Steroid alternatives can be dangerous | Tricare prior-authorization waiver period ends; GAO issues report | VA, DHA officials brainstorm solutions to opioid crisis
April 18, 2018
AMSUS SmartBrief
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Steroid alternatives can be dangerous
Steroid alternatives known as SARMs, or selective androgen receptor modulators, were developed for people with age-related muscle loss, but the drugs, which were never approved by the FDA, are gaining popularity among elite athletes and soldiers. The FDA warns that SARMs might cause heart attack, stroke and liver damage, and a recent study found many drugs marketed as SARMs contain unapproved drugs and other hormones.
The New York Times (tiered subscription model) (4/12) 
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Military Health System
Tricare prior-authorization waiver period ends; GAO issues report
April 15 marked the end of a temporary waiver period that eased rules for Tricare Prime enrollees in the West seeking specialty care, but waivers ordered before that date are valid through June 15. Separately, a Government Accountability Office report said the Defense Health Agency has not fully developed an implementation plan for the new Tricare Select system.
Military online (4/16) 
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Veterans Health Administration
VA, DHA officials brainstorm solutions to opioid crisis
Leaders from the Defense Health Agency, the VA and Fort Bragg met with elected officials and civilian health care providers to share best practices and discuss possible solutions to opioid misuse and addiction. Opioid prescribing has fallen within the VA health care system as providers prescribe more alternative pain treatments, but Dr. Padma Gulur of Duke Health said civilian health insurance policies and shortfalls in prescriber education hamper civilian efforts to reduce opioid prescriptions.
The Fayetteville Observer (N.C.) (4/14) 
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National Health Care
USPSTF: Seniors should rely on exercise, not vitamin D, to cut risk of falls
USPSTF: Seniors should rely on exercise, not vitamin D, to cut risk of falls
(Christopher Furlong/Getty Images)
The US Preventive Services Task Force updated guidance issued in 2012 to recommend against use of vitamin D supplements by community-dwelling adults over age 65 to prevent falls. The report in the Journal of the American Medical Association said while there is insufficient evidence to support the use of vitamin D supplements, evidence clearly supports exercise to reduce the risk of falls.
HealthDay News (4/17) 
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Pain Management and Opioid Safety in the MHS
The MHS Stepped Care Model seeks to provide patients with the most effective pain management guided by CPGs while avoiding chronic pain, reducing opioid use, and minimizing complications for the minority of patients requiring opioids. Click for details on this May 4th event at USO Ft. Belvoir.
Health and Medical Research
Stem cell therapy to be tested in patients with severe head trauma in Houston
Surgeons at Memorial Hermann Hospital in Houston have developed an experimental therapy for severe brain trauma using infusions of autologous bone marrow cells. The therapy is being studied in a Phase II clinical trial.
STAT (tiered subscription model) (4/13) 
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Study: Stopping opioids may not lead to more pain
Study: Stopping opioids may not lead to more pain
(John Moore/Getty Images)
Researchers who followed 600 veterans found those who cut back on opioid medications or switched to a non-opioid drug or therapy still had pain at levels comparable to when they relied mostly on opioids, according to a study presented at the Society of Behavioral Medicine conference. Researchers said the data show pain may not increase for patients who stop taking opioid drugs.
The Oregonian (Portland) (4/11) 
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Other News
Two AMSUS upcoming events -- similar topic, different delivery and purpose
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AMSUS merchandise
Browse our selection of AMSUS merchandise including pins, medals, ribbon and the 125th Anniversary Coin. There is a limited quantity of coins -- once sold out, they will not be re-ordered.
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If you reject the food, ignore the customs, fear the religion and avoid the people, you might better stay home.
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