Viewpoints: Weigh Health Risks Of Football And The Big Feast This Thanksgiving; Count The Ways Drug Reps Were Taught To Market Opioids

Stat: Concussions, Broken Bones, And More: A Week Of U.S. Football 
News about concussions and other injuries to young football players appears with alarming frequency, as do reports of the long-term damage to NFL players.Young pro players are leaving the game for fear of permanent harm to their brains and bodies. Last month, Joshua Perry discussed his retirement at age 24 after suffering six concussions. He’s following in the footsteps of A.J. Tarpley, who retired at age 23, also because of concussion concerns. In March, USA Today called for a ban on tackle football for kids under 14, and one month later the journal Pediatrics reported results from a survey in which a majority of parents who responded supported age restrictions on tackling. (Kathleen Bachynski, Lisa Kearns, and Arthur Caplan, 11/27)

Los Angeles Times: Thanksgiving: A Time For Family, Fun And Food-Borne Illness
For the third year in a row, public health officials are warning people not to eat romaine lettuce. In this current outbreak, lettuce traced to the Salinas Valley was found to contain a dangerous strain of the E. coli bacteria that has made at least 67 people sick in California and 18 other states. And everyone should heed this warning because the strain, 0157:H7, is a particularly nasty one that can cause kidney failure and even death. It’s also the same strain that was making people sick in 2017 and 2018, a worrisome trend that underscores the danger in the FDA’s decision to put off rules requiring microbial testing of the water that farmers use to irrigate their produce. But tossing out suspected greens won’t guarantee that everything else in the Thanksgiving meal is safe. Indeed, even in the absence of any current turkey recalls, all birds should be treated as if they are armed — with salmonella, campylobacter or E. coli — and dangerous to your health. (11/27)

The Washington Post: I Was A Drug Rep. I Know How Pharma Companies Pushed Opioids.
For every dollar the pharmaceutical industry spends on research and development, it spends two on marketing. When I worked as a pharmaceutical sales representative in the neuroscience division of Eli Lilly, I was the living embodiment of this investment. I took doctors out to so many fancy Manhattan restaurants that the maitre d’s greeted me by name. The company hosted them at catered “speaking programs” and gave away tickets to baseball games and Broadway musicals. We even sent doctors and their families to sponsored academic conferences at tony resorts in Florida and California. During the day, if doctors didn’t have time to see me, I chatted up their receptionists, plying them with food and gifts (stress balls, umbrellas, clocks) and asking, breezily, which medications their bosses preferred prescribing, and why. (Shahram Ahari, 11/26)

Stat: Changing ED Doctors' Behavior Boosts Opioid Use Disorder Treatment
Emergency departments have become the front line in the battle against the epidemic of opioid use disorder, in part because they are the place individuals are brought after overdosing or during withdrawal. In addition, individuals with addiction are often marginalized from traditional sources of primary care, and so often default to using what is available to them: emergency departments. Our nation’s emergency departments have seen a nearly 100% increase since 2005 in visits by patients seeking help related to opioid addiction. The rates of hospitalizations related to opioid addiction rose 64% over the same period. Fortunately, there is an effective treatment for opioid addiction that emergency doctors can begin. Called medication for opioid use disorder (MOUD), it uses buprenorphine to reduce cravings for opioids. This treatment increases the likelihood that a patient will enter a recovery program and stick with it, yet the vast majority of patients with opioid addiction are discharged from emergency departments with inadequate or no treatment at all. (Alister Martin and Ted Robertson, 11/27)

The Washington Post: My Friend And I Both Took Heroin. He Overdosed. Why Was I Charged With His Death?
We gathered along the banks of the Columbia River at sunset. In front of the assembled crowd, a volunteer read the names of more than 40 people in our Oregon community who had died from overdoses. Four of those names belonged to people I loved, including my mom and my best friend, Justin. I attended this vigil with Justin’s mother, Ember. She had watched us struggle with addiction throughout our young adulthood. Now she and I stood arm in arm. We lit candles and thought of Justin, who in 2014 fatally overdosed from heroin I had sold to him — an act that resulted in my conviction and imprisonment for five years. (Morgan Godvin, 11/26)

USA Today: Trump Would Restrict Science, Weaken Life-Saving Air & Water Standards
In a proposed rule published over a year ago, the Environmental Protection Agency indicated that in the future, when computing how pollution causes health damages, EPA would only be willing to use scientific results from studies where all the underlying data could be made public. Hundreds of leading scientists sent comments explaining in technical detail why doing that would be a very bad idea — and would preclude the use of some of the best science in setting environmental standards. This month it began to look like the EPA may be blowing off all that scientific advice. (M. Granger Morgan, 11/25)

The Washington Post: Our Flawed Health-Insurance System Depends On Self-Defeating Decisions By Consumers
The “moderates” in the Democratic presidential primary hope to build on the Affordable Care Act, rather than make the more dramatic shift to Medicare-for-all — and even Sen. Elizabeth Warren (D-Mass.) has changed course to embrace a plan that would move to Medicare-for-all more slowly. But if they want to build on the ACA, they need to confront a serious perversity of the private insurance system underlying it: The system’s financial health depends on people choosing the wrong plans. (Peter A. Ubel, 11/26)

The Hill: Congress Should Follow Cities' Lead On Mental Health 
President John F. Kennedy died 56 years ago last week. The inspiring young president’s last piece of legislation, the Community Mental Health Act, called for states to close mental hospitals and open community health care centers in their place. The bold new idea was that people could get humane and comprehensive treatment for mental health and substance disorders while bolstered by the support of families and communities.Kennedy’s vision never became reality. Without needed federal dollars, many states closed their institutions without replacing them with community-based supports. More than half of the Act’s proposed centers never opened. Far too many people ended up getting no treatment or services at all, living on the streets, in shelters, or detained in jails and prisons. Some of the nation’s key providers of psychiatric care are not hospitals or clinics, but jails in Los Angeles, Chicago, and New York City. (Chirlane McCray, 11/25)

Boston Globe: Improving Access To Behavioral Health
As primary care providers who have been working on the front lines of health care for a combined 60 years, we find this bill to be, in many ways, music to our ears. Experience and research show that in communities that have access to primary care, populations are healthier and the cost of spending is lowered. (Katherine Gergen Barnet and Barry Zuckerman, 11/27)

Nashville Tennessean: Reducing Prison Recidivism Calls For Quality Reentry Programs
Gov. Bill Lee’s Criminal Justice Investment Task Force recently met to review new data on Tennessee’s incarcerated population.Among other findings, the data revealed 47% of those released from custody are rearrested within three years. And while Tennessee’s recidivism rate is lower than the national average for state prisoners at 68%, much more must be done to help these individuals successfully reenter society. (Damon Hininger, 11/27)