Saturday, August 21, 2021

Time to retire Black from the Boxed Warning

While some would say this is innocent terminology and has no negative connotation; why should we make ourselves aware of this phrasing and possible negative associations? I realize that many will brush this off as some libtard complaining about political correctness and fear of insulting others. After all there was the BLACK DEATH to describe bubonic plague. Are we now going to ask to rewrite history to remove the term BLACK? What is the root why we associate BLACK with more severe, harmful or disastrous outcomes?  Why is this important?  

The cautionary labeling by the FDA never was called a Black Box warning however is taught in nearly every medical and pharmacy school as being called that. The term is thrown around in usual discussion in many treatment teams to convey potential risk of harm. However it is simply a Boxed Warning (per FDA) and while the ink used in printing the package insert is typically if not always black, that is true for all sections of the insert. Do we really need to say Black to convey more serious risk, harm, or disastrous outcome? If so, why?  

The only reason I can think for a historical association of black with danger is related to dangers of the night. Throughout history of humanity it is likely that dangers exist at nighttime due to reduced vision, predictors, criminal activity as well as imagined fears and unknowns. While this is likely the root of black being associated with fear of harm, i don't think black is the most appropriate descriptor of the night time dangers either. Surely over more recent history especially in the United States fear of black is tied to white people being fearful of black individuals, which is well documented and was widely propagated throughout the South and others areas after slavery was abolished. The criminalization of being black soon became the norm in our countries unspoken and embarrassing past. As noted in social events last summer, may still be imbedded into the culture of many law enforcement agencies.  

Thus being at this cross-road in social justice, I would advocate to all clinicians to drop the BLACK from the boxed warning. Do you really need to say BLACK to make your point when describing the risk?  If so why?   

Sunday, December 17, 2017

December 2017 - Residency and Wenstrup

It is a busy year once again and the period between ASHP Mid-year and Christmas seems to pass in a blink of the eye. In trying to keep balance between parental responsibilities, occupational demands, social expectations, spousal relationship development and still get in a showing of the new Star Wars movie, there is little time for anything else.  However wanted to put a quick update here that the 2018-19 PGY2 Residency page has been updated with links to the program brochure and deadline. Unfortunately, there are a couple places on the web that list old application deadline dates. The deadline for Phorcas applications is January 13th, 2018 (as listed in Phorcas). Since that is a Saturday, applications may not be reviewed until the following Monday, however must still be submitted by the 6:59 pm EST deadline to be reviewed.

In other news, yesterday presented the opportunity to have met Congressman and US Army Colonel Brand Wenstrup. The Cincinnati native, gave an engaging speech presenting a narrative of his experience this past June in Alexandria, Va where House Majority Steve Scalise was shot during the Congressional baseball practice. Wenstrup who was a combat surgeon in Iraq, was able to come to the aid of Scalise and apply a life-saving tourniquet to his gunshot wound prior to being treated at local hospital. Beyond this instant of heroism,Wenstrup has a track record of doing the right thing and demonstrating good will towards others. Thus, I was elated to have been able to meet and shake hands after the formalities of the event we were attending.

There was even a brief moment to discuss one of pieces of legislature that Wenstrup is sponsoring that directly effects psychiatric pharmacy. In the House of Representatives, Wenstup currently serves on the Committee on Veterans' Affairs where he is the Chairman on the Subcommittee on Health. Mr. Wenstrup introduced H.R. 1662 in May 2017.  This Bill proposes to bring the VA to the same standard as other modern medical campuses and all other federal building by 100% eliminating tobacco from all VA campuses.  Currently, VA's are locked into an old public health rule that requires they provide a designated smoking shelter on all federally owned campuses. While the older legislature prevents tobacco use within VA hospitals, it also prevents modernization to be 100% tobacco free like most non-VA medical centers have now adopted. The repeal of the 1992 Veterans Health Care Act (Staggers Amendment), which mandates allowing use of tobacco on VA campuses in designated areas, is a long overdue initiative.

Psychiatric pharmacists working at VA's should prepare to discuss the details and rational with veterans whom they have contact. There likely will be many concerns and questions regarding the new rules. Additionally, psychiatric pharmacists should be prepared to offer tobacco treatment as tobacco use can often be a deeply personal and emotional struggle. Tobacco use kills more than 400,000 Americans each year (equivalent to 2 jumbo jets per day worth of fatalities) . Psychiatric pharmacists are positioned in a unique way to be leaders in addressing both pharmacological and cognitive-behavioral aspects of treatment.

Mr. Wenstrup reports he expects the Bill to move forward sometime in early 2018. With the current political climate and initiatives overshadowing the importance of this Bill, I hope it will indeed make headway early next year. If you have time and also believe this legislature is important, please write your representatives encouraging them to take action on this Bill quickly.