Many more Americans may be getting opioids for their pets, and veterinarians appear to be prescribing increasingly potent versions of these drugs to animals, a small study suggests. 

The researchers examined data on opioid tablets and patches dispensed or prescribed by 134 veterinarians at an academic small-animal hospital in Philadelphia from 2007 to 2017. Over the decade, the amount of opioids used for creatures like rabbits, birds and reptiles surged 41 percent even though visits to the hospital increased by only 13 percent. 

“We have no way of knowing if any of these prescriptions were obtained by pet owners for themselves, and most were likely not,” said senior study author Dr. Jeanmarie Perrone, a toxicologist with the emergency medicine department at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. 

“However, the risk to humans is that leftover opioid prescriptions to animals end up in the same medicine cabinets as leftover opioids for people, leading to opportunities for misuse by teenagers or unintentional exposures in children that can be lethal,” Perrone said by email. 

The study included 366,468 pet visits to the animal hospital. During these visits, veterinarians prescribed a total of 105.2 million tablets of tramadol, more than 97,000 tablets of hydrocodone, almost 39,000 tablets of codeine and 3,153 fentanyl patches. 

Most were for dogs

Dogs got the most drugs, accounting for 73 percent of these prescriptions, followed by cats at 22.5 percent and exotic animals at 4.5 percent. 

A major factor contributing to the growing opioid crisis in the U.S. is the increasing availability of these drugs, which addicts often get from friends or relatives when they aren’t able to obtain a prescription, researchers note in JAMA Network Open. 

Although medical and dental health providers are the biggest source of these opioids, the current study suggests that veterinary prescriptions may also be part of the problem, they write. 

Veterinarians and animal hospitals can be registered with the U.S. Drug Enforcement Administration, and in many states vets can prescribe, stock and dispense opioids without the same reporting requirements that are in place at many retail outlets. 

Only 20 states require veterinarians to report opioid prescribing as medical doctors do to a registry designed to limit misuse, the study authors note. 

Pennsylvania is one of many states without reporting requirements, and results from the study may reflect what happens in other states that lack registries to help curb abuse, Perrone said. 

It’s not clear if the increase in prescriptions in Pennsylvania might be due to an increased push to better manage pain for animals and pets, said Dr. Lee Newman, a researcher at the Colorado School of Public Health in Aurora, or if it is due to the growing number of people with substance abuse problems trying to get medications from veterinarians, or both. 

Switch surmised

“It’s speculation on my part, but it could be that when a human patient stops getting opioid prescriptions from their doctor that they next turn to the veterinarian to try to get drugs,” Newman, who wasn’t involved in the study, said by email. 

While the study suggests that opioid prescribing from veterinarians represents only a small fraction of the overall opioid prescribing in the country, it also suggests that veterinary practices may be an overlooked part of the problem, said Kirk Evoy, an assistant professor in both the College of Pharmacy at the University of Texas at Austin, and at the School of Medicine at the University of Texas Health Science Center at San Antonio.

“This study brings to light that this is yet another potential source of access to opioids that many clinicians and policymakers may not be thinking about in their efforts to curtail the country’s opioid abuse epidemic,” Evoy, who wasn’t 

involved in the study, said by email. 

“Furthermore, while human opioid prescribing has begun to level off in recent years in response to the opioid epidemic, this data seems to indicate that, at least in the specific hospital being studied, prescribing of opioids for animals has continued to climb,” Evoy said. 
…

Many more Americans may be getting opioids for their pets, and veterinarians appear to be prescribing increasingly potent versions of these drugs to animals, a small study suggests. 

The researchers examined data on opioid tablets and patches dispensed or prescribed by 134 veterinarians at an academic small-animal hospital in Philadelphia from 2007 to 2017. Over the decade, the amount of opioids used for creatures like rabbits, birds and reptiles surged 41 percent even though visits to the hospital increased by only 13 percent. 

“We have no way of knowing if any of these prescriptions were obtained by pet owners for themselves, and most were likely not,” said senior study author Dr. Jeanmarie Perrone, a toxicologist with the emergency medicine department at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. 

“However, the risk to humans is that leftover opioid prescriptions to animals end up in the same medicine cabinets as leftover opioids for people, leading to opportunities for misuse by teenagers or unintentional exposures in children that can be lethal,” Perrone said by email. 

The study included 366,468 pet visits to the animal hospital. During these visits, veterinarians prescribed a total of 105.2 million tablets of tramadol, more than 97,000 tablets of hydrocodone, almost 39,000 tablets of codeine and 3,153 fentanyl patches. 

Most were for dogs

Dogs got the most drugs, accounting for 73 percent of these prescriptions, followed by cats at 22.5 percent and exotic animals at 4.5 percent. 

A major factor contributing to the growing opioid crisis in the U.S. is the increasing availability of these drugs, which addicts often get from friends or relatives when they aren’t able to obtain a prescription, researchers note in JAMA Network Open. 

Although medical and dental health providers are the biggest source of these opioids, the current study suggests that veterinary prescriptions may also be part of the problem, they write. 

Veterinarians and animal hospitals can be registered with the U.S. Drug Enforcement Administration, and in many states vets can prescribe, stock and dispense opioids without the same reporting requirements that are in place at many retail outlets. 

Only 20 states require veterinarians to report opioid prescribing as medical doctors do to a registry designed to limit misuse, the study authors note. 

Pennsylvania is one of many states without reporting requirements, and results from the study may reflect what happens in other states that lack registries to help curb abuse, Perrone said. 

It’s not clear if the increase in prescriptions in Pennsylvania might be due to an increased push to better manage pain for animals and pets, said Dr. Lee Newman, a researcher at the Colorado School of Public Health in Aurora, or if it is due to the growing number of people with substance abuse problems trying to get medications from veterinarians, or both. 

Switch surmised

“It’s speculation on my part, but it could be that when a human patient stops getting opioid prescriptions from their doctor that they next turn to the veterinarian to try to get drugs,” Newman, who wasn’t involved in the study, said by email. 

While the study suggests that opioid prescribing from veterinarians represents only a small fraction of the overall opioid prescribing in the country, it also suggests that veterinary practices may be an overlooked part of the problem, said Kirk Evoy, an assistant professor in both the College of Pharmacy at the University of Texas at Austin, and at the School of Medicine at the University of Texas Health Science Center at San Antonio.

“This study brings to light that this is yet another potential source of access to opioids that many clinicians and policymakers may not be thinking about in their efforts to curtail the country’s opioid abuse epidemic,” Evoy, who wasn’t 

involved in the study, said by email. 

“Furthermore, while human opioid prescribing has begun to level off in recent years in response to the opioid epidemic, this data seems to indicate that, at least in the specific hospital being studied, prescribing of opioids for animals has continued to climb,” Evoy said. 
…

Lawmakers in the U.S. Northwestern state of Washington, which is battling a measles outbreak, are considering a bill that would prohibit parents from claiming a personal or philosophical exemption to their children receiving vaccinations.

Hundreds of people opposed to the bill lined up early Friday to attend a hearing in Olympia, the state capital, where lawmakers heard testimony from both supporters and opponents of the proposed bill.

The measure came after health officials reported at least 52 known cases of the measles in the state and four cases in the neighboring state of Oregon.

Current law

Washington state law requires children to be vaccinated for nearly a dozen diseases, including measles, before they can attend schools or child care centers. However, exemptions are allowed for parents based on personal beliefs, including medical, religious and philosophical views.

The proposed bill would eliminate that personal exemption, meaning all children would have to be vaccinated for a range of diseases before enrolling in schools or child care facilities.

The bill has the support of the state medical association as well as Washington Gov. Jay Inslee, who declared a state of emergency last month because of the measles outbreak. 

Opponents testifying against the bill Friday included environmental activist Robert F. Kennedy Jr., who has questioned vaccine safety standards.

The Associated Press cited state Department of Health records that showed 4 percent of Washington secondary school students had nonmedical vaccine exemptions. The records showed that 3.7 percent of those exemptions were personal, while the remainder were religious exemptions.

Arguments for, against

Proponents of eliminating the personal exemption argue that schools must be safe and protect vulnerable children. Opponents of the eliminating the exemption argue that the vaccines come with a medical risk and that therefore people must have a choice about whether to use them. 

Both California and Vermont have removed personal belief vaccine exemptions for schoolchildren.  
…

Lawmakers in the U.S. Northwestern state of Washington, which is battling a measles outbreak, are considering a bill that would prohibit parents from claiming a personal or philosophical exemption to their children receiving vaccinations.

Hundreds of people opposed to the bill lined up early Friday to attend a hearing in Olympia, the state capital, where lawmakers heard testimony from both supporters and opponents of the proposed bill.

The measure came after health officials reported at least 52 known cases of the measles in the state and four cases in the neighboring state of Oregon.

Current law

Washington state law requires children to be vaccinated for nearly a dozen diseases, including measles, before they can attend schools or child care centers. However, exemptions are allowed for parents based on personal beliefs, including medical, religious and philosophical views.

The proposed bill would eliminate that personal exemption, meaning all children would have to be vaccinated for a range of diseases before enrolling in schools or child care facilities.

The bill has the support of the state medical association as well as Washington Gov. Jay Inslee, who declared a state of emergency last month because of the measles outbreak. 

Opponents testifying against the bill Friday included environmental activist Robert F. Kennedy Jr., who has questioned vaccine safety standards.

The Associated Press cited state Department of Health records that showed 4 percent of Washington secondary school students had nonmedical vaccine exemptions. The records showed that 3.7 percent of those exemptions were personal, while the remainder were religious exemptions.

Arguments for, against

Proponents of eliminating the personal exemption argue that schools must be safe and protect vulnerable children. Opponents of the eliminating the exemption argue that the vaccines come with a medical risk and that therefore people must have a choice about whether to use them. 

Both California and Vermont have removed personal belief vaccine exemptions for schoolchildren.  
…

In 2001, the government of Nigeria, along with all African Union countries, pledged to spend 15 percent of its annual budget on health care. But the country has never come close to reaching that goal.

The result is that up to 70 percent of medical spending in Nigeria is out of pocket, forcing many with sudden health problems into debt or poverty.

Ajayi Taiwo is one of those people. Taiwo was involved in a car accident a year ago that injured his right leg and pelvis three weeks before his wedding.

Today, he’s still recovering.

“I actually spent like two … close to two months in the hospital and all the resources we had gathered together for the wedding to make it good actually went into hospital bills,” he said.

Discounts promised, not granted

The government hospital where Taiwo was taken would not grant him discounts promised under Nigeria’s national health care plan.

So he had to sell his car and other valuables to pay for care.

“Imagine — I went to a government hospital and I was paying heavily as if I was in a private hospital,” he said.

​Health care pledge

The 2001 health care pledge made by Nigeria and its fellow African Union countries is called the Abuja Declaration.

But 18 years later, Nigeria’s highest-ever budget share for health care was just 7 percent. Last year, it dropped to less than 4 percent.

The impact is that 70 percent of hospital spending in Nigeria is out-of-pocket, which pushes Nigerians like Taiwo into debt or poverty.

“Having to pay out of pocket is a huge, devastating effect on any family,” said Elijah Miner, a consultant surgeon. “I mean you’ve got to look out for food first for the family, school fees, and other things, just basic things to live and that’s why you find out that a lot of people that end up in the hospital come only when it is late simply because they don’t have the funds.”

Out-of-pocket costs

Nneka Orji is a financial officer in Nigeria’s Ministry of Health. She said the government is partnering with international and private affiliates to make health care more affordable.

“Our out-of-pocket expenditure was estimated at over 70 percent and even the estimate we have for 2017 is even higher,” she said. “So our goal is to use this strategy from the basket funding and making sure with basic minimum package of care to reduce the out-of-pocket expenditure.”

But until Nigeria dramatically increases its health care budget, patients like Taiwo likely face a struggle to stay physically and financially healthy.
…

The World Health Organization reports it is scaling up efforts to try to control an outbreak of Lassa fever, which is escalating at a rapid pace.  

Lassa fever is an acute viral hemorrhagic illness that occurs after human exposure to the urine or feces of infected Mastomys rats. It is also transmitted person to person. About 80 percent of those infected show no symptoms. The disease can be effectively treated in its early stages with the antiviral drug Ribavirin.

West Africa is in the midst of a seasonal outbreak, which usually flares between December and March. The disease is endemic in the region so, the current outbreak was expected. But, WHO spokesman Tarek Jasarevic says what is alarming is the scale and speed with which the disease is spreading.

“Right now, since the beginning of the outbreak until now, we already have one-third of the number of cases that we had last year,” said Jasarevic. “And already last year was the biggest Lassa fever outbreak. So, basically, we are seeing more cases than usual.” 

Nigeria declared an outbreak on January 22.  The disease so far has affected 16 states. The Nigeria Center for Disease Control confirms 213 cases, including 42 deaths in what is seen as the largest outbreak in West Africa.  

While Nigeria is the source of the most anxiety, WHO reports a total of 12 cases, including two deaths have been confirmed in Benin, Guinea, Liberia and Togo, with more suspected cases being investigated.

Jasarevic says the Lassa fever season is expected to last another four months. He tells VOA it is crucial that communities take certain preventive hygienic measures.

“For example, to store grain and other food in rodent-proof containers, disposing of garbage far from their home, maintaining clean households and keeping cats,” said Jasarevic. “Because this particular type of rat is abundant in endemic areas, it is not really possible to completely eliminate them from the environment.” 

Jasarevic says the WHO is intensifying its technical assistance, enhancing surveillance, and mobilizing experts to the region to support case management and infection prevention and control. He says the agency is also supporting prevention and readiness activities in six other countries at risk of outbreaks.

 
…

Rainwater is essential for life.

It helps plants and food crops flourish, and it keeps grasslands green and lush.

But too much of it, especially in the city, can lead to flooding, causing sewers to overflow and carry pollutants and contaminants to nearby streams and waterways.

To combat the problem in urban areas of the country, a growing number of cities across the U.S. are initiating programs like rooftop gardens.

​A labor of love

To help with that initiative in the nation’s capital, a team at the University of the District of Columbia has created a rooftop garden on campus with a wide variety of vegetation to help absorb excess rainwater and grow food at the same time.

Architect David Bell, who designed five “green roofs” on the campus, says he’s excited about the project because “it meant doing something more than just dealing with storm water management.”

“It took advantage of a resource above the city that you see all over where you have these flat roofs that aren’t doing anything and really made it into something that was about urban agriculture,” he said.

Rainwater is distributed through an irrigation system and collected in cisterns for the rooftop garden. It is also used in other parts of the campus.

The result is a picturesque sea of green vegetation and patches of brightly colored plants and flowers that attract pollinating insects and other wild creatures.

​Urban agriculture

“In an urban environment, you don’t have that many spaces to choose from, and so rooftops are just unutilized space,” said Caitlin Arlotta, a graduate student in the school’s Urban Agriculture program. “So it’s a really good way to not have to restructure your city necessarily and be able to incorporate green roofs.”

The project, she points out, is part of a research initiative to see which plants are best suited for rooftop environments, both for food as well as pollination. They include hibiscus, strawberries, tomatoes and sweet potatoes.

“We have the same experiment running with tomatoes as we do with strawberries, so we’re doing variety trials and we’re trying to see which variety grows the best in a green roof setting,” she said.

A community affair

She pointed out that plants grow in a variety of different systems on campus, not just on the rooftop.

“We have a hydroponic experiment, aquaponics experiment, we have a couple of bucket experiments going on with partner rooftops, and then we also have our own farm experiments,” Arlotta said. “Within each of those growing systems, we want to be able to tell people which varieties of these crops grow the best.”

A main goal of the program she explained, is to have “food justice.”

“So bringing fresh food into cities where you wouldn’t necessarily have that access,” she said.

And that includes produce for immigrant members of the community as well.

“In the U.S., it may not seem very common to use hibiscus leaves and sweet potato leaves as food, but in many places around the world it is,” Arlotta said.

An excess of riches

Sandy Farber Bandier coordinates UDC’s Master Gardener program, which seeks to “enhance the ecological health and aesthetics of urban environments by training District of Columbia residents to become Master Gardeners.”

She says she’s been surprised by the garden’s bountiful harvest.

“We produced 4,250 pounds (about 1,928 kilos) of produce the first year and were able to disseminate that to people in need,” she said.

Grateful recipients included a number of area food banks and charities.

Spreading the wealth

Another benefit, Bandier says, was being able to show D.C. residents and people beyond the nation’s capital what — and how — food can be grown on a rooftop.

“It’s a wonderful feeling,” she said. “This is the future for food. What we have established here at this college is the food hub concept: you grow it here, you prepare it in a commercial kitchen, you distribute through farmers markets, food trucks, and then you recycle, you recycle, you compost.”

While D.C. is home to one of the largest numbers of green roofs in the country, not all of them are designed to grow food. Architect David Bell hopes that over time, that will change.

“I’d like to see this becoming more of the standard, where people design and build buildings with farming on the roof, with the ability to actually go up there and enjoy it and have a better connection to nature, but also to provide better fresh food to people in urban areas,” he said.
…

The National Institutes of Health is investigating whether a dozen researchers there failed to report taking funding from foreign governments, specifically China.

Last August, NIH sent a letter to more than 10,000 research institutions urging them to ensure that NIH grantees are properly reporting their foreign ties. The agency also said it is investigating about a half-dozen cases in which NIH-funded investigators may have broken reporting rules, and it reminded researchers who review grant applications that they should not share proposal information with outsiders.

NIH is also getting pressure from Congress.

Sen. Charles Grassley, a Republican from Iowa, last month requested the NIH Inspector General’s office investigate “threats posed by foreign actors seeking to steal U.S. intellectual property by exploiting U.S. research institutions and the vetting processes in place regarding researchers and public grants [supported] by taxpayer-funded research.”

“The threats to our academic institutions from foreign governments are well known,” Grassley wrote. “Our government must take all reasonable and necessary steps to protect the integrity of taxpayer-funded research.” 

Grassley inquired about the background checks of the researchers conducted by the FBI, as well, asking if “federal law enforcement has taken to educate various government agencies and institutions of higher learning about the threat and a history of investigatory and prosecutorial steps taken by the department in the last five years.”

The senator pointed to testimony in December 2018 from Justice Department witness John Demers, who testified that some “researchers in labs, universities, and the defense industrial base … may have undisclosed ties to Chinese institutions and conflicted loyalties.” 

​In February 2018, FBI Director Christopher Wray testified before the Senate Select Committee on Intelligence about worldwide threats that the Chinese are “exploiting” and “taking advantage” of our academic institutions. 

The same month, Florida Republican Sen. Marco Rubio wrote to four Florida universities imploring them to sever their relationship with “Confucius Institutes,” or language and cultural programs sponsored by the Chinese government, and in the past few years, accused of spreading Chinese propaganda.

“There is mounting concern about the Chinese government’s increasingly aggressive attempts to use Confucius Institutes … to influence foreign academic institutions, and critical analysis of China’s past history and present policies,” Rubio wrote.

​Several educational institutions have severed ties with “Confucius Institutes” in their countries, including France, Japan, Germany, Canada and Australia. In 2014, the American Association of University Professors (AAUP) published a statement titled “Confucius Institutes Threaten Academic Freedom.”

“Confucius Institutes function as an arm of the Chinese state and are allowed to ignore academic freedom,” AAUP wrote.

Grassley’s correspondence cited recent convictions of Chinese nationals who have stolen research from American universities. 

“In simple terms, it’s called cheating,” Grassley wrote. “And it’s only getting worse.”
…

Measles is spreading in the U.S. As of Feb. 5, there were 50 cases in Washington state and five in Houston. New cases are being added daily. Health officials, including the U.S. surgeon general, are urging parents to get their children vaccinated.

Measles was eliminated in the U.S. 19 years ago. The cases that occur here now are imported from other countries. But that is happening in the U.S. with greater frequency. Dr. Camille Sabella is a pediatric infectious disease specialist at the Cleveland Clinic.

“Measles is incredibly contagious,”he said. “Once it gets around the community it’s very difficult because it’s airborne.”

18 state allow exemptions

Eighteen states allow parents to not vaccinate their children if they have moral, personal or philosophical objections to it.

A measles outbreak in the U.S. northwestern state of Washington has state health officials scrambling to contain it. Dr. Jason Hanley sees emergency cases at the medical center, PeaceHealth.

“I hope I’m wrong, but I think the cases are going to get more frequent and spread throughout the country from this epicenter,” he said.

Rural areas in the U.S. tend to be have higher numbers of unvaccinated children. But there are significant numbers in cities such as Houston, Austin and Seattle, where immunization rates are lower than in other U.S. cities.

Houston just reported two new cases of measles in children younger than 2, bringing the total to five as of Feb. 6.

Doctors, including U.S. Surgeon General Jerome Adams, are urging parents to get their children vaccinated.

“As United States Surgeon General, I want everyone to know that the best protection is getting vaccinated,” he said.

The measles vaccine is almost 100 percent effective. Doctors recommend that children get two doses.

“With one dose of vaccine, about 95 percent of children will become protected against measles. The reason that we give a second dose is because about 5 percent of children do not respond to the first dose. So with two doses over 99 percent of children are protected against measles.”

Measles can be fatal

Measles makes people very sick, and it is especially dangerous for young children. At Children’s National Medical Center, Dr. Roberta DeBiasi works as an infectious disease specialist.

“One-third of those cases will end up hospitalized, and that may be due to a variety of complications,” she said.

Complications such as pneumonia or encephalitis, a swelling of the brain, can be fatal or lead to permanent disability.

That’s why doctors urge parents to get their children vaccinated.
…