California: Coronavirus testing cost zero if insured, employee & employer benefits


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 Only leaves tens of millions uninsured. Does nothing about cost for medical care or home health care after testing positive..

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Governor Newsom, State Health Officials Announce More than 22 Million Californians Now Eligible for Free Medically Necessary COVID-19 Testing

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Today, under the direction of Governor Gavin Newsom, the Department of Managed Health Care directed all commercial and Medi-Cal health plans regulated by the Department to immediately reduce cost-sharing to zero for all medically necessary screening and testing for the COVID-19 in theAll Plan Letter (PDF). This includes waiving cost-sharing for emergency room, urgent care or provider office visits when the purpose of the visit is to be screened and tested for COVID-19. The need for COVID-19 testing is based on medical necessity, a clinical determination made on a case by case basis by medical professionals.

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“Californians shouldn’t have to fear a big medical bill just because they took a test for COVID-19,” said Governor Newsom. “This action means that Californians who fit the testing requirements can receive the test at no cost. We’re all in this together, and I’m grateful to those health providers who have already stepped up and heeded our call.”

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“This action will ensure that Californians who need a test will receive one at no cost,” said Dr. Mark Ghaly, secretary of the California Health and Human Services Agency. “This doesn’t mean every Californians should be seeking a test. If you are experiencing symptoms of COVID-19 and may have had contact with a person with COVID-19 or recently traveled to countries with apparent community spread, call your health care provider or local public health department first before seeking medical care.”

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Today the California Department of Insurance issued similar direction providing cost free medically necessary testing for an additional 2 million Californians. Combined these announcements ensure that 24 million more Californians are eligible to receive testing, should their health care provider deem it medically necessary.Insurance Bulletin COVID-19 Screening and Testing (PDF).

 

The Department of Managed Health Care also directed health plans to increase capacity to screen and treat COVID-19 as needed to minimize further transmission by encouraging health plans to expand telehealth services and to take steps to ensure patients receive medically necessary medication if there is a shortage of a particular drug.

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These orders from the Department of Managed Health Care and the Department of Insurance do not apply to individuals in self-insured health coverage products.

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Support Now Available for Employers and Workers Impacted by COVID-19

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Also today, the California Employee Development Department announced support services to individuals affected by COVID-19 in California. For faster and more convenient access to those services, the use of online options is encouraged.

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Individuals who are unable to work due to having or being exposed to COVID-19 (certified by a medical professional) canfile a Disability Insurance (DI) claim.

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Disability Insurance provides short-term benefit payments to eligible workers who have full or partial loss of wages due to a non-work-related illness, injury, or pregnancy. Benefit amounts are approximately 60-70 percent of wages (depending on income) and range from $50 – $1,300 a week.

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Californians who are unable to work because they are caring for an ill or quarantined family member with COVID-19 (certified by a medical professional) canfile a Paid Family Leave (PFL) claim.

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Paid Family Leave provides up to six weeks of benefit payments to eligible workers who have a full or partial loss of wages because they need time off work to care for a seriously ill family member or to bond with a new child. Benefit amounts are approximately 60-70 percent of wages (depending on income) and range from $50 – $1,300 a week.

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Employers experiencing a slowdown in their businesses or services as a result of the Coronavirus impact on the economy may apply for the UI Work Sharing Program. This program allows employers to seek an alternative to layoffs – retaining their trained employees by reducing their hours and wages that can be partially offset with UI benefits. Workers of employers who are approved to participate in the Work Sharing Program receive the percentage of their weekly Unemployment Insurance benefit amount based on the percentage of hours and wages reduced, not to exceed 60 percent.

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Visit the Work Sharing Program to learn more about its benefits for employers and employees, and how to apply.

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Governor Proclaimed State of Emergency

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Governor Gavin Newsom yesterday declared a State of Emergency to make additional resources available, formalize emergency actions already underway across multiple state agencies and departments, and help the state prepare for broader spread of COVID-19. The proclamation comes as the number of positive California cases rises and following one official COVID-19 death.

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The emergency proclamation includes provisions that protect consumers against price gouging, allow for health care workers to come from out of state to assist at health care facilities, and give health care facilities the flexibility to plan and adapt to accommodate incoming patients.

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View a copy of the emergency proclamation (PDF).

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COVID-19 in California by the Numbers (as of 10 a.m. Pacific Time):

60– Positive cases

1 – Death

24 – Cases of positive tests related to federal repatriation flights

36 – Cases not related to repatriation flights

  • 18 – Travel-related

  • 10 – Person to person

  • 4 – Community transmission

  • 4 – Currently under investigation

9,400+ – number of people self-monitoring who returned to the U.S. through SFO or LAX

49 – Number of local health jurisdictions involved in self-monitoring

15 – Labs with test kits

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How Can People Protect Themselves:

Every person has a role to play. So much of protecting yourself and your family comes down to common sense:

  • Washing hands with soap and water.

  • Avoiding touching eyes, nose or mouth with unwashed hands.

  • Avoiding close contact with people who are sick.

  • Staying away from work, school or other people if you become sick with respiratory symptoms like fever and cough.

  • Following guidance from public health officials.

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What to Do if You Think You’re Sick:

  • Call ahead: If you are experiencing symptoms of COVID-19 and may have had contact with a person with COVID-19 or recently traveled to countries with apparent community spread, call your health care provider or local public health department first before seeking medical care so that appropriate precautions can be taken.

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California’s Response to COVID-19:

We have been actively and extensively planning with our local public health and health care delivery systems. Here are some of the things we are already doing:

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  • As in any public health event, the California Department of Public Health’s Medical and Health Coordination Center has been activated and is coordinating public health response efforts across the state.

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  • California continues to prepare and respond in coordination with federal and local partners, hospitals and physicians.

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  • California activated the State Operations Center to coordinate response efforts across the state.

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  • Governor Gavin Newsom requested the Legislature make up to $20 million available for state government to respond to the spread of COVID-19.

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  • California made available some of its emergency planning reserves of 21 million N95 filtering facepiece masks for use in certain health care settings to ease shortages of personal protective equipment.

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  • The Public Health Department is providing information, guidance documents, and technical support to local health departments, health care facilities, providers, schools, universities, colleges, and childcare facilities across California.

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  • It is coordinating with federal authorities and local health departments that have implemented screening, monitoring and, in some cases quarantine of returning travelers.

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  • In coordination with the CDC, state and local health departments, we are actively responding to cases of COVID-19.

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  • The Public Health Department is supporting hospitals and local public health laboratories in the collection of specimens and testing for COVID-19.

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  • The California Department of Public Health’s state laboratory in Richmond and 14 other public health department laboratories now have tests for the virus that causes COVID-19.

 

 

 

 

 

 

 

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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For My Home Page, click here:  Welcome to my Weblog on Pain Management!

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Please ignore the ads below. They are not from me.

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The advertising below is not mine.

In exchange, this blog is less expensive.

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No Respirator Masks, No Respirators, Healthcare Workers Not Protected


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National Shortage of Everything Needed to protect

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Healthcare Workers

 

A massive kick in the gut REALITY

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We will have to accept a deadly crisis as stark dead cold reality in vast numbers with things we’ve never imagined could happen here. Don’t be getting bored or lulled to sleep now by the quiet that comes before the tsunami.

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“As coronavirus cases in Washington state mounted and the country’s first death was announced Saturday, health authorities scrambled to get more specialized masks for front-line clinicians who need to protect themselves from the highly contagious disease.

Washington state authorities sent an urgent request for 233,000 respirators and 200,000 surgical masks to be released from the federal government’s Strategic National Stockpile. The stockpile is a repository of drugs and supplies for deployment in major public health emergencies, such as an infectious disease outbreak.

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Within 24 hours, Washington state’s liaison to the federal government, Casey Katims, was told his state would get assistance. But it would be less than half the amount they requested — 93,600 N95 respirators and 100,200 surgical masks..Washington’s experience highlights one of the country’s biggest gaps in preparedness for battling the respiratory virus that causes the disease known as covid-19. The United States has about 1 percent of the 3.5 billion respirators that experts estimate the health-care system needs a year to fight a severe influenza pandemic. That translates to 12 million N95 respirators and 30 million surgical masks, Health and Human Services Secretary Alex Azar has said. An additional 5 million N95 respirators may be expired, he has said.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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For My Home Page, click here:  Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

The advertising below is not mine.

In exchange, this blog is less expensive............

Policies unintended consequences. Ethical distribution of limited resources.


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Concluding paragraphs from The Washington Post, March 2, 2020:

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The coronavirus could hit the U.S. harder than other wealthy countries

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Our inequities create unique vulnerabilities —

as does our current political climate

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…To reduce exposure, people with the virus must come forward. They must also identify their contacts. Fear that this may result in deportation or harm for loved ones may make this essential step impossible for many. As we learned during the Ebola and Zika responses in New York City, without the active engagement of immigrant communities that have the closest ties to the countries with the highest burden, prevention efforts could falter.

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We don’t mean for this analysis and its grim outlook for what lies ahead to create additional fear or panic in the United States. Indeed, there is much to be reassured by: For many young, healthy Americans, as well as children, the risk of serious illness and death is low, and health departments across the country are accurately assessing risk and implementing prevention measures.

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.Yet at the national level, we need an intentional, human-rights-based response that pays attention to health equity. This will require honest conversations about the potential human rights challenges posed by quarantine and other measures as well as more discussions about the ethical distribution of limited resources. It may also require some self-reflection on how policies can have unintended consequences for public safety and public health.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

In exchange, this blog is less expensive.

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Do you don’t want people to avoid tests or treatment because of a $3,000 medical bill?


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Coronavirus shows the importance of Bernie Sanders & Medicare for All.

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In a pandemic, you don’t want people avoiding getting tested or treated because they can’t afford a $3,000 medical bill. A lot of working families cannot afford that.

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We’re only as safe as the least insured person among us. Everyone has to be covered.

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One American man who flew back from Wuhan with his small daughter was hospitalized at Rady Children’s Hospital in San Diego for several days until the daughter tested negative for coronavirus. After living in Wuhan for 15 years, he did not have American insurance.

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Our CDC had no test kits available so it took many days for results to be flown to CDC and returned. England has now tested 10,000 people on national health insurance. We have tested 420 but many people were untested as kits were not available and they are in our communities spreading the highly contagious virus.

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What is the cost of high-level bio-containment units that function like ICU’s? My guess is that 6 days would easily be $60,000 if not far more.

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This poor man.

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One business man in Florida paid $3500 for a test to prove he was well after flying back from China so he did not have to quarantine for two weeks. His insurance refused to pay. Will yours pay for testing of your family?

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.ed 

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

In exchange, this blog is less expensive.

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Medicare & Insurers Crack Down on Opioids – Patients Suffer


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Individualized pain management does not exist.

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Correction from reader: 

“Individualized treatment does exist, but insurance companies are not paying for it. This has to change.” 

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The New York Times reports “Medicare is Cracking Down on Opioids” (link below).

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Last year an insurer denied 10 mg daily Oxycontin for one of my seniors who had been safely taking this for many years. That is less than 1 mg per hour for 12 hour relief. Pharmacy refused to fill unless insurer approved. That’s one way to reduce healthcare costs without an uprising. There is little tolerance for someone with pain. Are they viewing patients as addicts? Would they do this for cancer? 

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The material on this site is for informational purposes only.

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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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Comments are welcome.

This site is not for email, not for medical questions, and not for appointments.

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For My Home Page, click here:  Welcome to my Weblog on Pain Management!

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Please IGNORE THE ADS BELOW. They are not from me.

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Best wishes to all!


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Please ignore the Advertising – has nothing to do with me.

Anger


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Anger at the failure of our medical system to support research and treatment of pain, anger at failure of the few currently available analgesics, anger at lack of interest or funding from Pharma – it requires at least $10,000,000 more to finish one important human treatment before submitting to FDA – that’s just one study. Pharma does not care, the price is peanuts to them. At one point, a company bought it, intending only to bury it. They do that for rheumatology treatments too, both the innate immune system and the adaptive immune system are being ignored. What could be more powerful than the immune system?

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Anger

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Anger at the failure of most medical organizations to discuss cannabis, medical marijuana. Training in cannabis is imperative.

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I am thrilled that Scripps Memorial Hospital Grand rounds in 10 days is a one hour lecture by the doctor who is head of HelloMD, national leaders in physician approval for medical marijuana, and in education.

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Anger at the destruction of the field of pain management. I posted on this two days ago, top left column. Anger at the greed in the medical system where pharma can buy whatever they want by sprinkling money at congress who will never ever ever do anything about the unholy prices of drugs. Certain elements in power will never stop trampling on the poor and the disabled. They will never treat the addicts. There is no will, they are paid off and nobody wants to help the disabled, the unwell, the poor. Not in  the U.S. Voters do not want to hear it.

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Anger says step back, surrender.

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There is nothing anyone can do. The swamp is exhausting, dirty, dangerous and black.

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I have tried 7-1/2 years to introduce a new paradigm. At various lifetimes in medicine, I have had funding, sat on boards of companies, and panels at FDA. I have witnessed the destruction of what it once was 43 years ago when I entered practice. A long and tortured history, but still the most exciting thing in the world is medicine, science. So what? They shut off the field of pain and are killing it. The world is the world. Always was, always will be. Lust and greed, says the sage. You cannot uncurl the curly tail of a pig, says the sage. Always was, always will be. Do your duty. You cannot escape it. But surrender to love.

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Surrender. Do what you can and surrender the results to the Infinite.

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Read these books:

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Dying to Get High, Marijuana as Medicine

by Wendy Chapkis and Richard J. Webb

NYU Press 2008

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From back leaf:

“How can a substance that is no mystery to half of all adults in the United States prompt such confusion and misrepresentation in the realms of law, medicine, and policy?…. Offering nuance in place of slogans, Dying to Get High tells an inspiring story of the tactics and philosophies of a little-understood health movement.”

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“A beautifully written account from the front lines of the struggle between a federal drug war complex determined to keep demonizing marijuana and the growing movement of patients and doctors who have found marijuana to be a valuable medicine.”

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“….. Provides a human element to the history, pharmacology, psychology, and politics of medical marijuana in a way that no other work has. I loved reading it.”

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Heroin Century

by Tom Carnwath and Ian Smith

Routledge Press, London

2002

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This is an extremely important, amazingly interesting, readable book for everyone.

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From back cover:

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Is heroin really dangerous? Or Is it just dangerous because it is illegal?

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Page-one 93,

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“The income of the drug barons is an annual $254 thousand million dollars, greater than the American defense budget.”

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Read this book. A page turner! Exciting! fast paced, awesome! mind boggling!

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And just because you might flash some anger to propel you to actually do something, don’t get stuck there. Be at peace. Work hard. Use your expertise. Surrender to the Infinite.

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While you are thinking about it, tell Congress to make pain management a mandatory course in more than the current 3% of medical schools, less then 30 hours in 4 years. Fund research and treatment of neuropathic pain such as CRPS, Complex Regional Pain Syndrome because it can be so disabling – the same neuropathic pain can occur from strokes. Don’t we deserve better? Not even cancer pain is taught, let alone grade schoolers who should be taught about the body, about addiction, drugs, sex. Teach all that opioids cause pain because they trigger inflammation in the immune system and that stimulates pain. The more opioid you give, the more the pain. Teach about the brain’s pleasure centers and addiction, how drugs and food and cigarettes work there and how addiction kills.

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Have a wonderful life all of you. There’s a lot of work to take up. You will meet great people. Can’t wait to see what a little anger will do.

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The material on this site is for informational purposes only.

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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~

Comments are welcome.

This site is not for email, not for medical questions, and not for appointments.

~~~~~

For My Home Page, click here:  Welcome to my Weblog on Pain Management!

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Please IGNORE THE ADS BELOW. They are not from me.

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