By Anthony Mladinov, RPh., Pharm.D. - Director of Pharmacy Compliance

Tuesday, August 8th, 2017

                  The Miami Herald recently reported that 10 year old Alton Banks collapsed on June 23 and subsequently died, due to what preliminary toxicology reports indicate was the presence of fentanyl in his system. My initial exposure to this story was as a very brief news blurb that I placed in the basket with most of the terrible stories the media supplies.  But, when a person I consider astute and insightful (and the CEO) says there could be a message brought forth from this tragedy I investigated further.  My initial thought was that the child came into contact with an inadvertently discarded or lost fentanyl patch. The patch is the most common means of legitimately obtaining fentanyl as an outpatient. Additionally, the victim had been at a public pool, on a hot day. Perhaps if the child had found a patch, placed it on his hot skin, the accelerated release might have been a deadly factor. But no, depending on the news source, the fentanyl may have been mixed with heroin and another opioid. The neighborhood was near locations where the detritus of illicit drug use was clearly visible. The Miami Police have created a video advising and instructing parents and caregivers how to protect and warn your children from potentially deadly exposure to illicit drugs.   

                   So I must proceed on the basis that this tragedy was something that I, along with my fellow healthcare professionals could not have prevented. There is a good chance the fentanyl that killed Alton Banks was never part of the typical health care process that legitimately provides narcotics to the patients that need them. The fentanyl could have been manufactured in an illegal lab. What could I do to prevent this tragedy?  Nothing. Right?

            Wrong. Very wrong. I have seen the numbers that suggest that illicit drug use, from sources other than diverted drugs from legitimate health care scenarios, is on the rise…….perhaps because the regulations, restrictions, and monitoring of the legitimate use of narcotics has been significantly intensified. That seems to be a problem for the law enforcement agencies of this country. But the healthcare professional’s vigilance is in the foundation of all efforts in decreasing the illicit use of drugs. A legitimate drug diverted can be the stepping stone to years of drug abuse. Patients incorrectly monitored may provide the means to divert unlimited amounts of powerful opioids. Improper therapy may create a drug abuser out of a patient that had no nefarious intents.           

            For years, I have been a critic of therapies that have denied adequate pain relief. Reluctant use of narcotics due to the impediments of regulatory requirements, ignorance, and fear of abuse, have no place in correct protocols for pain management. However, these impediments can be overcome with professional effort, vigilance, and compassion.

          From my experience working in a poison control center, I am sorry to say there will be more stories such as Alton Banks in the news. Injury or death may come from fentanyl, antihistamines, vitamins, OTC analgesics or a houseplant. We must all do our part. Parents, be vigilant. Physicians, be vigilant. Pharmacists, be vigilant. Nurses, be vigilant.

Anthony Mladinov, RPh., Pharm.D

Anthony Mladinov, RPh., Pharm.D

                                                                                         

Posted
AuthorAnne Lackner

For the Viscardi Resources family Case Management is a collaborative process defined by respect for people and a relentless pursuit of efficiency.  Every interaction that takes place at our company - whether it's between colleagues or with a patient - is informed by these two ideas. Beyond human interaction, the creation, deployment and refinement of services takes place in an environment where a free exchange of ideas is encouraged and no area of improvement is too small to be taken seriously.  We are a company made up of people: people caring for people, people helping people, people bringing efficiency to a system.

Our growth over the past four years, following our strategic expansion initiative, has been astronomical.  I attribute a large part of this success to the fact that we've been guided by these principles of respect for people and a relentless pursuit of efficiency.  Collaborative Case Management lies at the heart of everything we do.  It's easy to look at Case Management, particularly in the workers' compensation industry, as a static entity.  Does a claim meet one of the pre-defined thresholds for the deployment of Case Management services? Yes, then put a nurse on it. End of conversation.  

At Viscardi Resources that doesn't constitute the beginning or the end of anything.  We acknowledge the fact that each patient has the potential to follow myriad treatment trajectories and aim to steer them down the best path from as close to the time of injury as possible.  Our Case Management teams do this by following specific protocols developed and refined in-house by the most capable specialists in the industry. In addition, research, development and refinement are done in a collaborative environment, with teams leveraging technology to maximize effectiveness at every stage.  The outcome is a set of highly efficient systems and novel solutions for the workers' compensation industry's toughest challenges.  

The outcomes provide proof that our method works: for starters, injured workers getting back on the job faster than the national standard and adjusters handling claims more effectively than they ever imagined possible. 

John Viscardi- Executive Vice President of Viscardi Resources

Posted
Authorjohn viscardi

Congratulations to the Nurses' Health Study on their 40th year and a big thank you to all those nurses who continue to participate in this project.  Your dedication and mine has contributed to the massive knowledge obtained in the area of chronic health and has influenced much in the field of public health.  Well done and thank you!   For more on this topic, click here.

Posted
Authorjohn viscardi

This year during National Case Management week, we honor all those involved in the collaborative process of improving people's lives.  It takes a village. 

Posted
Authorjohn viscardi

BY THE PRESIDENT OF THE UNITED STATES OF AMERICA

A PROCLAMATION

Each year, more Americans die from drug overdoses than in traffic accidents, and more than three out of five of these deaths involve an opioid. Since 1999, the number of overdose deaths involving opioids, including prescription opioid pain relievers, heroin, and fentanyl, has nearly quadrupled. Many people who die from an overdose struggle with an opioid use disorder...

Posted
Authorjohn viscardi

A new study by the Workers Comp Research Institute observed a noticeable reduction in the amount of opioids prescribed per claim in a majority of the 25 states investigated.  

The 25 States in the study are Arkansas, California, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Wisconsin. 

Click Here for the Abstract, Executive Summary and to order the study. 

Posted
Authorjohn viscardi

First response mental health support, also known as psychological first aid, is shown to provide a number of benefits to employees who have experienced a traumatic injury/event at the workplace. 

Click Here to view the article 

Posted
Authorjohn viscardi

New York City officials announced Monday, February 1st, 2016 that many NYC Walgreen and Duane Reade pharmacies would join some CVS and Rite Aid pharmacies to sell Naloxone without a prescription. Naloxone is utilized to combat the effects of opioid overdose, a substance found in drugs such as heroin and OxyContin.

 

Posted
Authorjohn viscardi