Disclaimer: this is not an all-encompassing list of news updates from the month of May 2021.
From the overturning of Roe vs Wade to drug supply chain issues, 2022 was one of the most impactful years in regards to medicine. As we begin the start of 2023, here are some of the biggest stories in the medical field that occurred last year.
Roe V Wade Overturned
In 1973, the U.S. Supreme Court’s ruling in Roe v. Wade recognized that the decision to continue or end a pregnancy is up to the individual and not the government. However, nearly five decades later, in June of 2022, the U.S Supreme Court overturned Roe vs. Wade which subsequently eliminated the right of abortion and in turn, gave states more power to control abortion rights.
This overturn has sparked outcry across the country as millions will and have already been affected. Many states immediately following the court’s decision took action to either restrict or ban abortion altogether.
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Monkey Pox
COVID-19 might have seemed like it was dying down at this time, but in 2022, another outbreak started lurking its head around. Monkeypox is a rare disease caused by infection with the monkeypox virus. Despite its name, monkeypox is not related to chickenpox.
First human cases of mpox were recorded in 1970 and prior to the 2022 outbreak were found in several central and western African countries. Ninety-nine percent of patients that are infected are likely to survive. However, people with severely weakened immune systems, children under 1 years of age, people with a history of eczema, and people who are pregnant or breastfeeding are most likely to become seriously ill or die if infected.
A few months after the re-emergence of monkeypox, the World Health Organization (WHO) adopted the preferred term, “mpox” over the original monkeypox. The reasoning behind the name change was to deter the racists and stigmatizing language that occurred when the outbreak occurred earlier in the year.
Fentanyl Candy
Just when the thought of the opioid epidemic could not get any worse, reports of colorful fentanyl or “fentanyl candy” started appearing in communities around the country. What made it worse was it was happening around Halloween time when children would be the most effected.
Fentanyl is a synthetic opioid which is used to treat severe pain. It is found inpatient as an intravenous (IV) formulation or prescribed outpatient in forms of lozenges or transdermal patches and it is 50 to 100 times more potent than morphine. Over the last few years there have been many cases of fentanyl related deaths and overdoses. Recently, fentanyl has also been mixed with heroin and cocaine as a combination product in order to increase euphoric effects.
However, since the start of August 2022, the Drug Enforcement Administration (DEA) and law enforcement partners, seized the brightly colored fentanyl pills in 26 different states. According to a DEA administrator, rainbow fentanyl is a “deliberate effort” made by drug traffickers to cause addiction amongst kids and young adults.
In 2020, there were more than 56,000 deaths involving synthetic opioids in the United States, which included fentanyl.
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CDC’s Updated Opioid Prescribing Guidelines for Pain
In November of 2022, the CDC released updated guidelines for clinicians prescribing opioids for adults experiencing either acute or chronic pain.
The clinical practice guidelines included 12 recommendations for clinicians who are prescribing opioids. They were grouped into four different categories:
- Determining whether to initiate opioids for pain
- Selecting opioids and determining opioid dosages
- Deciding duration of initial opioid prescription and conducting follow-ups
- Assessing risk and addressing potential harms of opioid use
In summary, the recommendations made by the CDC were as follows:
- Nonopioid therapies are at least as effective as opioids for many common types of acute pain.
- Nonopioid therapies are preferred for subacute and chronic pain.
- When starting opioid therapy, immediate-release opioid medications should be used over extended-release.
- When opioids are started, the lowest effective dose should be prescribed.
- When patients are already established on opioids, the benefits and risks should be weighed out against each other in order to provide the best care for the patient.
- When opioids are needed for acute pain, clinicians should prescribe no greater than needed for the duration of pain severe enough to warrant opioids.
- Clinicians should evaluate treatment within 1-4 weeks of starting opioid therapy for subacute or chronic pain.
- Clinicians should evaluate risks for opioid-related harm and discuss with patient before either starting or periodically during continuation opioid therapy.
- Clinicians should review patient’s history of controlled substance prescriptions using state prescription drug monitoring program (PDMP) to determine if they are receiving dosages or other controlled substances that may put patient at risk for overdose.
- When prescribing opioids, clinicians should consider the benefits and risks of toxicology testing to assess for prescribing medications.
- Precaution should be used when prescribing opioid pain medication and benzodiazepines.
- Clinicians should offer or arrange treatment to treat patients with opioid use disorder.
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Drug Shortages
Drug shortages are inevitable and can happen with any medication. This year pharmacies across the country experienced shortages with common medications such as, amoxicillin and Adderall, but what was not predicted was the shortages for an anti-diabetic medication class, GLP-1 agonists.
Although this class is effective in lowering both glucose levels and HgA1C in those with type-2 diabetes, it has also been effective in weight loss in people with and without diabetes. Because of these findings, many clinicians have been prescribing these medications for the sole purpose of weight loss in obese patients, especially for those at risk of developing diabetes and other chronic conditions.
Specifically, the GLP-1 agonist that has experienced the most shortage is semaglutide, or also called Ozempic (for type 2 diabetes) and Wegovy (for weight loss). Recently a TikTok trend has many people praising Ozempic for their weight loss and even celebrities have been catching on to these effects as well which have exacerbated the shortage of the drugs.
Other GLP-1 agonists such as, Vicotza, Trulicty and Bydureon are also available, but with the recent weight loss trend of the class itself, these medications are either at risk or already experiencing a shortage as well.
Read More:
- Empty pharmacy shelves shine a light on vulnerabilities in US drug supplies
- The TikTok Trend That Triggered a Diabetes Drug Shortage
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