Maine Medicine Weekly Update - 05/07/2018  (Plain Text Version)

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In this issue:
•  MMA Listening Session in Presque Isle on Tuesday, May 15 6-8pm
•  Jeffrey Barkin, MD, DFAPA Receives MAPP Lifetime Achievement Award
•  Update Will Change Buprenorphine MME Display in Most State PMPs
•  New Scrutiny for an Old Drug
•  New Interactive Online Course Ups Physicians’ Nutrition Knowledge, Supports Patients in Diabetes Prevention
•  Consumer and Healthcare Groups File Suit for Medicaid Expansion Implementation
•  Maine Physicians Participate in Regional State Medical Society Meeting in Connecticut Last Weekend
•  APM Set Forth for Opioid-use Disorder Treatment
•  The Honorable George J. Mitchell to Keynote MMA's 165th Annual Session
•  Legislative Report: Is This a Wrap-up?
•  Introduction to LEAN in Healthcare: Full-Day Workshop on Tuesday, May 8
•  MaineHealth MORE Conference - Managing the Opioid Response Effort - May 17th
•  Maine Chapter, American College of Surgeons Annual Meeting in Kennebunkport, ME - May 18-20
•  Monday, May 21 in Brewer: Next Steps in Addressing Maine's Opioid Crisis
•  Inspiring Hope: How to Support Recovery Ready Communities - May 24 Conference
•  One River, One Ocean: June 2-14, 2018
•  MCMI Training Programs - Level 1 and Level 2 - June 22
•  New Free CME on Alzheimer's Risk, Detection, and Management
•  Peer Navigation Program from Facing Our Risk of Cancer Empowered (FORCE)
•  Online Learning Opportunities Offering CME Credits - from the Northern New England Practice Transformation Network
•  Northern New England Society of Addiction Medicine 2018 Annual Conference & Meeting - Nov 2-3
•  Internal Medicine Outpatient Physician Opportunity
•  Ob/Gyn Physician Opportunity
•  Outpatient Internal Medicine Physician – Bangor, Maine
•  Family Practice Physician - Bucksport Regional Health Center
•  Relocate to Beautiful Southwestern Maine - Medical Director/Family Practice Physician
•  Psychiatry Faculty, Division of Child & Adolescent Psychiatry
•  Psychiatric Medical Director
•  Maine's Largest FQHC in need of Physician for Geriatric Program
•  Multiple Family Med Opportunities in Beloved Community Health Centers
•  Outpatient Only - Internal Medicine with Loan Repayment & Sign-on Bonus
•  Internal Medicine Outpatient Physician
•  Clinical Cardiology Opportunity
•  Opportunities at the VA for Volunteer Physicians


New Scrutiny for an Old Drug

With a significant drop in opioid prescriptions (32% in Maine from 2013-2017), doctors and other prescribers are looking for other ways to treat pain…and people are finding new ways to get high. That means the government gets involved.


The latest drug to come under FDA scrutiny is the generic gabapentin, the 9th most prescribed medication in the US. Commissioner Scott Gottlieb has stated, “I don’t want to be sitting here 5 or 10 years from now lamenting that we didn’t take more aggressive action.” Many physicians are not aware that people are using gabapentin, often mixed with opioids and other substances, to achieve a modified mental status. The AP reports that, according to medical journal articles, 15 to 25% of opioid users also use gabapentin. While it is not considered addictive, it has featured in a rising number of overdoses.

Some states are adding gabapentin to their tracking databases, and Kentucky has classified it as a “scheduled substance.” It appears that increased prescribing levels originated at a time when the drug’s original manufacturer began aggressive marketing. In 2004 the company, Warner-Lambert, pleaded guilty to charges of promoting gabapentin for a wide range of uses not approved by the FDA and paid over $430 million in settlement of the charges. Warner-Lambert was purchased by Pfizer in 2000.