Narcotic use rising among those expecting

Doctors are prescribing opioid painkillers to pregnant women in astonishing numbers, new research shows, even though risks to the developing fetus are largely unknown, says the New York Times.images

“Of 1.1 million pregnant women enrolled in Medicaid nationally,nearly 23 percent filled an opioid prescription in 2007, up from 18.5 percent in 2000, according to a study published last week in the journal Obstetrics & Gynecology. That percentage is the largest to date of opioid prescriptions among pregnant women. Medicaid covers the medical expenses for 45 percent of births in the United States.

“The lead author, Rishi J. Desai, a research fellow at Brigham and Women’s Hospital, said he had expected to “see some increase in trend, but not this magnitude.”

“One in five women using opioids during pregnancy is definitely surprising,” he added.In February, a study of 500,000 privately insured women found that14 percent were dispensed opioid painkillers at least once during pregnancy. From 2005 to 2011, the percentage of pregnant women prescribed opioids decreased slightly, but the figure exceeded 12 percent in any given year, according to Dr. Brian T. Bateman, an anesthesiologist at Massachusetts General Hospital, and his colleagues. Their research was published in Anesthesiology.Dr. Joshua A. Copel, a professor of obstetrics, gynecology and reproductive sciences at the Yale School of Medicine, said he was taken aback by the findings, which come even as conscientious mothers-to-be increasingly view pregnancy as a time to skip caffeine, sushi and even cold cuts. Continue reading “Narcotic use rising among those expecting”

Medicare reconsiders surgery rules

The federal Department of Health and Human Services announced Thursday that it will reconsider a longstanding denial of gender-confirming surgeries for transgender people on federally subsidized healthcare.

Since 1989, both Medicare and Medicaid, the federally-run health program for low-income families and individuals, have explicitly excluded the coverage of gender confirmation surgeries for transgender individuals, reports The Advocate images

“Under National Coverage Determination 140.3, the programs have been exempted from covering these surgeries, though the data cited in the government’s justification is based on a 1981 National Center for Health Care Technology report. “Because of the lack of well controlled, long term studies of the safety and effectiveness of the surgical procedures and attendant therapies for transsexuals, the treatment is considered experimental,” reads the report in its explanation for why such procedures are not covered by insurance. “Moreover, there is a high rate of serious complications for these surgical procedures. For these reasons, transsexual surgery is not covered.”

“A lot has changed since 1981, however. The American Medical Association and American Psychological Association have since issued statements in support of gender-confirmation surgeries as a medical necessity and acceptable treatment for those suffering from gender dysphoria.

“In a ruling released December 2, the Department of Health and Human Services Departmental Appeals Board declared that the current National Coverage Determination record “is not complete and adequate to support the validity” of the determination excluding coverage for gender-confirming surgeries. The board determined that the 1981 report, which reviewed medical and scientific sources published between 1966 and 1980, is no longer “reasonable in light of subsequent developments.”  Continue reading “Medicare reconsiders surgery rules”