Volume 114, No. 6Top
June 2018 Edition

They Said It...

"We find that sex in exchange for drugs does produce higher rates of syphilis. But that alone does not appear to be enough to explain the higher rates of syphilis among men having sex with men." Dr. Lenore Asbell, medical specialist for the STD Control Program of the Philadelphia Department of Public Health. Her comments appear in an examination of the syphilis epidemic in Philadelphia, in our next issue of the magazine version of Philadelphia Medicine, to be mailed to you soon.

In the News... 
Giving Philadelphia's Leading Killer More Room to Grow A1

Philadelphia City Council is holding hearings on a bill that would end the city regulation that bans new tobacco permits for stores near schools or in areas where there is already a high density of stores selling the product.

A Phila. Dept. of Public Health (PDPH) fact sheet on the issue, says Bill No. 180522 would allow new tobacco retailer permits just where the city doesn't need them - near schools and in areas already saturated with such stores.

The PDPH fact sheet points out that smoking is the leading cause of preventable death in Philadelphia. It kills more than 3,500 residents a year. The fact sheet reports that the city has the highest smoking rate of the 10 largest cities in the country.

PDPH adds that "increased tobacco retailer density is associated with more youth smoking initiation and less success when attempting to quit smoking."

The fact sheet states that the city already has twice as many tobacco retailers per 1,000 population, than Washington, DC, Los Angeles, New York City, San Francisco and Chicago. The fact sheet reports that Philadelphia's low-income neighborhoods have 69 percent more tobacco retailers and 63 percent more tobacco retailers within 500 feet of schools, than the city's higher income neighborhoods.

PDPH urges you to contact your local city council member and tell them to vote down Bill No. 180522.

A Push to End Frivolous Lawsuits at Senior Care Centers A2

The Pa. Coalition for Civil Justice Reform is calling on physicians and other members of the health care community to support House Bill 1037.

The bill would cap punitive damages for long-term care providers without limiting a person's right to sue or be made whole. The Coalition says the bill "simply extends the same protections that Pennsylvania physicians have had since 2002 - nothing more."

The Coalition urges you to contact your local state representative to register your support for H.B. 1037.

PAMED Opposes Bill That Would Require Licensure Program for Office-Based Prescribers of Buprenorphine A3

The Pa. Medical Society (PAMED) says Senate Bill 1054 is an unnecessary and burdensome addition to what is an already highly regulated medication.

The bill would require a $10,000 licensure fee, and it would not allow buprenorphine to be prescribed unless the patient is in an addiction treatment program licensed by the Pa. Dept. of Drug and Alcohol Programs.

Buprenorphine is the prime medication used in Medication Assisted Treatment (MAT) for opioid dependency. MAT uses Food and Drug Administration approved medication in conjunction with counseling and behavioral therapy to treat substance use disorders. PAMED believes Senate Bill 1054 would limit access to this kind of treatment.

Learn More About MAT A4

Prescribers and dispensers who are in the MAT program or preparing to implement the treatment are invited to attend a seminar on MAT, on June 28, from 6 to 9 pm at the PCMS building. You can find complete details on the event in our Calendar of Events, in this newsletter.

To register, you can also go to https://june28mat.eventbrite.com.

And This, too... A5

The Regional Overdose Prevention Coalition will once again host a conference for those responding to the opioid epidemic at the county or regional level. Just about anyone involved in such work - law enforcement, first responders, data analysts, payers, etc., are invited.

Robert Reed, the Pa. Executive Deputy Attorney General for Public Engagement, will give the keynote address.

The conference will be held on Friday, June 15, from 10 am to 2 pm at Montgomery County Community College. You can register at:

You can find more information on the conference by going to our Calendar of Events in this newsletter.

Other Bills PAMED Wants you to Act on... A6

PAMED urges you to...
  • tell your state rep to support House Bill 1293. It would minimize the prior authorization process...
  • ask your local senator to oppose Senate Bills 895 and 896, which would erode the supervisory role of the physician with physician assistants...
  • ask your rep and senator to vote "no" on House Bill 100 and Senate Bill 25. They would allow certified registered nurse practitioners to practice independently in Pa. without the safety net of a physician...
  • oppose Senate Bill 655, which would turn guidelines on opioid prescriptions, into mandates.
A Warning About Another Offshoot of the Drug Epidemic - Synthetic Cannabinoids A7

PDPH has just released a health advisory regarding coagulopathy, associated with synthetic cannabinoids.

There is a national outbreak of coagulopathy associated with synthetic cannabinoids. There have been 202 cases reported in the United States since March of this year. Five of those patients have died.

Clinicians are advised to ask all patients about illicit drug use, especially synthetic cannabinoid use.

There are several CDC links on the issue, including:
We're in the Thick of the Tick Season in Philadelphia A8

PDPH says the city is moving into the height of the season for tickborne infections. Lyme disease is still the most frequently diagnosed tickborne illness, but Philadelphia residents also contract babesiosis, anaplasmosis, ehrlichiosis, and Rocky Mountain spotted fever.

Since 2013, 43 percent of blacklegged ticks collected in the city's parks have tested positive for Lyme disease. Patients with rash of flu-like sypmptoms, including fever, fatigue and lymphadenopathy, should be evaluated for tickborne disease symptoms and diagnostic testing.

PDPH is offering an onsite presentation entitled, Overview of Tickborne Diseases in Philadelphia.

Other resources include:
Pa. Medical Marijuana Advisory Board Recommends Allowing Dry Leaf Marijuana A9

The Board's final report issued 21 recommendations. One of them called for medical marijuana to be dispensed in dry leaf or plant form, but to be administered only by vaporization. Smoking would still be prohibited.

It also recommended that patients under the age of 18 be certified by a practitioner who is a Board Eligible/Certified in Pediatrics or Pediatric Specialties. The Board is concerned about the effects marijuana could have on a developing brain. The Board pointed out that unlike most medications in clinical use, cannabis does "not have the benefit of years of investigation. Therefore, great caution will be needed when treating children with cannabis products."

You can read the complete report, including all of the Board's recommendations, on the Pennsylvania Medical Marijuana Program web page.

PCMS Membership Closing in on 6,000 A10

PCMS membership is climbing. As of June 1, there were 5,920 members, an increase of 406 members from May 1.

The increase includes 48 full active members. 347 residents and 11 students.

Calendar of EventsCalendar

8 - Philadelphia's 2nd Annual Conference on Hoarding Intervention

Date: Friday, June 8
Time: 8:00 AM - 4:30 PM
Place: Community Behavioral Health, 801 Market Street, 11th Floor, Philadelphia, PA 19107

Join the Philadelphia Hoarding Task Force for a variety of local and national experts on Hoarding Disorder and related issues.

15 - Regional Overdose Prevention Coalition

Date: Friday, June 15
Time: 10:00 AM - 2:00 PM
Place: Montgomery County Community College (Central Campus), 340 DeKalb Pike, Blue Bell PA 19422

The Regional Overdose Prevention Coalition is holding its next meeting, where the topics of opioid addiction treatment and the justice system will be discussed.

16 - President's Installation and Awards Night

Date: Saturday, June 16
Reception: 6:00 PM
Dinner: 7:00 PM
Place: The Philadelphia Country Club, 1601 Spring Mill Road, Gladwyne, PA 19035

Celebrating the Inauguration of Max E. Mercado, MD, as the 157th President of The Philadelphia County Medical Society.

28 - Implementing Medication Assisted Treatment (MAT): Compliance with SAMHSA and DEA Guidelines

Date: Thursday, June 28
Time: 6:00 PM - 9:00 PM
Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130

The Philadelphia County Medical Society, The Health Federation of Philadelphia and Prevention Point Philadelphia are presenting this free educational program for prescribers and dispensers who are currently providing or preparing to implement medication assisted treatment (MAT).

Philadelphia County Medical Society | stat@philamedsoc.org
215-563-5343 | http://philamedsoc.org