Day: 08/24/2015

Inside the mysterious world of Propofol, the drug that killed Michael Jackson

http://www.nzherald.co.nz/lifestyle/news/article.cfm?c_id=6&objectid=11486432

He said, “It’s finished. We’ve done it. You’re awake now.” Five minutes had passed in oblivion. Where had I gone, and how did propofol get me there? What does it do in the brain?

“Nobody knows,” says Auckland anaesthesiologist Dr Michael Kluger. “There’s lots of theories why anaesthetics work, but we don’t know. Which is kind of weird, because it’s what we do as a profession, and yet nobody can tell for sure.” …

Propofol is really only accessible to anaesthesiologists and surgical staff. That’s just the problem.

“When an anaesthetist decides to commit suicide, they do it very well,” says Dr Rob Fry. They choose propofol. They have the access, and they know exactly how it works. Fry is a member of the Welfare of Anaesthetists Special Interest Group, and has conducted surveys of substance abuse among anaesthetists in New Zealand and Australia. The most recent findings were published this year. Propofol was identified as the most commonly abused substance – higher than opiates or alcohol. The most chilling statistic records, “Death was the eventual outcome in eight cases of substance abuse (18 per cent), with three identified as suicide and five as overdose. All eight deaths involved propofol.” …

Studies in the US show a high percentage of users have suffered childhood trauma. They’re often unable to sleep, and they want to block out the world. A doctor at an addiction treatment centre in Virginia told an anaesthesiology journal, “I don’t know of any other drug where the perceived incidence of trauma, particularly of sexual trauma [in abusers], is so high. It’s really quite remarkable.” They want to forget. They want the milk of amnesia…

http://www.consumerreports.org/cro/news/2014/11/colonoscopy-anesthesia-overkill-deep-sedation-for-the-procedure-may-be-overkill/index.htm

But the rising tide of propofol use could be about to ebb. Beginning Jan. 1, 2015, Medicare is changing how it pays anesthesia professionals for colonoscopy care…

http://www.liverpoolecho.co.uk/news/liverpool-news/three-patients-died-walton-centre-9591775

http://fox6now.com/2015/04/21/a-wrongful-death-family-that-lost-loved-one-to-introduce-bill-to-add-cameras-to-operating-rooms/

An investigation revealed Rubenzer had been given a deadly dose of propofol…

Together, Rep. Sinicki and the Ayer family are introducing legislation called the “Julie Ayer Rubenzer Bill.” It would allow patients to request a camera in the operating room. That camera would record the entire surgical setting as surgery is performed…

http://www.cbc.ca/news/canada/british-columbia/dr-bob-rishiraj-accused-over-propofol-use-in-case-of-brain-damaged-teen-1.2834105

A College of Dental Surgeons in British Columbia hearing is underway into allegations of unprofessional conduct involving a Kamloops dentist, after a teenage patient suffered irreversible brain damage. The college is investigating allegations Dr.Bob Rishiraj used propofol for deep sedation without proper training…

http://www.jsonline.com/news/milwaukee/doctors-death-adds-to-cluster-of-fatal-fentanyl-cases-b99464264z1-296679701.html

The latest fentanyl death is Nathan Orlofsky, a 28-year-old doctor and anesthesiology resident at the Medical College of Wisconsin, who was found dead Feb. 11 in the bathroom of the apartment he and wife shared in Milwaukee’s Third Ward.

Orlofsky’s death has been ruled an accident by the medical examiner. Investigators found hospital-grade items near Orlofsky’s body, including needles, tourniquets and two empty vials of hydromorphine.

However, the medical examiner’s test results released this week didn’t show morphine in Orlofsky. Rather, they show he died of a mix of fentanyl and another drug, midazolam, which is used to make patients sleepy before surgery…

Orlofsky’s death reveals how illicit use of the drug cuts across social and economic classes and also highlights the problem of drug abuse among anesthesiologists…

Two studies, one in 1993 and another 15 years later, found a high rate of drug use by anesthesiology residents compared with other specialties. Over 10 years, 80% of U.S. anesthesiology residency programs reported encountering impaired residents and 19% reported at least one pretreatment death.

“The drug of choice for anesthesiologists entering treatment was an opioid, with fentanyl and sufentanil topping the list,” the 2008 study said…

http://www.motherjones.com/politics/2015/06/i-just-took-midazolam-supreme-court-oklahoma-death-penalty

Bye-bye 420 highway sign

http://www.mercurynews.com/bay-area-living/ci_28680887/idaho-sticks-it-420-aka-pot

For reasons that continue to remain murky, pot smokers have long co-opted the number 420 as code for, well, pot. These days there are 420 festivals, usually on April 20, and a lot of weed gets puffed at 4:20 p.m. (and maybe a.m., too) on that day. Enthusiasts love the numeric sequence so much that they often pilfer highway signs marking the 420th mile along various roads across the country, then do who knows what with them.

No more in Idaho, though. Transportation officials decided to give an inch and take a mile marker, replacing the 420 sign on Highway 95 with “419.9.”

Your Body Within an Hour of Drinking a Cup of Coffee

https://www.yahoo.com/health/maybe-youre-a-coffee-shop-junkie-or-a-cold-brew-127256169067.html

Maybe you’re a coffee-shop junkie or a cold-brew devotee. Or maybe you prefer to keep it old school with a trusty drip coffeemaker. However you consume it, if you’re among the 59 percent of Americans who drink coffee, that java buzz after downing a cup is probably familiar to you.

But chances are, you aren’t aware of the extent to which this beverage can affect nearly your entire body (from your eyes to your blood) within minutes post-sip. We took a look at how a cup of coffee affects the system right after you drink it — and some of what we found is pretty astounding…

Caffeine is a psychoactive compound that modulates these neurotransmitters, allowing them to operate more efficiently. “As a result, the brain is able to better process chemical messengers,” Leavey explains to Yahoo Health. “When used in moderation, coffee gives you an edge.” You’ll begin to feel more mentally alert after about 30 minutes, and the effects wear off a few hours later…

https://www.yahoo.com/health/when-its-happy-hour-on-a-hot-summer-day-there-126690007587.html

What Happens to Your Body Within an Hour of Drinking a Beer

While any health expert will tell you that binge-drinking alcohol is bad for your heart, the study showed that among men with coronary artery disease, drinking a single 12-ounce beer per day for a month may help reduce the risk of a heart attack. The reason: Beer is full of antioxidants (who knew?) and has anti-inflammatory properties.

Animal research also suggests that an ingredient in the sudsy stuff may boost brainpower. A study published in the journal Behavioral Brain Research found that a type of flavonoid in beer called xanthohumol could improve cognitive function…

Chris Christie Ties Heroin Epidemic To Obama

http://www.huffingtonpost.com/entry/chris-christie-obama-heroin_55db0c23e4b0a40aa3ab4fef?kvcommref=mostpopular

In a newly released campaign ad, Christie rattles off a list of criminal elements that have had free reign during the Obama administration. Near the top of the list, Christie references the spike in opioid drug use…

The heroin epidemic actually began nearly two decades before Obama took office. It started with the spread of OxyContin and Percocet addictions. “Pill mills” helped spur these painkiller addictions in Florida, Kentucky and West Virginia. But during the Obama administration, a crackdown on the mills helped spur a resurgence in heroin use.

In a Huffington Post investigation published in January, federal and state officials admitted that they knew such a crackdown would lead to a heroin problem.

“We always were concerned about heroin,” said Kevin Sabet, a former senior drug policy official for Obama who also worked under the Bush administration. “We were always cognizant of the push-down, pop-up problem. But we weren’t about to let these pill mills flourish in the name of worrying about something that hadn’t happened yet…

Christie elaborated on the ad Monday on MSNBC’s “Morning Joe.”

“This president has set a standard in Washington of lawlessness,” he said. “What I mean by that is this: If you don’t like the law, don’t enforce it…  If you don’t like the marijuana laws, don’t enforce the marijuana laws in certain states if they don’t feel like enforcing them.”

So, Mr. Christie, you don’t believe in state’s rights? Not very Republican of you.

Marijuana pushes the limits in the inexact science of DUID

http://weedrush.news21.com/marijuana-pushes-the-limits-in-the-inexact-science-of-duid/

A study published in 2015 by Forensic Science International found that THC stays in the blood of chronic users longer than previously thought. Researchers monitored 21 participants who admitted to consuming marijuana heavily over the previous three months. Each participant abstained from the drug over the course of the study. After 24 hours, nine of the participants still had active delta-9-THC levels above 5 nanograms per milliliter of blood, meaning they would have been over the legal limit in states with per se limits of 5 nanograms or less, as well as any state with a zero-tolerance policy. Two participants still tested at 5 nanograms more than five days into the study…

In February 2015, the NHTSA released a study that explored crash risk associated with drugs and alcohol. In the executive summary, the NHTSA touted the study as the “largest and most carefully controlled of its kind.” The report ultimately concluded that when alcohol consumption and demographics were controlled, there was no “increase in population-based crash risk associated with THC use.” …

Washington also has 208 police officers across state, city and county agencies that are certified drug recognition experts. Each of them are given three weeks of classroom and field training, during which time they observe participants under the influence of various drugs and learn the typical signs and behaviors associated with each substance, according to Sharpe. For marijuana, officers look for a green tongue, muscle spasms, eyelid flutters, an inability to cross the eyes, and, of course, the distinctive odor…

“Impaired driving is the single largest cause of fatal collisions in Washington,” she added. “It is our number one priority.”

http://www.marianomoraleslaw.com/blog/top-factors-washington-state-car-accidents/

Top Five Contributing Factors in Fatal Collisions

Under influence of alcohol – 133
Crossing over center line –102
Exceeding reasonable safe speed – 95
Exceeding stated speed limit –60
Other – 50

Also according to the Department of Transportation:

-The leading cause of all accidents on state and county roads is exceeding safe reasonable speeds.
-The leading cause of all accidents on city streets is failing to yield the right of way.
-The leading cause of fatal accidents on state and county roads is alcohol impairment.
-The leading cause of fatal accidents on city streets is exceeding stated speed limit.

https://reason.com/blog/2015/08/21/is-marijuana-causing-more-car-crashes-in

(8/21/2015) Is Marijuana Causing More Car Crashes in Washington?

http://www.businessinsider.com/the-cause-of-the-most-fatal-car-crashes-2015-5

The Auto Insurance Center, a car insurance news and information site, sought to answer that question. It compiled data on every fatal car accident in the US recorded by the National Highway Traffic Safety Administration’s (NHTSA) Fatal Accident Reporting System from 2009 to 2013.

The data includes driver, passenger, and pedestrian fatalities. The findings, shown below in map form, show what causes the most driving fatalities in every US state…

http://www.businessinsider.com/here-is-what-we-do-on-our-smart-phones-while-driving-2015-5#ixzz3bN6XB430

According to the study, 70% of respondents say they engage in smartphone activities while driving. 61% say they text while driving and 33% say they send emails while driving.

In terms of social media, 27% of drivers enjoy checking Facebook while driving, while 14% check Instagram and Twitter, and 11% check Snapchat.

Other smart phone activities behind the wheel include internet browsing (28%), taking selfies (17%), and video chatting (10%)…

Of those polled, 22% cite addiction as the reason for why they use their phone behind the wheel, and 27% believe they can do it safely while driving…

America’s Weed Rush

“America’s Weed Rush,” an investigation of marijuana legalization in America, is the 2015 project of the Carnegie-Knight News21 program, a national multimedia investigative reporting project produced by the nation’s top journalism students and graduates.

This year, 27 journalism students from 19 universities traveled through half the country to report on the politics, regulation and science behind the nation’s marijuana movement. From Nevada to Maine, California to Connecticut, reporters interviewed politicians, parents, patients, dispensary owners, farmers, police and advocacy groups on all sides of the debate…

http://weedrush.news21.com/while-marijuana-advocates-look-to-legalize-in-arizona-concerns-remain-about-medical-marijuana-program/

Phoenix Police Department Commander Brent Vermeer said via email that he didn’t have empirical data to show the impact of medical marijuana on law enforcement, but “it unequivocally has not impacted the cartels’ sales practices for marijuana.”

He wrote in an email that the department has investigated homicides related to marijuana, and burglars recently stole $500,000 worth of marijuana from one dispensary. “Within two days, their front office was robbed at gunpoint of several thousands of dollars,” he wrote.

“Violence follows drugs, regardless of whether they are legal or not,” he added…

Come now, that’s not true, or else it wouldn’t be safe to walk into a Walgreens or CVS. Most dispensaries are forced by federal laws to operate cash businesses, which increases the possibility of a robbery.

State medical boards have filed multiple complaints against naturopathic physicians since medical marijuana became legalized. Runbeck said several naturopathic doctors originally reprimanded by the Arizona Naturopathic Physicians Medical Board did not understand how to correctly use the state’s controlled substances database, which allows physicians to see if patients have prescriptions to other controlled substances. Doctors must access the system before writing certifications for medical marijuana…

Phoenix medical marijuana dispensaries Encanto Green Cross and Nature’s AZ Medicines list their cheapest ounces of marijuana at $280, while medium-quality black market marijuana goes for under $210 per ounce in Arizona, according to Price of Weed, a crowdsourced marijuana price index…

Saving $70 or more a month is a lot of money — it’s the cost of my electric bill this month, although I’m sure many patients pay a lot more for their electricity. And $280 an ounce is a fairly good price — but $210 is a lot more fair and affordable. Now compare $280 to the current price per ounce at Sacred Garden in New Mexico, at $364. And in Washington state: “Medical growers estimated the cheapest medical marijuana is selling for between $125 and $140 an ounce, while the cheapest ounces available at Uncle Ike’s and Ocean Greens — two of Seattle’s most popular retail stores — are around $190.”

The Marijuana Policy Project initiative allows city governments to forbid retail marijuana stores from opening within their borders, but cities could not bar stores opened by prior dispensary owners. It also creates a marijuana board to regulate both medical and recreational licensing, with three of the board’s seven members coming from members of the marijuana industry.

“They’re protecting their industry, the medical marijuana dispensaries, from newcomers entering the business,” Leibsohn said. “(Marijuana lawyer Tom Dean and I) don’t agree on much, but he put it well: If the MPP’s initiative passes, a handful of people will get very, very wealthy.”

This investigative report covers a number of states, including Montana. I haven’t read very much about Montana’s medical cannabis program, but this report covers the issues pretty well. And I have to say, it’s a very sad state of affairs in Montana…

http://weedrush.news21.com/in-montana-medical-marijuana-in-danger-as-debate-drags-on/