found the group. “Because if we’re not doing this, I’m not sure anyone will.”

    More than 19,600 migrants have come to Chicago over the last year since Texas Gov. Greg Abbott began sending buses to so-called sanctuary cities. The migrants wait at police stations and airports, sometimes for months, until there’s space at a longer-term shelter, like park district buildings.

    Once in shelter, they can access a county clinic exclusively for migrants. But the currently 3,300 people in limbo at police stations and airports must rely on a mishmash of volunteers and social service groups that provide food, clothes and medicine.

    Izquierdo noted the medical care gap months ago, consulted experienced doctors and designed a street-medicine model tailored to migrants’ medical needs. Her group makes weekly visits to police stations, operating on a shoestring budget of $30,000, mostly used for medication.

    On a recent Saturday, she was among dozens of medics at a South Side station where migrants sleep in the lobby, on sidewalks and an outdoor basketball court. Officers didn’t allow the volunteers in the station so when one patient requested privacy, their doctor used his car.

    Abrahan Balizario saw a doctor for the first time in five months.

    The 28-year-old had a headache, toothache and chest pain. He recently arrived from Peru, where he worked as a driver and at a laundromat but couldn’t survive. He wasn’t used to the brisk Chicago weather and believed sleeping outdoors exacerbated his symptoms.

    “It is very cold,” he said. “We’re almost freezing.”

    The volunteers booked him a dental appointment and gave him a bus pass.

    Many migrants who land in Chicago and other U.S. cities come from Venezuela where a social, political and economic crisis has pushed millions into poverty. More than 7 million have left, often risking a dangerous route by foot to the U.S. border.

    The migrants’ health problems tend to be related to their journey or living in crowded conditions. Back and leg injuries from walking are common. Infections spread easily. Hygiene is an issue. There are few indoor bathrooms and outdoor portable toilets lack handwashing stations. Not many people carry their medical records.

    Most also have trauma, either from their homeland or from the journey itself.

    “You can understand the language, but it doesn’t mean you understand the situation,” said Miriam Guzman, one of organizers and a fourth-year medical student at UIC.

    The doctors refer patients to organizations that help with mental health but there are limitations. The fluid nature of the shelter system makes it difficult to follow-up; people are often moved without warning.

    Chicago’s goal is to provide permanent homes, which could help alleviate health issues. But the city has struggled to manage the growing population as buses and planes arrive daily at all hours. Mayor Brandon Johnson, who took office in May, calls it an inherited issue and proposed winterized tents.

    His administration has acknowledged the heavy reliance on volunteers.

    “We weren’t ready for this,” said Rey Wences Najera, first deputy of immigrant, migrant and refugee rights. “We are building this plane as we are flying it and the plane is on fire.”

    The volunteer doctors also are limited in what they can do: Their duffle bags have medications for children, bandages and even ear plugs after some migrants wanted to block out sirens. But they cannot offer X-rays or address chronic issues.

    “You’re not going to tell a person who has gone through this journey to stop smoking,” said Ruben Santos, a Rush University medical student. “You change your way of trying to connect to that person to make sure that you can help them with their most pressing needs while not doing some of the traditional things that you would do in the office or a big academic hospital.”

    The volunteers explain to each patient that the service is free but that they’re students. Experienced doctors, who are part of the effort, approve treatment plans and prescribe medications.

    Getting people those medications is another challenge. One station visit prompted 15 prescriptions. Working from laptops on the floor — near dozens of sleeping families — the doctors mapped out which medics would pick up medications the following day and how they’d find the recipients.

    Sometimes the volunteers must call for emergency help.

    Thirty-year-old Moises Hidalgo said he had trouble breathing. Doctors heard a concerning “crackling” sound, suspected pneumonia and called an ambulance.

    Hidalgo, who came from Peru after having left his native Venezuela more than a decade ago, once worked as a chef. He’s been walking around Chicago looking for jobs, but has been turned away without a work permit.

    “I’ve been trying to find work, at least so that I can pay to sleep somewhere, because if this isn’t solved, I can’t keep waiting,” he said.

    To stay warm while sleeping outside, he wore four layers of clothing; his loose pants cinched with a shoelace.

    The medics hope Chicago can formalize their approach. And they say they’ll continue to keep at it — for some, it’s personal.

    Dr. Muftawu-Deen Iddrisu, who works Advocate Illinois Masonic Medical Center, said he wanted to give back. Originally from Ghana, he attended medical school in Cuba.

    “I come from a very humble background,” he said. “I know how it feels. I know once sometime back someone did the same for me.”

    ___

    Associated Press video journalist Melissa Perez Winder contributed to this report.

    ___

    The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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  • Abortion restrictions in Russia spark outrage as country takes conservative turn

    Abortion restrictions in Russia spark outrage as country takes conservative turn

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    TALLINN, Estonia — Despite its last-minute scheduling, the meeting at a bookstore in Russia’s westernmost city of Kaliningrad still drew about 60 people, with many outraged by a lawmaker’s efforts to ban abortions in local private clinics.

    The weeknight turnout surprised and heartened Dasha Yakovleva, one of the organizers, amid recent crackdowns on political activism under President Vladimir Putin.

    “Right now, there is no room for political action in Russia. The only place left is our kitchens,” Yakovleva, co-founder of the Feminitive Community women’s group, told The Associated Press. “And here, it was a public place, well-known in Kaliningrad, and everyone spoke out openly about how they see this measure, why they think it’s unjustified, inappropriate.”

    Although abortion is still legal and widely available in Russia, recent attempts to restrict it have touched a nerve across the increasingly conservative country. Activists are urging supporters to make official complaints, circulating online petitions and even staging small protests.

    While only a proposal for now in Kaliningrad, private clinics elsewhere have begun to stop providing abortions. Nationwide, the Health Ministry has drawn up talking points for doctors to discourage women from terminating their pregnancies, and new regulations soon will make many emergency contraceptives virtually unavailable and drive up the cost of others.

    “It’s clear that there is a gradual erosion of abortion access and rights in Russia, and this is similar to what has taken place in the U.S.,” said Michele Rivkin-Fish, an anthropologist at the University of North Carolina at Chapel Hill.

    Last year’s U.S. Supreme Court decision rescinding a five-decade-old right to abortion has reshaped American abortion policy, shifting power to states. About half of U.S. states have adopted bans or major restrictions, although not all are being enforced due to legal challenges.

    In the Soviet Union, abortion laws meant that some women had the procedure multiple times due to difficulties in obtaining contraceptives.

    After the USSR’s collapse, government and health experts promoted family planning and birth control, sending abortion rates falling. At the same time, laws allowed women to terminate a pregnancy up until 12 weeks without any conditions; and until 22 weeks for many “social reasons,” like divorce, unemployment or income.

    That changed under Putin, who has forged a powerful alliance with the Russian Orthodox Church, promoting “traditional values” and seeking to boost population growth. Health Minister Mikhail Murashko has condemned women for prioritizing education and career over childbearing.

    Over the decades, the number of abortions in Russia fell from 4.1 million in 1990 to 517,000 in 2021.

    Only in instances of rape is an abortion legally allowed between 12 and 22 weeks. Some regions hold “Days of Silence,” when public clinics don’t provide them. Women must wait 48 hours or even a week -– depending on what stage of pregnancy -– between their first appointment and the abortion, in case they reconsider. They also are offered psychological consultations designed to discourage abortions, according to state-issued guidelines reviewed by AP.

    Health authorities have introduced an online “motivational questionnaire” outlining state support if women continue the pregnancy, according to a state clinic gynecologist who was not authorized to comment publicly and spoke on condition of anonymity.

    She said the waiting periods were psychologically hard for some of her patients. “During that week (of waiting), she might start getting nauseous and experience other symptoms of pregnancy,” she added. “They don’t understand the point.”

    State clinics in one region referred women to a priest before getting an abortion. Authorities maintained the consultation was voluntary, but some women told the media they had to get a priest to sign off to get an abortion.

    The anti-abortion push comes as Russian women appear to be in no rush to have more children amid the war in Ukraine and economic uncertainty. Sales of abortion pills in 2022 were up 60%, according to Nikolay Bespalov, development director of the RNC Pharma analytical company. They fell 35% this year, still higher than pre-2022 levels. Sales of contraceptive medications also have been rising in 2022-23, he said.

    A recent Health Ministry decree restricted circulation of abortion pills, used to terminate pregnancies in the first trimester. The decree puts mifepristone and misoprostol, used in the pills, on a registry of controlled substances requiring strict record-keeping and storage.

    For hospitals and clinics, where the pills are usually dispensed, the move will add more paperwork but not much else, said Dr. Yekaterina Hivrich, head of gynecology at Lahta Clinic, a private clinic in St. Petersburg.

    But it will affect the availability of emergency contraceptives, sometimes known as morning-after pills, which are taken within days of unprotected sex to prevent pregnancy. Three out of six brands available in Russia contain mifepristone in a lower dose, meaning they’ll be severely restricted once the decree takes effect Sept. 1, 2024.

    They will require a special prescription, and not all pharmacies will stock them, said Irina Fainman, an activist in the northern region of Karelia, adding that getting a prescription takes time that women might not have when they need the pills.

    The Health Ministry did not respond to questions on whether it will exclude morning-after pills in the decree. Officials earlier promised it won’t affect those pills, but some pharmacies already list those with mifepristone as available only under strict prescription conditions.

    After the restrictions were announced, Fainman said she and other activists stocked up on the pills to distribute in case of shortages.

    Sales of emergency contraceptives soared 71% through August 2023, over the same period last year, according to Bespalov. Those containing mifepristone account for about half the market. New measures likely will increase the cost of unrestricted medications and possibly lead to short-term shortages.

    Senior lawmaker Pyotr Tolstoy said that by spring, lawmakers would strive to adopt a nationwide ban on abortion in private clinics, where about 20% took place in recent years, according to state statistics.

    Conservative lawmakers failed to enact such a ban before, but the Health Ministry now says it is ready to consider it.

    To Irina Volynets, an abortion opponent and children’s rights ombudswoman in the Tatarstan region, “it gives hope that this procedure will be taken out of private clinics” eventually. She also wants increased state support for women with children as an incentive for boosting birthrates.

    Regional authorities have tried to get private clinics to stop offering abortions, with varying success. Kaliningrad is mulling a region-wide ban. In Tatarstan, about a third of all private clinics no longer provide them, officials said. In the Chelyabinsk region in the Urals, three clinics agreed to halt them.

    “It’s important to understand that the pressure on women will be growing” even in the absence of a total ban, said Kaliningrad psychotherapist and activist Lina Zharin, who helped organize the recent bookstore meeting. An online petition against the ban in Kaliningrad has gathered nearly 27,000 signatures.

    In seven other regions, the Health Ministry is using another pilot project: having gynecologists try to get women to reconsider having an abortion.

    A document obtained by AP and cited by other media outlines language doctors are told to use, including saying pregnancy is “a beautiful and natural condition for every woman,” while an abortion is “harmful to your health and a risk of developing complications.”

    Natalya Moskvitina, founder of Women For Life, which aids women who decide against abortion, said she helped develop the instructions and is introducing similar scripts for doctors in several regions.

    Moskvitina made headlines in August after the region of Mordovia adopted a law she helped draft to ban “encouraging” abortions. At least one other region is considering a similar ban. Her program, which instructs doctors to congratulate women on being pregnant and gives baby-themed presents and information on support resources, has driven the abortion rate down 40% in Mordovia, she and local officials said.

    For women with doubts about abortion, such conversations might indeed help them reach a decision but for others, they could be deeply uncomfortable.

    Olga Mindolina was contemplating an abortion in 2020, traumatized by an earlier, difficult pregnancy. But when a doctor in a state clinic in the western city of Voronezh asked her what she wanted to do, she said she didn’t know -– and was told, “In this case, you should give birth.”

    A clinic psychologist told her that women sometimes regret abortion, advising her to talk to her husband. A lawyer also told her about state benefits she could get if she gave birth. Mindolina decided to continue the pregnancy.

    Anastasia, a Muscovite who sought an abortion in 2020, said it “wasn’t very pleasant” when a doctor urged her to change her mind.

    “I simply don’t want any children,” she told AP, asking that her last name not be used for fear of reprisals.

    Dr. Lyubov Yeroveyeva, a gynecologist who spearheaded family planning projects in the 1990s, believes the key is preventing unwanted pregnancies with education about birth control and making contraceptives widely available.

    Instead of talking a woman out of an abortion, authorities should “do everything so she doesn’t have to seek one,” she said.

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  • Little light, no beds, not enough anesthesia: A view from Gaza’s hospitals

    Little light, no beds, not enough anesthesia: A view from Gaza’s hospitals

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    DEIR AL-BALAH, Gaza Strip — The only thing worse than the screams of a patient undergoing surgery without enough anesthesia are the terror-stricken faces of those awaiting their turn, a 51-year-old orthopedic surgeon says.

    When the Israeli bombing intensifies and the wounded swamp the Gaza City hospitals where Dr. Nidal Abed works, he treats patients wherever he can — on the floor, in the corridors, in rooms crammed with 10 patients instead of two. Without enough medical supplies, Abed makes do with whatever he can find – clothes for bandages, vinegar for antiseptic, sewing needles for surgical ones.

    Hospitals in the Gaza Strip are nearing collapse under the Israeli blockade that cut power and deliveries of food and other necessities to the territory. They lack clean water. They are running out of basic items for easing pain and preventing infections. Fuel for their generators is dwindling.

    Israel began its bombing campaign after Hamas militants surged across the border on Oct. 7 and killed over 1,400 people, mostly civilians, and abducted more than 200 others. Israel’s offensive has devastated neighborhoods, shuttered five hospitals, killed thousands and wounded more people than its remaining health facilities can handle.

    “We have a shortage of everything, and we are dealing with very complex surgeries,” Abed, who works with Doctors Without Borders, told The Associated Press from Al Quds Hospital. The medical center is still treating hundreds of patients in defiance of an evacuation order the Israeli military gave Friday. Some 10,000 Palestinians displaced by the bombing have also taken refuge in the hospital compound.

    “These people are all terrified, and so am I,” the surgeon said. “But there is no way we’ll evacuate.”

    The first food, water and medicine trickled into Gaza from Egypt on Saturday after being stalled on the border for days. Four trucks in the 20-truck aid convoy were carrying drugs and medical supplies, the World Health Organization said. Aid workers and doctors warned it was not nearly enough to address Gaza’s spiraling humanitarian crisis.

    “It’s a nightmare. If more aid doesn’t come in, I fear we’ll get to the point where going to a hospital will do more harm than good,” Mehdat Abbas, an official in the Hamas-run Health Ministry, said.

    Across the territory’s hospitals, ingenuity is being put to the test. Abed used household vinegar from the corner store as disinfectant until the stores ran out, he said. Too many doctors had the same idea. Now, he cleans wounds with a mixture of saline and the polluted water that trickles from taps because Israel cut off the water.

    A shortage of surgical supplies forced some staff to use sewing needles to stitch wounds, which Abed said can damage tissue. A shortage of bandages forced medics to wrap clothes around large burns, which he said can cause infections. A shortage of orthopedic implants forced Abed to use screws that don’t fit his patients’ bones. There are not enough antibiotics, so he gives single pills rather than multiple courses to patients suffering terrible bacterial infections.

    “We are doing what we can to stabilize the patients, to control the situation,” he said. “People are dying because of this.”

    When Israel cut fuel to the territory’s sole power plant two weeks ago, Gaza’s rumbling generators kicked in to keep life-support equipment running in hospitals.

    Authorities are desperately scrounging up diesel to keep them going. United Nations agencies are distributing their remaining stocks. Motorists are emptying their gas tanks.

    In some hospitals, the lights have already switched off. At Nasser Hospital in the southern city of Khan Younis this week, nurses and surgical assistants held their iPhones over the operating table, guiding the surgeons with the flashlights as they snipped.

    At Shifa Hospital, Gaza’s biggest, where Abed also worked this week, the intensive care unit runs on generators but most other wards are without power. Air conditioning is a bygone luxury. Abed catches beads of sweat dripping from his patients’ foreheads as he operates.

    People wounded in the airstrikes are overwhelming the facilities. Hospitals don’t have enough beds for them.

    “Even a normal hospital with equipment would not be able to deal with what we’re facing,” Abed said. “It would collapse.”

    Shifa Hospital — with a maximum capacity of 700 people — is treating 5,000 people, general director Mohammed Abu Selmia says. Lines of patients, some in critical condition, snake out of operating rooms. The wounded lie on floors or on gurneys sometimes stained with the blood of previous patients. Doctors operate in crowded corridors filled with moans.

    The scenes — infants arriving alone to intensive care because no one else in their family survived, patients awake and grimacing in pain during surgeries — have traumatized Abed into numbness.

    But what still pains him is having to choose which patients to prioritize.

    “You have to decide,” he said. “Because you know that many will not make it.”

    ___

    DeBre reported from Jerusalem.

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  • Amazon will start testing drones that will drop prescriptions on your doorstep, literally

    Amazon will start testing drones that will drop prescriptions on your doorstep, literally

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    Amazon will soon make prescription drugs fall from the sky when the e-commerce giant becomes the latest company to test drone deliveries for medications.

    The company said Wednesday that customers in College Station, Texas, can now get prescriptions delivered by a drone within an hour of placing their order.

    The drone, programed to fly from a delivery center with a secure pharmacy, will travel to the customer’s address, descend to a height of about four meters — or 13 feet — and drop a padded package.

    Amazon says customers will be able to choose from more than 500 medications, a list that includes common treatments for conditions like the flu or pneumonia, but not controlled substances.

    The company’s Prime Air division began testing drone deliveries of common household items last December in College Station and Lockeford, California. Amazon spokesperson Jessica Bardoulas said the company has made thousands of deliveries since launching the service, and is expanding it to include prescriptions based in part on customer requests.

    Amazon Prime already delivers some medications from the company’s pharmacy inside of two days. But pharmacy Vice President John Love said that doesn’t help someone with an acute illness like the flu.

    “What we’re trying to do is figure out how can we bend the curve on speed,” he said.

    Amazon Pharmacy Chief Medical Officer Dr. Vin Gupta says the U.S. health care system generally struggles with diagnosing and treating patients quickly for acute illnesses, something that was apparent throughout the COVID-19 pandemic.

    Narrowing the window between diagnosis and treating makes many treatments more effective, he said.

    Amazon is not the first company to explore prescription deliveries by drone. The drugstore chain CVS Health worked with UPS to test deliveries in 2019 in North Carolina but that program has ended, a CVS spokesman said.

    Intermountain Health started providing drone deliveries of prescriptions in 2021 in the Salt Lake City area and has been expanding the program, according to Daniel Duersch, supply chain director for the health care system. Intermountain is partnering with the logistics company Zipline to use drones that drop packages by parachute.

    Companies seeking to use drones for commercial purposes have faced hurdles from regulators who want to make sure things are operating safely. Amazon founder Jeff Bezos had predicted a decade ago that drones would be making deliveries by 2018. Even now, the e-commerce giant is only using the technology in two markets.

    Lisa Ellman, the executive director of the Commercial Drone Alliance, an industry group that counts Amazon as one of its members, said to date, regulatory approvals have been limited to specific geographic areas and “in terms of their scope and usefulness to companies.”

    That said, she noted regulators have also been issuing more approvals. Last month, the FAA gave the OK for Zipline and UPS to fly longer-range drones.

    Walmart has also been working to expand its own drone deliveries.

    Amazon says its drones will fly as high as 120 meters, or nearly 400 feet, before slowly descending when they reach the customer’s home. The drone will check to make sure the delivery zone is clear of pets, children or any other obstructions before dropping the package on a delivery marker.

    The company said it hopes to expand the program to other markets, but it has no time frame for that.

    Amazon has been growing its presence in health care for a few years now.

    Aside from adding a pharmacy, it also spent nearly $4 billion to buy primary care provider One Medical. In August, the company added video telemedicine visits in all 50 states.

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  • New vaccine expected to give endangered California condors protection against deadly bird flu

    New vaccine expected to give endangered California condors protection against deadly bird flu

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    LOS ANGELES — Antibodies found in early results of a historic new vaccine trial are expected to give endangered California condors at least partial protection from the deadliest strain of avian influenza in U.S. history.

    The California condor is the only bird species in the U.S. that has been approved for the new emergency-use vaccine, which was administered this summer to condors bred in captivity during a trial at the Los Angeles Zoo, the San Diego Zoo Safari Park and the Oregon Zoo.

    Authorities launched the study after the avian influenza deaths earlier this year of 21 free-flying condors in Arizona, part of a Southwest flock usually accounting for a third of the wild population.

    Wildlife officials feared that the outbreak’s toll on the California condor population could erase any gains made to rebuild the wild population, spurring the efforts to fast-track the vaccine.

    After 40 years of recovery efforts to prevent the extinction of the iconic vulture with a 10-foot (3-meter) wingspan, the wild population today has fewer than 350 condors in flocks spanning from the Pacific Northwest to Baja California, Mexico.

    “Losing 20 birds is effectively akin to setting the recovery program back by 10 years,” said Dr. Hendrik Nollens, vice president of wildlife health for the San Diego Zoo Wildlife Alliance.

    The so-called bird flu reached the U.S. in February 2022 after wreaking havoc across Europe. U.S. agriculture officials consider this year’s cases to be part of last year’s outbreak, which was recorded as the country’s deadliest ever.

    Authorities confirmed the flu’s presence earlier this month in commercial poultry flocks in South Dakota and Utah, heightening concerns ahead of the spring migratory season. The outbreak cost poultry producers nearly 59 million birds across 47 states, including egg-laying chickens and turkeys and chickens raised for meat. The flu also caused spikes in egg and turkey prices for consumers and cost the federal government more than $660 million.

    Early results indicate that when 10 condors were vaccinated with half a milliliter (0.016 fluid ounces) on two occasions — an initial injection and a booster administered 21 days later — 60% of the birds showed measurable antibodies expected to protect them from avian flu after exposure.

    “We’re thankful that we’re getting any immune response,” said Ashleigh Blackford, the California condor coordinator for the U.S. Fish and Wildlife Service.

    The population was nearly wiped out by hunting during the California Gold Rush in the mid-1800s, as well as by poisoning from toxic pesticide DDT and lead ammunition.

    In the 1980s, only 22 California condors were left in the wild. They were captured and placed in captive breeding programs to save the species. Zoo-bred birds were first released into the wild in 1992 and in the years since have been reintroduced into habitats from which they had disappeared. The ongoing re-wilding efforts are considered a conservation success.

    The bird flu trial’s progress will allow wildlife officials to move forward and release roughly two dozen vaccinated condors into the wild in California and Arizona by the end of the year. The government is awaiting additional results before deciding whether free-flying condors should be captured and inoculated. Officials already vaccinate condors in captivity and in the wild for West Nile virus.

    Dr. Carlos Sanchez, the Oregon Zoo’s director of animal health, said wildlife officials faced questions about undertaking the bird flu vaccine study.

    “Human intervention, veterinary intervention, is not something we do all the time or take lightly,” he said. “It wasn’t an easy decision.”

    The shots initially were tested on black vultures to make sure they could be safely injected into condors in managed care beginning in July. The post-inoculation monitoring and testing lasted 42 days and officials said no adverse reactions occurred.

    Dr. Dominique Keller, the LA Zoo chief veterinarian, said participating in the historic trial was one of her career’s highlights. She hopes the condor study will lead to bird flu vaccines for other endangered species.

    “It was just so incredible to be the first one to hold the vaccine in my hand and actually give it to the first bird,” she said.

    The trial’s second test group includes 10 condors vaccinated with one dose of a single milliliter (0.03 fluid ounces). Results from those birds will determine whether condors in the wild will get the shot.

    “We want to look at the data more holistically before we kind of jump ahead to what’s next,” Blackford said.

    The condor is intrinsically tied to several Native American tribes in the West and is considered by tribal members to be equal or even superior to humans. The condor disappeared from the Yurok Tribe’s ancestral lands in Northern California in the late 1800s but returned in 2021 after major conservation efforts from a team led by Tiana Williams-Claussen, the tribe’s wildlife department director.

    Watching the avian flu wipe out 21 birds in Arizona just a few years later was “deeply impactful” to members of the tribe, Williams-Claussen said. The study and vaccine could prevent a repeat of the devastation.

    “We’re all kind of waiting with bated breath to see what the final results are going to be,” she said.

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  • Drug used in diabetes treatment Mounjaro helped dieters shed 60 pounds, study finds

    Drug used in diabetes treatment Mounjaro helped dieters shed 60 pounds, study finds

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    The medicine in the diabetes drug Mounjaro helped people with obesity or who are overweight lose at least a quarter of their body weight, or about 60 pounds on average, when combined with intensive diet and exercise, a new study shows.

    By comparison, a group of people who also dieted and exercised, but then received dummy shots, lost weight initially but then regained some, researchers reported Sunday in the journal Nature Medicine.

    “This study says that if you lose weight before you start the drug, you can then add a lot more weight loss after,” said Dr. Thomas Wadden, a University of Pennsylvania obesity researcher and psychology professor who led the study.

    The results, which were also presented Sunday at a medical conference, confirm that the drug made by Eli Lilly & Co. has the potential to be one of the most powerful medical treatments for obesity to date, outside experts said.

    “Any way you slice it, it’s a quarter of your total body weight,” said Dr. Caroline Apovian, who treats obesity at Brigham and Women’s Hospital and wasn’t involved in the study.

    The injected drug, tirzepatide, was approved in the U.S. in May 2022 to treat diabetes. Sold as Mounjaro, it has been used “off-label” to treat obesity, joining a frenzy of demand for diabetes and weight-loss medications including Ozempic and Wegovy, made by Novo Nordisk.

    All the drugs, which carry retail price tags of $900 a month or more, have been in shortage for months.

    Tirzepatide targets two hormones that kick in after people eat to regulate appetite and the feeling of fullness communicated between the gut and the brain. Semaglutide, the drug used in Ozempic and Wegovy, targets one of those hormones.

    The new study, which was funded by Eli Lilly, enrolled about 800 people who had obesity or were overweight with a weight-related health complication — but not diabetes. On average, study participants weighed about 241 pounds (109.5 kilograms) to start and had a body-mass index — a common measure of obesity — of about 38.

    After three months of intensive diet and exercise, more than 200 participants left the trial, either because they failed to lose enough weight or for other reasons. The remaining nearly 600 people were randomized to receive tirzepatide or a placebo via weekly injections for about 16 months. Nearly 500 people completed the study.

    Participants in both groups lost about 7% of their body weight, or almost 17 pounds (8 kilograms), during the diet-and-exercise phase. Those who received the drug went on to lose an additional 18.4% of initial body weight, or about 44 pounds (20 kilograms) more, on average. Those who received the dummy shots regained about 2.5% of their initial weight, or 6 pounds (2.7 kilograms).

    Overall, about 88% of those taking tirzepatide lost 5% or more of their body weight during the trial, compared with almost 17% of those taking placebo. Nearly 29% of those taking the drug lost at least a quarter of their body weight, compared with just over 1% of those taking placebo.

    That’s higher than the results for semaglutide and similar to the results seen with bariatric surgery, said Apovian.

    “We’re doing a medical gastric bypass,” she said.

    Side effects including nausea, diarrhea and constipation were reported more frequently in people taking the drug than those taking the placebo. They were mostly mild to moderate and occurred primarily as the dose of the drug was escalated, the study found. More than 10% of those taking the drug discontinued the study because of side effects, compared with about 2% of those on placebo.

    Lilly is expected to publish the results soon of another study that the firm says shows similar high rates of weight loss. The U.S. Food and Drug Administration has granted the company a fast-track review of the drug to treat obesity, which Eli Lilly may sell under a different brand name. A decision is expected by the end of the year.

    ___

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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  • ‘Miracle drug’ euphoria: Experts warn widespread use of weight loss medicine faces major hurdles

    ‘Miracle drug’ euphoria: Experts warn widespread use of weight loss medicine faces major hurdles

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    Two experts see major challenges facing the adoption of new obesity drugs.

    Dr. Kavita Patel, a physician and NBC News medical contributor, believes fresh data from Novo Nordisk on Ozempic’s ability to delay the progression of chronic kidney disease is among the strongest supporting evidence for secondary uses of the drug.

    However, she considers data supporting the use of obesity drugs for other conditions including Alzheimer’s and alcohol addiction as underdeveloped.

    “Those trials … are nowhere near as robust as the data we have on [Novo Nordisk trial] FLOW, on sleep apnea, cardiovascular risks, on diabetes control — double-blind placebo, randomized controlled trials that are incredible,” she told CNBC’s “Fast Money” on Wednesday. “We have a long way to go for that. I’ve seen a lot of miracle drugs before.”

    Novo Nordisk halted FLOW on Tuesday. According to the company’s press release, it happened more than a year after an interim analysis showed that Ozempic could treat chronic kidney disease in Type 2 diabetic patients.

    As of Friday’s close, Novo Nordisk is up 9.82% since its announcement. Its obesity drug maker competitor Eli Lilly is up 5.16% in the same period.

    Patel believes efficacy is just one of the major hurdles the medication needs to clear before it can be approved for uses outside of diabetes management.

    “We know this drug works really well in diabetics. But there are so many barriers to getting there —including cost, adherence, prescriber rate,” said Patel, who also served as a White House Health Policy Director under President Obama.

    Patients opting to use GLP-1 drugs — a group of medications initially designed to control diabetes — for weight management often must pay out-of-pocket.

    “Right now, we are seeing active employers, entire states that are declining to cover on the weight loss indication,” Patel said.

    What other industries could weight loss drugs disrupt?

    If the U.S. Food and Drug Administration approves Ozempic for use in Type 2 diabetics with chronic kidney disease, which Patel believes will happen, it could force the hand of insurance companies to expand their coverage of the drug.

    “We’ll see a final package of data that will just be so compelling, that it would be wrong not to cover this, because it should be superior to what we have available to us,” she noted. “That is something that I think the insurance companies will have a difficult time [with].”

    Mizuho Health Care Sector Strategist Jared Holz also expects challenges related to insurance coverage as more patients begin taking GLP-1 drugs, which could limit overall adoption.

    “The payers, at some point, are going to be saying, ‘We get it, but we cannot pay for these at this volume without seeing the benefit, which may be 10 years from now, 20 years from now, 30.’ We have no idea when the offset is going to be,” he also told CNBC’s “Fast Money.”

    Holz also pointed out the divide emerging in the health care sector between Novo Nordisk, Eli Lilly and their pharmaceutical peers.

    “We haven’t seen this kind of valuation disconnect between the peer group, maybe in the history of the sector,” he said.

    The growth trend may not be sustainable for Novo Nordisk and Eli Lilly, based on current supply constraints that have left patients unable to secure dosages.

    “The companies can’t make enough, I don’t think, to actually put out revenue that’s going to appease investors, given where the stocks are trading,” said Holz.

    A Novo Nordisk spokesperson did not offer a comment due to the company’s quiet period ahead of earnings. Eli Lilly did not immediately respond to a request for comment.

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  • National Survey Reveals Americans Saving $5,000 a Year by Ordering Prescriptions From Canada

    National Survey Reveals Americans Saving $5,000 a Year by Ordering Prescriptions From Canada

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    93% Say Prescription Drug Costs Are Important to How They’ll Vote in the Next Election, Compared to 84% a Year Ago


    WASHINGTON, October 12, 2023 (Newswire.com)
    –
    Americans choosing to import their prescription medications from licensed Canadian pharmacies report saving $4,920 a year and four times the savings compared to U.S. pharmacies, GoodRx and Amazon Pharmacy, according to survey results and price comparison analysis released today by the Campaign for Personal Prescription Importation (CPPI).

    This national CPPI survey demonstrates a remarkable trend of increasing savings for patients importing medications from Canada over the last five years. It also highlights the importance of personal prescription importation as a means of accessing affordable medication for Americans.

    Key Survey Findings

    • Average annual savings of $4,920 in 2023, as reported by Americans importing prescription medications from Canada, compared to U.S. costs, reveals a major 5-year trend:
      • In 2022, the average annual savings amounted to $3,744
      • In 2021, savings averaged $2,736
      • In 2020, savings averaged $2,940
      • In 2019, savings averaged $2,352
    • Americans importing their prescription medications from Canada reported saving an average of $410 per month, compared to U.S. costs.
    • 99% of respondents would recommend importation to their friends and family members.
    • 93% of respondents say that addressing the high cost of prescription drugs in the U.S. is important to how they will vote in the next election, compared to 84% just one year ago. 

    CPPI 2023 Survey Data Cross Tabs

    “Savings of nearly $5,000 a year on medications from Canada versus prices four times higher at U.S. pharmacies is often a matter of life and death for patients across America,” says Jack Pfeiffer, CPPI Executive Director. “While state and federal efforts aim to lower prescription drug costs, the truth is we hear from Americans every day who still can’t afford U.S. drug prices. Americans’ only immediate, safe solution to access critically necessary, affordable daily prescriptions is to order from licensed Canadian pharmacies.”

    Federal negotiation of drug prices for Medicare does not provide immediate relief from the astronomical prices that Americans pay for their life-saving medicines. The drugs subject to price negotiation will not be made available at lower cost until 2026 and it is unclear if consumers will see those lower prices. It is unlikely that any of the potential savings from this program will affect the hundreds of millions of Americans who are not eligible for Medicare. Only 10 drugs will be subject to the initial price negotiation. What’s more, the price negotiation is subject to multiple lawsuits and legislative challenges that could prevent lower prices from ever becoming a reality.  

    States have joined the battle to allow for the importation of affordable medicines from Canada. While 10 states have wholesale importation laws on the books, none are operational as none of the state programs have been approved by the Food and Drug Administration. The state plans face U.S. and Canadian regulatory restrictions, as well as legal challenges and opposition to wholesale importation. 

    Meanwhile, millions of Americans import prescription medications from abroad. 89% are over the age of 65 according to the CPPI survey. 91% cite the high cost of prescription drugs in the U.S. as the primary reason for ordering from licensed Canadian pharmacies. They rely on international pharmacies for critical daily prescription medications such as ELIQUIS and XARELTO to treat and prevent blood clots and strokes. 

    Daniel Wendell from California says, “I have had asthma since I was a child and have been on various drugs for its treatment my entire life. Generic versions of my inhaler did not work as well for me. Brand name inhaler prices in the U.S., even from a discount pharmacy, are outrageous — $400/month. I can get the same medicine from Canada for $100/month from a certified Canadian pharmacy.”

    Four Times The Savings

    CPPI price comparisons regularly demonstrate savings of 50% to 90% on commonly prescribed brand-name prescription medications from Canada compared to leading U.S. pharmacies, GoodRx and Amazon Pharmacy. Analysis of these price comparisons shows four times the savings on medications from Canada.  

    How to Find a Safe Pharmacy

    Americans need greater access to safe, reliable, and affordable medications. The importance increases for people with multiple underlying conditions, as 66% of survey respondents who report taking four or more medications can attest.

    • 80% of surveyed Americans who import their prescriptions report being referred by a trusted medical professional, friend, or family member.
    • 80% of survey respondents know how to identify “rogue” pharmacies and are savvy in their search to find an online pharmacy they can trust.
    • 99% of respondents would recommend importation to their friends and family members.

    CPPI recommends searching only certified websites for prescription drugs from licensed Canadian pharmacies. Click here for more information on how to find trusted Canadian pharmacies.

    Survey Methodology

    CPPI conducted this online survey between Nov. 15, 2022, and June 31, 2023. Based on the universe of followers of CPPI, this sample of 1,162 responses represents statistically significant findings with a standard sampling error of plus or minus 5%. All registered trademarks referred to herein belong to their respective owners.

    Source: Campaign for Personal Prescription Importation

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  • California Gov. Gavin Newsom vetoes bill that would have decriminalized psychedelic mushrooms

    California Gov. Gavin Newsom vetoes bill that would have decriminalized psychedelic mushrooms

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    SACRAMENTO, Calif. — California Gov. Gavin Newsom has vetoed a bill aimed at decriminalizing the possession and personal use of several hallucinogens, including psychedelic mushrooms.

    The legislation vetoed Saturday would have allowed those 21 and older to possess psilocybin, the hallucinogenic component in what’s known as psychedelic mushrooms. It also would have covered dimethyltryptamine (DMT) and mescaline.

    The bill would not have legalized the sale of the substances and would have barred any possession of the substances on school grounds. Instead, it would have ensured people are neither arrested nor prosecuted for possessing limited amounts of plant-based hallucinogens.

    Newsom, a Democrat who championed legalizing cannabis in 2016, said in a statement Saturday that more needs to be done before California decriminalizes the hallucinogens.

    “California should immediately begin work to set up regulated treatment guidelines – replete with dosing information, therapeutic guidelines, rules to prevent against exploitation during guided treatments, and medical clearance of no underlying psychoses,” Newsom’s statement said. “Unfortunately, this bill would decriminalize possession prior to these guidelines going into place, and I cannot sign it.”

    The legislation, which would have taken effect in 2025, would have required the California Health and Human Services Agency to study and to make recommendations to lawmakers on the therapeutic use of psychedelic substances.

    Even if California made the bill a law, the drugs would still be illegal under federal law.

    In recent years, psychedelics have emerged as an alternative approach to treating a variety of mental illnesses, including post-traumatic stress disorder. The Federal Drug Administration designated psilocybin as a “breakthrough therapy” for treatment-resistant depression in 2019 and recently published a draft guideline on using psychedelics in clinical trials.

    Public opinion on psychedelics, which have been mostly associated with 1960s drug culture, has also shifted to support therapeutic use.

    Supporters of the legislation include veterans, who have talked about the benefits of using psychedelics to treat trauma and other illnesses.

    “Psilocybin gave me my life back,” Joe McKay, a retired New York City firefighter who responded to the 9/11 attacks, said at an Assembly hearing in July. “No one should go to jail for using this medicine to try to heal.”

    But opponents said the drugs’ benefits are still largely unknown, and the bill could lead to more crimes — though studies in recent years have shown decriminalization does not increase crime rates. Organizations representing parents also worry the legislation would make it easier for children and young people to access the drugs.

    State Sen. Scott Wiener, who authored the bill, called the veto a missed opportunity for California to follow the science and lead the nation.

    “This is a setback for the huge number of Californians — including combat veterans and first responders — who are safely using and benefiting from these non-addictive substances and who will now continue to be classified as criminals under California law,” Wiener said in a statement Saturday. “The evidence is beyond dispute that criminalizing access to these substances only serves to make people less safe and reduce access to help.”

    He said he would introduce new legislation in the future. Wiener unsuccessfully attempted to pass a broader piece of legislation last year that would have also decriminalized the use and possession of LSD and MDMA, commonly known as ecstasy.

    Lawmakers can override a governor’s veto with a two-thirds vote, but they have not tried in decades.

    In 2020, Oregon voters approved decriminalizing small amounts of psychedelics, and separately were the first to approve the supervised use of psilocybin in a therapeutic setting. Two years later, Colorado voters also passed a ballot measure to decriminalize psychedelic mushrooms and to create state-regulated centers where participants can experience the drug under supervision.

    In California, cities including Oakland, San Francisco, Santa Cruz and Berkeley have decriminalized natural psychedelics that come from plants and fungi.

    Despite Newsom’s veto, California voters might have a chance to weigh in on the issue next year. Advocates are attempting to place two initiatives to expand psychedelic use on the November 2024 ballot. One would legalize the use and sale of mushrooms for people 21 and older, and the other would ask voters to approve borrowing $5 billion to establish a state agency tasked with researching psychedelic therapies.

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  • Pharmacist shortages and heavy workloads challenge drugstores heading into their busy season

    Pharmacist shortages and heavy workloads challenge drugstores heading into their busy season

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    A dose of patience may come in handy at the pharmacy counter this fall.

    Drug and staffing shortages haven’t gone away. Stores are starting their busiest time of year as customers look for help with colds and the flu. And this fall, pharmacists are dealing with a new vaccine and the start of insurance coverage for COVID-19 shots.

    Some drugstores have addressed their challenges by adding employees at busy hours. But experts say many pharmacies, particularly the big chains, still don’t have enough workers behind the counter.

    Chris Adkins said he left his job as a pharmacist with a major drugstore chain a couple years ago because of the stress. Aside from filling and checking prescriptions, Adkins routinely answered the phone, ran the register and stocked pharmacy shelves.

    “I just didn’t have time for the patients,” he said. “I am OK working hard and working long hours, but I just felt like I was not doing a good job as a pharmacist.”

    In recent years, drugstores have struggled to fill open pharmacist and pharmacy technician positions, even as many have raised pay and dangled signing bonuses.

    Larger drugstore chains often operate stores with only one pharmacist on duty per shift, said Richard Dang, an assistant professor of clinical pharmacy at the University of Southern California. That kind of thin staffing can make it hard to recruit employees.

    “I think that many pharmacists in the profession are hesitant to work for a company where they don’t feel supported,” said Dang, a former president of the California Pharmacists Association.

    Customers have noticed.

    John Staed, of Pelham, Alabama, said a CVS pharmacist gave him the wrong prescription about a decade ago: the pills were a different color than usual. He worries the chances for another mistake could increase as pharmacists take on more work.

    “These pharmacists always look stressed,” he said.

    A CVS spokeswoman said the company is focused on addressing concerns raised by its pharmacists and has taken several actions, including “providing additional pharmacy resources” in markets that need support. She declined to say how many pharmacists or technicians the company has hired.

    Former Walgreens CEO Rosalind Brewer said in late June that the company had added more than 1,000 pharmacists in the second quarter, but was running into a shortage of job candidates. Walgreens is adding processing centers around the country to ease some of the prescription workload for its stores.

    Brewer, who left in late August, also said the company was limiting hours at 1,100 pharmacies, or about 12% of its U.S. locations. That was down from 1,600 earlier this year, but a company executive has said it doesn’t expect to return all pharmacies to normal operating hours by year’s end.

    Labor strife and staffing shortages in health care are not isolated to drugstores, as the recent Kaiser Permanente strike shows.

    But drugstores have some additional challenges in the fall. Many customers come to them for vaccines for COVID-19, flu and pneumonia. Plus, federal officials have approved a new shot for people ages 60 and older for a virus called RSV.

    All told, CVS touts in a pharmacy counter brochure that the company can offer more than 15 vaccines to customers.

    Ongoing drug shortages also have kept pharmacy workers on the phone more.

    Jonathan Marquess said one of his drugstores fielded 100 questions one day last fall about the antibiotic amoxicillin and the attention deficit-hyperactivity disorder treatment Adderall, two drugs in short supply.

    Marquess runs several independent pharmacies in Georgia and serves on the National Community Pharmacists Association board. He has done a few things to help his stores adapt to the extra workload, he said, including training all employees to answer basic questions about vaccines.

    Marquess also adds extra staff when he knows they will have an influx of customers, like when a nearby company sends its employees over for vaccines.

    “We learned from our experiences,” he said. “Training your entire staff is very, very important.”

    Pharmacists say customers aren’t powerless and can help things run smoothly.

    People should bring all their insurance cards to vaccine appointments, especially since insurance coverage is new for the COVID-19 shots, Marquess said.

    Dang said customers should avoid showing up right after pharmacies reopen from a lunch break or just before they close, times when pharmacists and technicians are especially busy.

    Making appointments for vaccines gives pharmacy workers a better sense for their workload. Calling several days in advance for a prescription refill also helps, said Jen Cocohoba, a pharmacy professor at University of California San Francisco.

    “That tiny piece of control can help, because there’s so many things you cannot predict when you’re inside the community pharmacy,” Cocohoba said.

    ___

    AP Business Writer Josh Funk contributed to this report.

    ___

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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  • Arkansas jail inmates settle lawsuit with doctor who prescribed them ivermectin for COVID-19

    Arkansas jail inmates settle lawsuit with doctor who prescribed them ivermectin for COVID-19

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    LITTLE ROCK, Ark. — Five former inmates at an Arkansas county jail have settled their lawsuit against a doctor who they said gave them the antiparasitic drug ivermectin to fight COVID-19 without their consent.

    A federal judge last week dismissed the 2022 lawsuit against Dr. Robert Karas, who was the doctor for the Washington County jail and had administered the drug to treat COVID, citing the settlement.

    The U.S. Food and Drug Administration has approved ivermectin for use by people and animals for some parasitic worms, head lice and skin conditions. The FDA has not approved its use in treating or preventing COVID-19 in humans. According to the FDA, side effects for the drug include skin rash, nausea and vomiting.

    The inmates said they were never told ivermectin was among the medications they had been given to treat their COVID-19 infections, and instead were told they were being given vitamins, antibiotics or steroids. The inmates said in their lawsuit that they suffered side effects from taking the drug including vision issues, diarrhea and stomach cramps, according to the lawsuit.

    “These men are incredibly courageous and resilient to stand up to the abusive, inhumane experimentation they endured at the Washington County Detention Center,” said Holly Dickson, executive director of the American Civil Liberties Union of Arkansas, which represented the inmates. “The experimental use of Ivermectin without the knowledge and consent of these patients was a grave violation of medical ethics and the rights of the patients and these brave clients prevented further violation of not only their own rights, but those of others detained in WCDC.”

    Under the settlement, each of the former inmates will receive $2,000. Two of the inmates are no longer in custody and the other three are now in state custody, Dickson said. The jail has also improved its notice and consent procedures and forms since the lawsuit was filed, the ACLU said.

    Michael Mosley, an attorney for the defendants in the case, said they didn’t admit any wrongdoing by settling the case.

    “From our perspective, we simply settled because the settlement (as you can see) is very minimal and less than the projected cost of continued litigation,” Mosley said in an email to The Associated Press. “Additionally, the allegations by some that Dr. Karas conducted any experiment regarding ivermectin were and are false and were disproven in this case.”

    The state Medical Board last year voted to take no action against Karas after it received complaints about his use of ivermectin to treat COVID among inmates. Karas has said he began giving ivermectin at the jail in November 2020. He told a state Medical Board investigator that 254 inmates at the jail had been treated with ivermectin.

    Karas has defended the use of ivermectin to treat COVID-19, and said no inmates were forced to take it.

    U.S. District Judge Timothy L. Brooks in March denied the motion to dismiss the inmates’ lawsuit, ruling that they had a “plausible” claim that their constitutional rights had been violated.

    The American Medical Association, the American Pharmacists Association and the American Society of Health-System Pharmacists in 2021 called to an immediate end to prescribing and using the drug to treat COVID-19.

    Pharmacy prescriptions for ivermectin boomed during the pandemic, and health officials in Arkansas and other states issued warnings after seeing a spike in poison control center calls about people taking the animal form of the drug to treat COVID-19. The CDC also sent an alert to doctors about the trend.

    Despite the warnings, the drug had been touted by Republican lawmakers in Arkansas and other states as a potential treatment for COVID-19.

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