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How a Letter to an Editor Written in 1980 Fueled Prescription Opioid Crisis in US

A 1980 letter, published in the New England Journal of Medicine, is believed to have given wings to the current prescription opioid crisis in America. The letter summarized the study conducted to determine the risks of narcotic addiction. The researchers examined 39,946 patients, of whom 11,882 were subjected to a brief narcotic intervention. It was observed that there were only four cases wherein patients with no prior history had developed addiction.

The drugs in question were meperidine, Percodan, and hydromorphone. Authors Jane Porter and Hershel Jick from Boston Collaborative Drug Surveillance Program of Boston University Medical Center, said, “We conclude that despite widespread use of narcotic drugs in hospitals, the development of addiction is rare in medical patients with no history of addiction.”

Unfortunately, the entire purpose of the study was taken out of context and was used to fuel the myth that opioids are safe without any risk of addiction. Pharmaceutical companies and drug makers have cited the content of the letter numerous times (a recent study indicates that it has been cited more than 600 times) to market their products. Some have even gone to the extent of pointing out that opioids are perfectly safe in outpatient settings, a point that has been countered by one of the authors.

In a note to the Associated Press, Jick explained that since the study was conducted in hospital settings and looked only at patients who had received opioids for short duration therefore, it “has no bearing on long-term outpatient use.”

Pain used as excuse to prescribe opioids

More than 52,000 drug overdosing mortalities were reported in 2015 with 63 percent deaths attributed to opioids. Overdosing proved to be more fatal than automobile accidents (more than 38,000 mortalities) and gun violence (36,000 mortalities) during the year. The 2015 numbers even surpassed the mortality rates when the dreaded HIV/AIDS was at its peak and 43,000 people reportedly lost their lives to it. The Centers for Disease Control and Prevention (CDC) estimates that 91 Americans succumb to opioid overdose every day.

Pharmaceutical companies have taken it upon themselves to promote drugs such as OxyContin and Percocet for chronic pain despite suggestions by researchers that opioid painkillers aren’t fully effective and have serious side effects. It is also interesting to note that ever since Purdue Pharma introduced OxyContin in the 1990s, there has been a surge in the way prescription drugs have been doled out. As more Americans suffer from pain, these companies have tapped the opportunity to persuade health care professionals to prescribe more opioids. As a result, many physicians end up overprescribing and risking their patients’ lives.

Mortified by how the pharmaceutical companies unscrupulously used the content of the letter to serve their own ends, Jick said, “I’m essentially mortified that that letter to the editor was used as an excuse to do what these drug companies did. They used this letter to spread the word that these drugs were not very addictive.”

Controlling prescription drug misuse

Pain is a relative concept and it is open to interpretation. In the absence of any biological measure, physicians prescribe medication based on what they deem fit and how an individual responds to questions. Even if opioids are prescribed to treat pain, doctors should closely monitor the doses, trace the patient’s history of drug use and inform them about harmful effects of long-term use. Leftover opioids at home should be discarded before they get into the hands of a child and causes mayhem. Self-medication through prescription drugs should be strictly avoided as it may lead to physical and mental health complications.

How To Make Sure The Toys You Buy Are Safe

There are some very strict safety regulations in the United States that attempt to insure the safety of toys that are sold. But even with the strict regulations there are occasions from time to time where unsafe toys make it into the market.As a whole the regulations that are in place to ensure toy safety have been very successful. When compared to the number of toys that are sold on the market each year there have been very few incidents which were caused by unsafe or defective toys. Most accidents are caused by improper usage or common accident such as tripping on them.In the few cases where defective or unsafe toys have actually made it into the market they were recalled fairly quickly. But this is no reason for parents not let their guard down when buying toys.Check The Label: Safety Labels Are A MustThe first thing that should be checked when buying a toy is whether or not is has the appropriate safety labels. The primary label in the United States would be that of the Consumer Product Safety Commission which signifies that the toy meets the minimum safety standards.The next important labels to look for when shopping for toys would be age labels. You should always follow age guidelines, as they are an essential part of toy safety.Most toys have age labels, even if they are not legally required. Any toy that is not suitable for children under 36 months must have a visible label stating so.

Though, in general most toys give guidance as to what age group they are designed for. These guidelines let you know what age group will benefit the most from the toy, in terms of development, fun, and understanding. Here is a brief guide of different kinds of toys and what age group they are intended for:Under three yearsFor this age group the greatest threat that toys pose is a choking hazard. Most everything a baby or toddler gets their hands on, ends up in their mouth. For this reason, very small toys or toys with small parts are especially unsuitable. Be sure to keep marbles and small balls or buttons out of their reach; be careful with inflatable toys and balloons; and avoid toys with pointy or sharp edges.Three to five yearsChildren of this age are full of discovery and are capable of playing with more sophisticated toys. However, you should still be cautious as certain toys could still pose a risk to them. Avoid toys made with thin plastic that might break and cause injury and still watch for small parts that they may still be tempted to put in their mouth.Six to twelve yearsBy this age children will be able to safely play with almost any toy they are given. However, always read hazard warnings and instruction pamphlets for maintenance guides. For example, if you buy a trampoline you will need to carry out maintenance on it on a regular basis. If you buy a bike or skateboard for your child, you should also buy appropriate protective equipment. Always make sure you get the right size ride on toy for your child, so he/she can handle and enjoy what he/she is given.Things can get a little complicated when you have children of varying ages. When you have lots of different toys that are suitable for varying ages you have to stay vigilant. For starters, you should teach older children to keep their toys out of reach of younger children, especially when they contain small parts and/or are breakable. It is also best if you do not put different age appropriate toys into one toy bin. Have a separate box for each child and make sure they do not swap out toys. To help keep organized, you should follow and separate based on the age labels on the toys.In general it is a good idea to be organized and keep toys in order. Having toys lying around the house is a common cause of accidents. If you have children of varying ages, this can be dangerous and allow smaller children to get to toys not intended for their age group. Keep in mind that children are intended to play with the toys, but all maintenance, such as changing of batteries should be carried out by an adult.

Toy safety labels offer an important safeguard against dangerous toys reaching our children, but it is just as important to use your own common sense. Before purchasing a toy, examine it thoroughly yourself to make sure that it is sturdy and well constructed. Check for any sharp edges or pointy corners, especially when buying toys for younger children. For example, if you are buying a stuffed animal make sure all stitching is secure and small items like the eyes or nose will not come off easily.If your child has an accident with a toy or you suspect a toy is potentially harmful, you should take immediate action. The first step is to take the toy out of the reach of all children. Once the child is cared for and the immediate danger has passed, you should report the toy to the appropriate authorities. You will need to keep the toy safe for examination and you should also try to provide details of where and when you bought the toy. It is important to regularly check online for toy recalls. This way you can remove a potentially dangerous toy before any incident occurs.