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Anchor lead: The US attorney general has revealed a crackdown on some opioid treatment centers, Elizabeth Tracey reports

Imagine seeking help for your opioid addiction, only to be sent off to an out of state treatment facility where bogus treatment practices are employed. That’s been the sad reality for some, and now the US attorney general has revealed a crackdown on such centers. Eric Strain, an expert on drug dependency at Johns Hopkins, says many treatment centers do fine work, but some caveats are in order.

Strain: Clearly there are programs now that are catering to providing services, and we’ve seen these on television ads late at night. This is where family members need to be careful, I think we need to watch what is the outcomes that these programs can have, to ask them for data on their outcomes, to look at how long these programs have been established. There are certainly residential programs that have been in existence for literally decades that have good track records of success, can point to those track records and are established in the community.  :32

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: If typical antidepressants don’t work, adding another type of medicine may help, Elizabeth Tracey reports

In people with depression that doesn’t respond totally to the usual antidepressant medications, adding another type of drug known as an atypical antipsychotic may help, a recent study found. Eric Strain, a psychiatrist at Johns Hopkins, says adding a medicine that works via a different mechanism is an idea that’s been increasingly popular.

Strain: There are patients now who get put on antidepressants who respond to the antidepressant but don’t have a full therapeutic response. And I think the field is moving forward now with the idea that we shouldn’t be complacent if somebody is 70 or 75% better, that we need to be thinking about what can we do to get them back to 100%? So that’s where I start to think about using a second agent that has perhaps a different mechanism of action to augment the foundational antidepressant that they’re on.   :31

Strain says there is no substitute for clinical experience in use of additional types of drugs to those with treatment resistant depression and that the strategy is well worth trying. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Will Maryland’s new law to prevent generic drug price gouging spread nationally? Elizabeth Tracey reports

Should pharmaceutical companies be able to raise the price of generic drugs by thousands of percentage points overnight, in the absence of any increased costs on their part? No, the state of Maryland asserts in a new law. Jeremy Greene, one author of a perspective on the law in the New England Journal of Medicine from Johns Hopkins, says such state actions are increasing nationally.

Greene: We witness the Maryland law as part of the increasing wave of action on the part of the states to take steps to address this increasing problem of escalating drug prices and drug spending. States have seen a substantial portion of their budgetary increase go towards drugs over the past decade, certainly states as actors have become increasingly sensitive to drug prices. We have seen several years now of discussions of drug prices on a federal level that have not led to conclusive actions to actually close these loopholes.  :32

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: The state of Maryland takes the lead in reining in generic prescription drug price gouging, Elizabeth Tracey reports

The state of Maryland is to be applauded for stepping into territory the federal government has been unable to navigate with the passage of a law to rein in astronomical price increases of generic drugs. Jeremy Greene, one author of a recent perspective in the New England Journal of Medicine on the law from Johns Hopkins, explains its implications.

Greene: Maryland has just passed into law the first attempt to make price gouging on off patent essential drugs illegal. Most recently the concern has to do with naloxone, of course this crucial drug for dealing with this expanding opioid epidemic, off patent yet the price skyrockets, old, essential medicines are becoming untenably expensive because of a small group of bad actors who recognize the ability to exploit effectively this loophole in American generic drug policy. And the state of Maryland put forward a bill to say not in Maryland.  :33

Greene says the State, healthcare professionals and patients themselves are all empowered to report possible gouging. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Scientists have successfully produced a virus from scratch, Elizabeth Tracey reports

Using freely available materials and methods, researchers have revealed the successful recreation of an extinct virus, a relative of smallpox. Andrew Pekosz, a virologist at Johns Hopkins, isn’t joining the chorus of gloom and doom surrounding the news.

Pekosz: We have emerging infectious diseases come around almost every year and for all intents and purposes, those are the same as for instance if someone was releasing a new, engineering virus into the population. So we really shouldn’t be focusing on stopping people from making viruses we should really be improving our ability to deal with these new viruses when they emerge in the human population because if we do that we’ll be able to not only stop these terrorists from using bioweapons but we’ll also be helping ourselves in terms of the naturally occurring outbreaks that happen so frequently to us.  :32

Pekosz notes that a considerable amount of expertise is still required to recreate a functional virus, so he doesn’t look for this to become a common practice. At Johns Hopkins, I’m Elizabeth Tracey.

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view of an aluminum can of sugar free soda

This week’s topics include early adulthood weight gain and outcomes, the dangers of artificial sweeteners, an opioid reduction strategy, and consequences of reduced readmissions.

Program notes:
0:33 Artificial sweeteners
1:33 Really not effective at reducing BMI
2:32 Best to avoid
2:42 Weight gain in mid-life
3:42 Dose dependent negative outcomes
4:42 Decreases risk for type 2 diabetes
5:08 Opioid tapering and cessation
6:10 If they decreased or ceased it decreased pain
7:10 Use of non-opioid analgesics
7:45 Readmissions and mortality
8:45 A priori would have predicted more death
9:35 May help with patient concerns
10:22 End
Related blog: https://podblog.blogs.hopkinsmedicine.org/2017/07/21/artificial-sweeteners-not/
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UnknownThis week’s topics include diet quality and longevity, health and coffee, treating depression, and prostatectomy in early prostate cancer.

Program notes:

0:33 Coffee drinking and longevity
1:33 Over 185,000 people followed in one study
2:32 Can’t advocate for a type of coffee
3:01 Prostatectomy or not in early prostate cancer
4:01 Higher incidence of side effects
5:01 What kinds of means are used to monitor?
5:40 Treatment of refractory depression
6:40 Added atypical antipsychotic
7:40 Adding another agent that works differently
8:32 Quality diets and longevity
9:32 Substitute healthier foods
10:55 End

Related blog: https://podblog.blogs.hopkinsmedicine.org/2017/07/14/more-joy-for-coffee-drinkers/

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