Addition: Earlier in the week, we offered our congratulations to two Georgia pharmacists who won reelection this year. We also want to add our congratulations and thanks to Representative Butch Parrish (who ran unopposed). He’s been a one of our pharmacy champions year after year,
and we’re looking forward to continuing to work with him under the Gold Dome. Congratulations,
Butch!

Major e-cig limits are coming

Do you sell e-cigarettes? Be prepared for some “severe restrictions” as the FDA cracks down hard. (Yes, this is about convenience stores and gas stations. But do you really expect that rule not to spread?)

As soon as next week, FDA Commissioner Scott Gottlieb is expected to announce a ban on the sale of most flavored e-cigarettes in tens of thousands of convenience stores and gas stations across the country, according to senior agency officials.

Meanwhile….

Cigarette smoking by Americans is down to its lowest level evah. (But more among some people than others. Low-income undereducated and divorced/separated gays and lesbians living in the South or Midwest still have a ways to go.)

Reminder: Immunization for community pharmacists

Don’t forget about the Pharmacy Times dinner in Buckhead on November 13: Immunization Considerations for the Community Pharmacist. It’s a great way to get ideas for growing the immunization side of your practice

It’s at the South City Kitchen Buckhead (3350 Peachtree Road NE) from 6:00 to 8:00 pm. Click here for more info and to register — no robots allowed.

Pharma foe about to get a lot more power

When the Democrats take control of the House in January, Maryland’s Rep. Elijah Cummings is likely to chair the House Oversight and Government Reform Committee. As Stat explains…

“It’s a high-profile role […] that will give him the opportunity to haul in executives from drug companies or pharmacy benefit managers and demand explanations for their price hikes or murky rebate systems.

AMA considers endorsing drugs from Canada

The American Medical Association is deciding whether to endorse allowing patients to buy drugs in Canada to save money. (Before you get too angry, this would only apply to people physically going to The Great White North and buying those drugs in a brick-and-mortar Canadian pharmacy. No online sales.)

A roundtrip ticket from ATL to Toronto runs about $250, so this is probably more an issue for those northern states.

Should kratom be C-I?

HHS wants to make kratom a Schedule-I drug, like heroin, ecstasy, and LSD (and, amusingly, marijuana — but that’s another discussion).

The issue: Sure, kratom has abuse potential, but it also has use potential to combat addiction (people do use it as an alternative to heroin), and making it C-I means it’s harder to do research.

Read all about it.

Guess who’s back?

If you said “Primatene Mist OTC” you win 150 Internet Points!

Bonus cool science part: It was taken off the market because its propellent contained CFCs, which were ruining the ozone layer. Remember when those were banned? Well, the ban worked, and the ozone is getting a lot better.

This is NOT a path to fixing the opioid problem

The gods of economics will not be denied. And the result, as Stat News explains, is not good at all.

First, big production increases mean the price of street opioids like heroin is going down.

In the early 1980s, a gram of pure heroin cost about $2,200. Today that same amount costs less than $500, nearly an 80 percent decrease. A bag of heroin today will set you back about $5, the cost of a pumpkin spice latte.

Meanwhile increased demand has pharma companies raising the price of the overdose antidote, naloxone.

Given the ongoing devastation of the opioid crisis, you might expect that naloxone would be widely available at a low price. Not so. A decade ago, a lifesaving dose of naloxone cost $1. Today, that same dose costs $150 for the nasal spray, a 150-fold increase. A naloxone auto-injector, approved in 2016, costs $4,500.

This could be a path toward fixing the opioid problem

Turns out that most surgery patients use only a quarter of the post-op opioids they’re given. Even more interesting: The prescription size seems to have more effect on how many they take than any other factor; give them more pills and they take more pills.

“In what we tell patients about what kind of pain to expect after surgery, and how many pills we give, we set their expectations — and what the patient expects plays a huge role in their post-operative pain experience. So if they get 60 pain pills, they think they have to take many of them.”

The long read: When is a placebo no longer a placebo?

Here’s a really interesting idea: What if there’s actually a biological reason for the placebo effect?

New research is zeroing in on a biochemical basis for the placebo effect — possibly opening a Pandora’s box for Western medicine.