California Legislature To Consider Antibiotic Ban in Animals

Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).

Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).

by Joe Rubin

A new bill in the California Legislature could give California the distinction of going where the federal government hasn’t — more strictly regulating the way that livestock are given antibiotics.

But the Freshman Assemblyman Kevin Mullin who is introducing the bill, AB1437, says getting it through the agricultural committee is a bit of long shot.

More than seventy percent of all antibiotics in the U.S are given to animals, often to healthy livestock. Until very recently drug companies marketed the growth-promoting benefits of antibiotics. And many meat producers, keen for additional profits and assured by pharmaceutical companies that the practice was safe for people and animals, would routinely add antibiotics to feed.

In December, the Food and Drug Administration, after years of debate on the issue, asked drug companies to voluntarily stop marketing the growth promoting benefits of antibiotics out of concerns for public health. The companies are largely complying. But critics like the National Resources Defense Council and New York Times food writer Mark Bittman have criticized the FDA’s approach as lax and unlikely to lead to any real change.

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Walgreens Store Redesign Raises Privacy Concerns

(Lisa Aliferis/KQED)

(Lisa Aliferis/KQED)

By Chris Richard

Privacy activists are voicing concern that Walgreens pharmacies may endanger the confidentiality of customer records with a new business model that places pharmacists at a desk on the store floor.

The “Well Experience” model makes it much easier for customers to view pharmacists’ computer screens and documents on their desks, according to a report prepared by the research arm of Change to Win, a labor-backed organization whose constituents include pharmacists and pharmacy technician unions.

“We have heard from pharmacists, not necessarily in our membership, who work in this model, who are very concerned about its implications for the practice of pharmacy,” said Nell Geiser, associate director of Change to Win Retail Initiatives.

“Think about it for a moment. If you were to go to a doctor, would you want to be out in the lobby talking to your doctor?” — Beth Givens, director of the San Diego-based Privacy Rights Clearinghouse

“Pharmacists want to do their job well and serve the public, and they also want to protect their license, which is on the line if any error takes place in their pharmacy.”

Change to Win is concerned about the possibility of increased thefts — especially of narcotics –   as well as the risk of errors in formulating prescriptions under the new Walgreens model. The model removes pharmacists from their usual in-person supervisory role, Geiser said. Continue reading

Powerful Narcotic Painkiller Up For FDA Approval

(Getty Images)

(Getty Images)

by Rob Stein, NPR

The Food and Drug Administration is trying to decide whether to approve a powerful new prescription painkiller that’s designed to relieve severe pain quickly, and with fewer side effects than other opioids.

While some pain experts say the medicine could provide a valuable alternative for some patients in intense pain, the drug (called Moxduo) is also prompting concern that it could exacerbate the epidemic of abuse of prescription painkillers and overdoses.

An FDA advisory committee is holding a daylong hearing Tuesday to decide whether to recommend that the agency approve the drug.

“This is a product that is very easy to misuse, very easy to crush and snort or crush and inject,” says addiction specialist Andrew Kolodny.

Moxduo for the first time combines morphine and oxycodone in one capsule. It’s designed to provide quick relief to patients suffering severe pain from accidents or surgeries, such as knee replacements, back surgeries or cancer operations, says Ed Rudnic, COO of QRxPharma, the company that makes Moxduo.

The drug allows patients to take lower doses of the two narcotics than they’d need if they took either of the medicines alone, Rudnic says.

“We believe that we’ve achieved some benefit in reducing the risk of some of the respiratory complications of these strong opioids,” he says.

Suppressed breathing and other respiratory complications are the most serious risks of these drugs — the main reason people die from taking too much.

Some pain experts think the idea behind Moxduo is a good one. A lot of patients can’t take enough morphine or oxycodone to ease their discomfort because of the risk to breathing and other side effects, such as nausea, vomiting, dizziness and severe itchiness.

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Obamacare Opens Door for Some to Leave Jobs

Because Mike Smith of Long Beach was able to get insurance through the Affordable Care Act, he could retire from his job. (Stephanie O'Neill/KPCC)

Because Mike Smith of Long Beach was able to get insurance through the Affordable Care Act, he could retire from his job. (Stephanie O’Neill/KPCC)

By Stephanie O’Neill, KPCC

It’s just after noon on a recent weekday and Mike Smith, 64, of Long Beach is standing over his stove, gently mixing together a sizzling dish of bright green brussels sprouts with caramelized shallots.” Even people who don’t like brussels sprouts love this dish,” he says of the recipe he culled from the pages of Bon Appétit Magazine many years ago.

They were afraid if they tried to buy insurance on their own, an insurance company would reject them. And now that can’t happen.”
We’ve got organic shallots, organic brussels sprouts and organic apple cider vinegar,” Smith says as he stirs the ingredients. “I love the smell of the shallots, don’t you?”

Until recently, Smith had little time to to experiment in the kitchen, to practice guitar or to visit his elderly in-laws or his two-year-old grandchild.

Instead, he worked 11 hours a day, Monday through Friday and then half a day on Saturday, as a district manager for a national auto parts chain. Early retirement, while certainly appealing, wasn’t a viable option, as both he and his wife relied heavily on his job-provided health insurance. Continue reading

In Los Angeles, How Pharmacists Are Improving Patients’ Health

Dr. Sarah Ma goes over medications and dosages with diabetes patient Joe Navarro. (Credit: Anacleto Rapping)

Sarah Ma, a pharmacist with USC, goes over medications with diabetes patient Joe Navarro. (Credit: Anacleto Rapping)

By Laurie Udesky, CHCF Center for Health Reporting

Jose Navarro regularly trekked to the drugstore after being diagnosed as a diabetic seven years ago. In a sign of transformation in the local fight against diabetes, the pharmacist is now coming to him.

On a recent day Sarah Ma, a 28-year-old USC clinical pharmacist, set up shop at Navarro’s kitchen table in Santa Ana.

She checked Navarro’s blood pressure and blood sugar, examined his feet for cuts or infection, and refilled his monthly pill box. On previous visits she had changed the hour he took some medications, altered some doses, and discontinued others.

She inspected the refrigerator. “I see carrots, eggs, beets, cheese and yogurt that I haven’t seen before,” she said, delighted.

It wasn’t all great news. Navarro, 78, had told Ma that the pastry he had at breakfast was tiny. Actually, it engulfed half the plate Ma brought with her to illustrate what portions to eat of different food groups. Continue reading

Caffeine: How Our Favorite Drug Affects Us

(Getty Images)

(Getty Images)

As I’m writing this, I’m hitting my mid-afternoon slump. And it’s Friday, no less. The time seems perfect for a cup of coffee. And now, because caffeine was the topic on KQED’s Forum this morning, I know how and why caffeine is an apparent energy booster.

And who knew it was also a natural pesticide?

“Its primary role is a simple one,” said Forum guest Murray Carpenter. He’s the author of Caffeinated and is full of facts about the “bitter white powder.” Let’s start with the biochemistry: caffeine blocks a neurotransmitter called adenosine. This is the signal that tells you that you are drowsy. When you consume caffeine, it blocks adenosine from sending the “fatigue” message. “Fully 50 percent of the receptors are blocked” after we consume caffeine, Carpenter explained, “and it’s that simple trick that allows caffeine to do its work.”

But caffeine has another role that I had never heard of: it’s a natural pesticide. If insects consume a caffeinated plant, they become paralyzed and die. Odd that it works so differently on humans.

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Male in Life, Female in Death: The Story of Christopher Lee’s Death Certificate

Christopher Lee lived his life as a man, but after he died by suicide, the death certificate listed his gender as female.

Christopher Lee lived his life as a man, but after he died by suicide, the death certificate listed his gender as female.

By Matt Levin

Death certificates are typically pretty boring documents. A box for name, a box for date, a box for place and time, for cause of death. A bureaucratic afterthought to help family and friends settle the affairs of a deceased loved one.

“I looked at it, and it said ‘female’ on it. And I asked her, ‘Why does it say female? He was male.’”
A death certificate was not on the forefront of Chino Scott-Chung’s mind as he waited for the ashes of his best friend, Christopher Lee. Lee, 48, had committed suicide in December 2012, and Scott-Chung was still reeling from the death of the friend who had served as best man in his wedding.

After receiving the ashes, Scott-Chung prepared to leave when the employee from the Oakland cremation services company handed him Lee’s death certificate.

Scott-Chung immediately noticed something was wrong. Something that Christopher would never have consented to if he were still alive. Continue reading

Obamacare: More Than 3.3 Million Californians Signed Up

Covered California executive director Peter Lee speaking to advocates and reporters in San Francisco on Oct. 1, 2013. (Angela Hart/KQED)

Covered California executive director Peter Lee speaking to advocates and reporters in San Francisco on Oct. 1, 2013, the day the marketplace opened. Open enrollment ended Tuesday. (Angela Hart/KQED)

The final numbers are in from the first open enrollment for Covered California. The exchange closed at midnight Tuesday, an extension of two weeks from the original March 31 deadline for those who had tried to enroll but were unsuccessful for technical reasons. Officials reported Thursday that just shy of 1.4 million Californians signed up since October 1.

“The people enrolling continue to get younger, continue to get more diverse and reflect the state of California.” 
An additional 1.9 million people are newly enrolled in Medi-Cal, the state’s health insurance program for people who are low income, and several hundred thousand more people have been deemed “likely eligible” by the state. They are awaiting final determination of eligibility.

At a press conference in Sacramento Thursday morning, Peter Lee walked through some of the demographics. Covered California had drawn criticism for its flawed outreach to Latinos earlier this year, but the agency had made a “concerted effort to expand and build on outreach,” Lee said. “That hard work has paid off.”

From April 1-15, 39 percent of the sign ups were Latino, Hispanic or Latin origin. Just over 305,000 Latinos are now enrolled, just a bit under 28 percent of all enrollees. That’s up from 21 percent at the end of January. Continue reading

Obamacare Means New Challenges for California’s Safety Net Providers

Natividad Medical Center is a public hospital in Salinas. It's part of the system of safety net institutions that serve Californians with nowhere else to go. Even as health reform is implemented, millions of Californians will remain uninsured. (Lisa Morehouse/KQED)

Natividad Medical Center is a public hospital in Salinas. It’s part of the system of safety net institutions that serve Californians with nowhere else to go. Even as health reform is implemented, millions of Californians will remain uninsured. (Lisa Morehouse/KQED)

By Lisa Morehouse

California leads the nation in the number of people getting insurance through the Affordable Care Act. But now that the final deadline has come and gone on Tuesday, millions are still left uninsured. These people will still turn to community clinics and public hospitals for care — they are the safety net institutions that serve Californians with nowhere else to go. But as the ACA is implemented, those institutions are facing changes.

One such place is Centro Medico. It’s tucked away in a corner of a shopping center in Cathedral City, a predominantly Latino bedroom community sandwiched between the resort towns of Palm Springs and Rancho Mirage. Here is where many hospitality workers who serve the neighboring resorts live.

Centro Medico’s manager, Daisy Morfin, sees a lot of pent-up need for medical care. Since enrollment in the Affordable Care Act started last fall, she says the clinic is getting up to 10 new patients a day.

Many are people who have qualified for health insurance for the first time in years — or ever. Continue reading

Prisons Are Main Source of California’s Psychiatric Housing

(Photo/Gregory D. Cook)

(Photo/Gregory D. Cook)

By Hannah Guzik, HealthyCal

California’s jails and prisons hold far more people with severe psychiatric illnesses than state hospitals, according to a recent report from the Treatment Advocacy Center and the National Sheriffs’ Association.

“For a state with 38 million people — 1 in every 8 Americans lives in California — there are almost no public psychiatric beds available for individuals with serious mental illness,” the report says.

Four state hospitals — Metropolitan, Patton, Napa, and Atascadero — have just over 4,500 beds, but 88 percent of them are reserved for mentally ill individuals who have been charged with crimes, according to the report. Another state hospital at Coalinga is used almost exclusively for sexually violent predators. Continue reading