Issue 41: FDA wants smoke with Juul, suspending the youth in school, insurance companies say hell no to oxycontin, and more

FDA tells Juul to stop targeting teens otherwise there's gonna be smoke

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Usually I can somewhat keep up with all the new hip lingo that the kids are using these days. I can recognize when something is "lit," and I know that Facebook is out and Instagram and Snapchat are in. But, I felt like a total newb when I had to ask a high schooler what a Juul was a few months ago. Juul, an e-cigarette company, makes tiny e-cigarettes that look like USBs--making them easier to conceal, and also more trendy. They also come in fun flavors like creme brûlée or mango. Since then this electronic e-cigarette trend has skyrocketed--especially among teenagers. In a statement released by the FDA earlier this week, if companies don't stop marketing their products to appeal to a younger audience, and stores aren't more vigilant in stopping the sale of e-cigarettes to underage users, an FDA ban against e-cigarettes could be coming our way. Research has consistently shown the negative effects and addictive nature of nicotine. Nicotine is especially concerning for young people and their developing brains. While e-cigarettes have been touted to be helpful for those trying to wean off cigarette smoking, the use of e-cigarettes is worrisome when we have a whole generation of new users experimenting with it. So while I'm down for a good trend (i.e. another Peter Kavinsky meme), we need to be more cautious of how the media is advertising products that are harmful to our health.

Contributed by Aish Thakur from UCSF 

Suspending young students doesn't help

dank Boonk meme

It seems like recidivism rates are high among all types of offenders, in both adults and…kids? Not surprisingly, suspending young children (especially males) ensures an increased risk of them being suspended again in elementary school. To be honest though, I’m still reeling at the first sentence of this article: “Some kindergarteners and first-graders suspended from school can find it challenging to reverse the negative trajectory in their academic life.” I’m sorry, what? Kindergarteners and first-graders? How do you even get suspended that early in life?! It clearly doesn’t have any good effects on the kids, since after their suspension they’re less likely to be referred for supportive services in the future, and they’re also more likely to drop out of school later in life.  Teachers were more likely to suspend both African American students, as well as female students whose parents weren’t really involved with the school. It looks like this disciplinary approach really isn’t helping young students and only serves to alienate them from academic settings.

Contributed by Sameera Chaudry from Rutgers 

Insurance companies say get that oxycontin outta here

Image from Kaiser Health News

Slowly but surely insurance companies are refusing to pay for the addictive opioid oxycontin made by Purdue Pharmaceuticals. Last fall Cigna and Blue Cross Blue Shield of Florida said they would no longer cover oxycontin prescriptions. Earlier this week the largest insurer in Tennessee, Blue Cross Blue Shield of Tennessee, also said get that sh!t outta here. The official reason was that there were less addicting alternatives for pain relief on the market. Blue Cross Blue Shield of Tennessee will start covering Xtampza and Morphabond in place of oxycontin. Of course Purdue Pharma shot back and said that Blue Cross Blue Shield was doing it for financial reasons rather than genuinely being concerned about their precious oxycontin being addictive. In order to fight against the opioid epidemic that has reached an all time high in Tennessee, the state has created a set of strict guidelines on how opioids can be prescribed. Unfortunately despite these new regulations overdose deaths are still at an all time high. 

Baby aspirin controversy 
A major study released Sunday in the prestigious NEJM is causing some drama in the medical community. According to the study there were no health or longevity benefits for healthy elderly adults taking a daily baby aspirin. The study enlisted more than 19,000 participants older than 65 in both Australia and the US. Participants were either given 100mg of aspirin while the control group was given a placebo. Both groups were followed for a little less than 5 years and it turns out baby aspirin didn't do sh!t. The ASPREE trial, which is short for Aspirin in Reducing Events in the Elderly, is bound to get providers all up in their feelings. That being said there still remains strong evidence that a daily baby aspirin CAN help decrease the risk of patients who have ALREADY had a stroke or heart attack from suffering another future CV event. 

Do No Harm doc exposes physician suicide crisis  

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Earlier this week a special screening took place in NYC for the new documentary Do No Harm which examines why so many young doctors are depressed and turning to suicide. More than 200 med students, residents, and attendings attended the premiere. The film's director, Robyn Symon, and Dr. Pamela Wible also organized a march near Mount Sinai Hospital to remember the lives of a medical student and resident losing their lives to suicide earlier in the year. The documentary does not appear to be on the internet yet (I looked) but you can damn bet we need to start talking about this crisis more instead of just burying it underneath the rug.