Feb. 13, 2025 – In the new documentary Sly Lives! (aka the Burden of Black Genius), which hits Hulu on Feb. 13, the legendary musician’s daughter Phunne Stone recalls a moment from her childhood in which she once snorted chalk in an attempt to mimic her dad. “I think that my dad is really actually shy, and I think drugs helped him be fearless,” she says. “My mom loved him more than any man. She never dated another man after my dad. But he wasn’t always around when I lived with my mom.” Phunne was often the only child around, and she says she lived “in an adult world, to where I thought I was grown.”
One day, while playing house with friends, Stone stopped by, leaving behind a collection of razor blades that he’d used to cut lines of cocaine.
“I went and grabbed me one and my box of chalk. And I said, ‘We gon’ do what the grown folks do.’ So I got my chalk and I chopped up about 37 lines of chalk out there and got the Monopoly money, rolled it up. ‘OK!’” Phunne recalls. “We were out there [snorts] about 19 lines. We sneezing…
Feb. 13, 2025 – Named Recovery Gateway, it consists of 42 single-occupancy homes and four double-occupancy homes for couples, for a total of 46 available units for 50 people. Residents will be welcome to stay up to 24 months, or until they are connected to longer-term recovery housing. Sobriety in homeless shelters and transitional housing is a hot topic, as it is often a barrier to entry in much-need facilities. While some “low barrier” shelters exist — meaning they do not require background or credit checks, income verification, sobriety, or an ID to access services — they often struggle to maintain sustainable funding.
Additionally, according to American Addiction Centers, it can often be more challenging for people who are homeless to stop using substances, because they “may not have easy access to treatment, often have smaller social support networks, may have decreased motivation to quit drugs or alcohol, and may have other, higher priorities, such as finding housing or food.”
Feb. 13, 2025 – In the video below from AXS TV, the legendary Joe Walsh talks to Sammy Hagar about how he stays sober and the secret to longevity in the music business. Then, Sammy interviews Queen guitarist Brian May, Tanya Tucker and Paul Shaffer.
Collection agents for the state of Iowa have sent letters seeking millions of dollars from the estates of at least two people with disabilities who died after spending most of their lives in a state institution.
The amounts represent what Medicaid spent covering the residents’ care when they lived at the Glenwood Resource Center, a state-run facility that closed last summer.
The bills are extraordinary examples of a practice called Medicaid estate recovery. Federal law requires states to try to collect money after some types of Medicaid recipients die. The point is to encourage people to use their own resources before relying on the public program. But some states, including Iowa, are particularly aggressive about the collections, national reports show.
Joy Higgins was stunned by a letter she received a few weeks after her 41-year-old daughter, Kristin, died last May. The letter was written on Iowa Department of Health and Human Services stationery. At the top, in bold letters, it said, “Re: Kristin Higgins.”
“Dear Joy Higgins,” the letter read. “Our sincere condolences to you, as we understand the above person is deceased.”
The letter explained that any money Kristin Higgins left behind would have to be remitted to the state to help repay Medicaid $4,263,148.67. Her family had 30 days to respond.
Joy Higgins, who lives in Council Bluffs, wonders why state debt collectors would send a massive bill to the family of someone like her daughter, who had little income because of a severe developmental disability stemming from a premature birth.
“What are they gaining? That’s my question. Except for kicking someone in the face right after they lost a loved one?” Higgins said.
Kristin Higgins’ only income was a Social Security disability benefit of $1,105 monthly. Most of that went directly to the state institution, where she lived for more than 30 years. Just $50 was set aside monthly as an allowance for personal expenses, according to a state ledger obtained by her family. “They knew exactly how much she had,” her mother said.
When she died, Kristin’s personal account had a balance of $2,239.84. The family put that money toward her funeral, an allowed expense. Nothing was left for the state to take. Higgins said receiving the letter was traumatic even though the family didn’t have to pay the Medicaid bill.
The Higginses have heard about similar attempts to collect from other families, including that of Eric Tomlyn, who died in 2020 at age 29 after spending most of his life at the Glenwood Resource Center.
Shortly after his death, the Tomlyn family received a Medicaid bill of more than $4.2 million. His mother, Susan Tomlyn, was shocked by the letter. “I was like, ‘What? What? Oh my God,’” she recalled.
Shortly after his 2020 death, Eric Tomlyn’s parents, Tim and Susan Tomlyn, received a Medicaid bill for more than $4.2 million. Susan was shocked by the letter. “I was like, ‘What? What? Oh my God,’” she recalled.(Tracy Lovett)
She filled out a form explaining that the small balance in her son’s personal account had gone toward his funeral. “That’s the last I heard of it,” Tomlyn said.
Supporters of estate recovery efforts say the rules encourage people to pay for their own care before applying for Medicaid, which is mainly intended to help those with little money.
Critics of estate recovery programs say they often target families with little to give. Wealthier families tend to have lawyers who can structure estates in ways that avoid Medicaid repayment demands, the critics note.
Like Higgins, Tomlyn thought her Medicaid recovery bill came from state officials because it was printed on letterhead from the Iowa Department of Health and Human Services. The people who signed the letters identified themselves as being from the “Estate Recovery Program.” But the people who produce such letters work for private contractors hired to collect Medicaid debts, according to Alex Murphy, a spokesperson for the state agency. Their contract requires them to use state stationery.
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Murphy said in an email to KFF Health News that such letters are sent after every death of an Iowa Medicaid recipient who was at least 55 years old or who lived in a long-term care facility. He said the letters “request information from family members regarding the deceased person’s assets and expenses,” and the letters note that repayments are expected only from the person’s estate.
Iowa’s Medicaid collections are handled by Sumo Group, a Des Moines company. Its director, Ben Chatman, declined to answer questions, including why the company sent bills to families of people with disabilities who lived most of their lives in state institutions. “I don’t do media relations,” Chatman said.
Sumo Group is a subcontractor of a national company, Gainwell Technologies, which has handled Medicaid collections for several states. In Iowa, the company is paid 11% of whatever it can collect from the estates of Medicaid participants. A spokesperson for Gainwell declined to comment.
Iowa’s Medicaid estate recovery program brought in $40.2 million in the fiscal year that ended last June, up nearly 14% from two years earlier, state records show. That total represents a sliver of the state’s total Medicaid budget, which is expected to hit $9 billion this year.
Nearly two-thirds of Iowa estate recovery cases wound up being closed with no collection of money last fiscal year, according to the state. In cases in which money was recouped, the average amount paid was about $10,000.
Thirty-five Iowa families were granted hardship waivers, which the state allows if an heir’s health or life would be endangered because payment of the Medicaid bill would deprive them of food, clothing, shelter, or medical care. Officials denied an additional 20 requests for hardship waivers.
A 2021 report to Congress estimated states collected more than $700 million annually from Medicaid participants’ estates. That money is shared with the federal government, which helps finance Medicaid. Some states claw back much less than others. Hawaii, for example, collected just $31,000 in 2019, the latest year analyzed in the federal report. Iowa, with about twice as many residents as Hawaii, raked back more than $26 million that year.
Americans aren’t subject to such clawbacks for using any other federal health program, including Medicare, which covers older people of all income levels.
The national group Justice in Aging has helped lead opposition to Medicaid estate recovery programs. Eric Carlson, a California attorney for the group, said the issue usually comes into play after the death of a person who had nursing home care covered by Medicaid. Recovery demands often force survivors to sell homes that are their families’ main form of wealth, he said.
Carlson said he hadn’t previously heard of Medicaid estate recovery bills topping $4 million, like the ones sent to survivors of the two Iowans with disabilities.
He wondered why debt collectors would pursue such cases, which are unlikely to yield any money but could cause anxiety for families. “Of course, if you open up a piece of mail that says you owe millions of dollars, you’re going to think the worst,” he said.
Carlson said he would advise anyone who receives such a letter to respond to it with documentation showing that their loved one’s estate can’t repay a Medicaid debt. “It’s never a good idea to ignore it,” he said. Failure to respond to the bill could lead to continued collection efforts, which could threaten a family member’s finances or property, he said.
Some states have reined in their Medicaid clawback efforts. For example, Massachusetts legislators last year voted to drastically limit their program. This was the second time Massachusetts reduced its Medicaid estate recovery effort, which once was one of the most aggressive in the U.S.
Critics in Congress have also tried to limit the practice.
Rep. Jan Schakowsky (D-Ill.) has twice introduced bills to eliminate the federal requirement that states claw back Medicaid spending from recipients’ estates. Last year’s bill gained 47 Democratic co-sponsors, but it received no support from the Republicans controlling the chamber, and there was no similar bill in the Senate. She plans to try again this year, even though her party remains in the minority.
Schakowsky said in an interview that she’d never heard of Medicaid estate recovery demands reaching millions of dollars, as the Iowa families faced. But demands for hundreds of thousands of dollars are common. For many families, “that’s still impossible” to meet, she said.
Schakowsky hopes that members of Congress from both parties will agree to curtail the program once they realize how much angst it causes their constituents and how relatively little money it returns to the government. “The whole program is ridiculous,” she said.
Her quest could become even tougher if the Trump administration moves ahead with proposals to trim Medicaid spending.
The office of Sen. Chuck Grassley, who is the senior member of Iowa’s all-Republican congressional delegation and has taken leading roles in many health policy debates, declined to comment on the issue.
The Iowa Department of Health and Human Services said it notifies families about the estate recovery process when they apply for Medicaid. Joy Higgins said she doesn’t recall seeing such a notice.
The institution where Kristin Higgins spent most of her life was closed last year after federal officials investigated complaints of poor medical care. But Joy Higgins said her daughter was treated well there overall. “If I had millions in the bank, I’d give it to the state,” she said. “I would. It was worth it.”
Has your family been sent bills for repayment of Medicaid expenses after the death of a loved one who was covered by the program? Click here to tell KFF Health News your story.
This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
McMINNVILLE, Tenn. — Each month, Michelle Shaw went to a pain clinic to get the shots that made her back feel worse — so she could get the pills that made her back feel better.
Shaw, 56, who has been dependent on opioid painkillers since she injured her back in a fall a decade ago, said in both an interview with KFF Health News and in sworn courtroom testimony that the Tennessee clinic would write the prescriptions only if she first agreed to receive three or four “very painful” injections of another medicine along her spine.
The clinic claimed the injections were steroids that would relieve her pain, Shaw said, but with each shot her agony would grow. Shaw said she eventually tried to decline the shots, then the clinic issued an ultimatum: Take the injections or get her painkillers somewhere else.
“I had nowhere else to go at the time,” Shaw testified, according to a federal court transcript. “I was stuck.”
Shaw was among thousands of patients of Pain MD, a multistate pain management company that was once among the nation’s most prolific users of what it referred to as “tendon origin injections,” which normally inject a single dose of steroids to relieve stiff or painful joints. As many doctors were scaling back their use of prescription painkillers due to the opioid crisis, Pain MD paired opioids with monthly injections into patients’ backs, claiming the shots could ease pain and potentially lessen reliance on painkillers, according to federal court documents.
Michelle Shaw, a former patient of Pain MD in Tennessee, testified in federal court that the pain clinics threatened to discharge her as a patient, which would have cut off her painkiller prescriptions and likely sent her into withdrawal, if she did not agree to monthly injections in her back, making her pain worse. Shaw was a key witness in the trial of Pain MD president Michael Kestner, who was convicted of 13 felonies related to health care fraud in October. Shaw was photographed at her Tennessee home on Jan. 14.(Brett Kelman/KFF Health News)
Now, years later, Pain MD’s injections have been proved in court to be part of a decade-long fraud scheme that made millions by capitalizing on patients’ dependence on opioids. The Department of Justice has successfully argued at trial that Pain MD’s “unnecessary and expensive injections” were largely ineffective because they targeted the wrong body part, contained short-lived numbing medications but no steroids, and appeared to be based on test shots given to cadavers — people who felt neither pain nor relief because they were dead.
Four Pain MD employees have pleaded guilty or been convicted of health care fraud, including company president Michael Kestner, who was found guilty of 13 felonies at an October trial in Nashville, Tennessee. According to a transcript from Kestner’s trial that became public in December, witnesses testified that the company documented giving patients about 700,000 total injections over about eight years and said some patients got as many as 24 shots at once.
“The defendant, Michael Kestner, found out about an injection that could be billed a lot and paid well,” said federal prosecutor James V. Hayes as the trial began, according to the transcript. “And they turned some patients into human pin cushions.”
The Department of Justice declined to comment for this article. Kestner’s attorneys either declined to comment or did not respond to requests for an interview. At trial, Kestner’s attorneys argued that he was a well-intentioned businessman who wanted to run pain clinics that offered more than just pills. He is scheduled to be sentenced on April 21 in a federal court in Nashville.
According to the transcript of Kestner’s trial, Shaw and three other former patients testified that Pain MD’s injections did not ease their pain and sometimes made it worse. The patients said they tolerated the shots only so Pain MD wouldn’t cut off their prescriptions, without which they might have spiraled into withdrawal.
“They told me that if I didn’t take the shots — because I said they didn’t help — I would not get my medication,” testified Patricia McNeil, a former patient in Tennessee, according to the trial transcript. “I took the shots to get my medication.”
In her interview with KFF Health News, Shaw said that often she would arrive at the Pain MD clinic walking with a cane but would leave in a wheelchair because the injections left her in too much pain to walk.
“That was the pain clinic that was supposed to be helping me,” Shaw said in her interview. “I would come home crying. It just felt like they were using me.”
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‘Not Actually Injections Into Tendons at All’
Pain MD, which sometimes operated under the name Mid-South Pain Management, ran as many as 20 clinics in Tennessee, Virginia, and North Carolina throughout much of the 2010s. Some clinics averaged more than 12 injections per patient each month, and at least two patients each received more than 500 shots in total, according to federal court documents.
All those injections added up. According to Medicare data filed in federal court, Pain MD and Mid-South Pain Management billed Medicare for more than 290,000 “tendon origin injections” from January 2010 to May 2018, which is about seven times that of any other Medicare biller in the U.S. over the same period.
Tens of thousands of additional injections were billed to Medicaid and Tricare during those same years, according to federal court documents. Pain MD billed these government programs for about $111 per injection and collected more than $5 million from the government for the shots, according to the court documents.
More injections were billed to private insurance too. Christy Wallace, an audit manager for BlueCross BlueShield of Tennessee, testified that Pain MD billed the insurance company about $40 million for more than 380,000 injections from January 2010 to March 2013. BlueCross paid out about $7 million before it cut off Pain MD, Wallace said.
These kinds of enormous billing allegations are not uncommon in health care fraud cases, in which fraudsters sometimes find a legitimate treatment that insurance will pay for and then overuse it to the point of absurdity, said Don Cochran, a former U.S. attorney for the Middle District of Tennessee.
Tennessee alone has seen fraud allegations for unnecessary billing of urine testing, skin creams, and other injections in just the past decade. Federal authorities have also investigated an alleged fraud scheme involving a Tennessee company and hundreds of thousands of catheters billed to Medicare, according to The Washington Post, citing anonymous sources.
Cochran said the Pain MD case felt especially “nefarious” because it used opioids to make patients play along.
“A scheme where you get Medicare or Medicaid money to provide a medically unnecessary treatment is always going to be out there,” Cochran said. “The opioid piece just gives you a universe of compliant people who are not going to question what you are doing.”
“It was only opioids that made those folks come back,” he said.
The allegations against Pain MD became public in 2018 when Cochran and the Department of Justice filed a civil lawsuit against the company, Kestner, and several associated clinics, alleging that Pain MD defrauded taxpayers and government insurance programs by billing for “tendon origin injections” that were “not actually injections into tendons at all.”
Kestner, Pain MD, and several associated clinics have each denied all allegations in that lawsuit, which is ongoing.
Scott Kreiner, an expert on spine care and pain medicine who testified at Kestner’s criminal trial, said that true tendon origin injections (or TOIs) typically are used to treat inflamed joints, like the condition known as “tennis elbow,” by injecting steroids or platelet-rich plasma into a tendon. Kreiner said most patients need only one shot at a time, according to the transcript.
But Pain MD made repeated injections into patients’ backs that contained only lidocaine or Marcaine, which are anesthetic medications that cause numbness for mere hours, Kreiner testified. Pain MD also used needles that were often too short to reach back tendons, Kreiner said, and there was no imaging technology used to aim the needle anyway. Kreiner said he didn’t find any injections in Pain MD’s records that appeared medically necessary, and even if they had been, no one could need so many.
“I simply cannot fathom a scenario where the sheer quantity of TOIs that I observed in the patient records would ever be medically necessary,” Kreiner said, according to the trial transcript. “This is not even a close call.”
Jonathan White, a physician assistant who administered injections at Pain MD and trained other employees to do so, then later testified against Kestner as part of a plea deal, said at trial that he believed Pain MD’s injection technique was based on a “cadaveric investigation.”
According to the trial transcript, White said that while working at Pain MD he realized he could find no medical research that supported performing tendon origin injections on patients’ backs instead of their joints. When he asked if Pain MD had any such research, White said, an employee responded with a two-paragraph letter from a Tennessee anatomy professor — not a medical doctor — that said it was possible to reach the region of back tendons in a cadaver by injecting “within two fingerbreadths” of the spine. This process was “exactly the procedure” that was taught at Pain MD, White said.
During his own testimony, Kreiner said it was “potentially dangerous” to inject a patient as described in the letter, which should not have been used to justify medical care.
“This was done on a dead person,” Kreiner said, according to the trial transcript. “So the letter says nothing about how effective the treatment is.”
Michelle Shaw and her fiancé, Thomas Truss, said in interviews that Pain MD clinics required patients to agree to multiple injections near their spines each month or be discharged. Shaw begrudgingly accepted the shots so she would not lose access to her painkiller prescriptions, but Truss said he refused the injections and was “kicked out.” Shaw was a key witness in the trial of Pain MD president Michael Kestner, who was convicted of 13 felonies related to health care fraud in October. Shaw and Truss were photographed at their Tennessee home on Jan. 14.(Brett Kelman/KFF Health News)
At the time, Pain MD defended the injections and its practice of discharging patients who declined the shots. When a former patient publicly accused the company of treating his back “like a dartboard,” Pain MD filed a defamation lawsuit, then dropped the suit about a month later.
“These are interventional clinics, so that’s what they offer,” Jay Bowen, a then-attorney for Pain MD, told The Tennessean newspaper in 2019. “If you don’t want to consider acupuncture, don’t go to an acupuncture clinic. If you don’t want to buy shoes, don’t go to a shoe store.”
Kestner’s trial told another story. According to the trial transcript, eight former Pain MD medical providers testified that the driving force behind Pain MD’s injections was Kestner himself, who is not a medical professional and yet regularly pressured employees to give more shots.
One nurse practitioner testified that she received emails “every single workday” pushing for more injections. Others said Kestner openly ranked employees by their injection rates, and implied that those who ranked low might be fired.
“He told me that if I had to feed my family based on my productivity, that they would starve,” testified Amanda Fryer, a nurse practitioner who was not charged with any crime.
Brian Richey, a former Pain MD nurse practitioner who at times led the company’s injection rankings, and has since taken a plea deal that required him to testify in court, said at the trial that he “performed so many injections” that his hand became chronically inflamed and required surgery.
“‘Over injecting killed my hand,’” Richey said on the witness stand, reading a text message he sent to another Pain MD employee in 2017, according to the trial transcript. “‘I was in so much pain Injecting people that didnt want it but took it to stay a patient.’”
“Why would they want to stay there?” a prosecutor asked.
“To keep getting their narcotics,” Richey responded, according to the trial transcript.
Throughout the trial, defense attorney Peter Strianse argued that Pain MD’s focus on injections was a result of Kestner’s “obsession” with ensuring that the company “would never be called a pill mill.”
Strianse said that Kestner “stayed up at night worrying” about patients coming to clinics only to get opioid prescriptions, so he pushed his employees to administer injections, too.
“Employers motivating employees is not a crime,” Strianse said at closing arguments, according to the court transcript. “We get pushed every day to perform. It’s not fraud; it’s a fact of life.”
Prosecutors insisted that this defense rang hollow. During the trial, former employees had testified that most patients’ opioid dosages remained steady or increased while at Pain MD, and that the clinics did not taper off the painkillers no matter how many injections were given.
“Giving them injections does not fix the pill mill problem,” federal prosecutor Katherine Payerle said during closing arguments, according to the trial transcript. “The way to fix being a pill mill is to stop giving the drugs or taper the drugs.”
This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
Newswise — A new study examining the treatment of xylazine-associated wounds in Philadelphia sheds light on the severe medical complications and healthcare challenges caused by the widespread presence of the drug in the city’s illicit supply.
Conducted by surgeons at Cooper University Hospital and researchers from Drexel University College of Medicine and the Philadelphia College of Osteopathic Medicine, and overseen by the Rothman Institute Foundation for Opioid Research & Education, the study provides some of the first detailed insights into how hospitals are grappling with the influx of patients suffering from severe necrotic wounds linked to the veterinary sedative known as “tranq.”
Xylazine is a non-opioid veterinary tranquilizer that is increasingly being used as an adulterant in heroin and fentanyl. The drug can cause severe necrotic wounds that are difficult to treat, can compromise limb viability, and often require surgery.
The study reviewed the cases of 55 patients with self-reported xylazine use and upper-extremity wounds treated at a single Philadelphia-area hospital. Researchers found that 40% of these patients were homeless, 26% had psychiatric diagnoses, and 84% had a history of tobacco use. Hepatitis C was present in 67% of cases, and 5% were HIV-positive. Patients were frequently hospitalized for their wounds, with an average of nearly six admissions per person and some requiring dozens of hospital visits. One patient was readmitted 44 times.
“These wounds are very challenging to treat,” said Dr. Asif Ilyas, one of the study’s authors. “They are often very deep and involve tendons, bones, and other structures.”
Dr. Ilyas also noted that patients with xylazine-associated wounds often have underlying health conditions that make it difficult for them to heal properly. “Many of these patients are also struggling with addiction, which can make it difficult for them to follow through with treatment,” he said. Of the 55 patients, 60% received nonoperative wound care, while 22 underwent surgery. However, surgical intervention was complicated by continued drug use, with a 59% complication rate due to infections, graft failures, and other wound issues. Despite the severity of their injuries, nearly half of the patients left the hospital against medical advice, and 68% continued drug use during their hospital stay.
The study’s authors, led by Katharine Criner Woozley, MD, Chief of Hand and Nerve Surgery at Cooper University Hospital, recommend that surgeons take a multidisciplinary approach to treating patients with xylazine-associated wounds. This approach should involve working with addiction medicine specialists, social workers, and other healthcare professionals to address the underlying factors that contribute to the development of these wounds before intervening surgically.
“We need to do a better job of identifying and treating patients at risk for developing these wounds,” said Dr. Ilyas, President of the Rothman Institute Foundation for Opioid Research & Education and Professor of Orthopaedic Surgery at Drexel University College of Medicine. He also noted that the increasing prevalence of xylazine is a public health concern. “This is a growing problem that we need to address,” he said. “We need to educate the public about the dangers of xylazine, and we need to make sure that people who are struggling with addiction have access to the treatment they need.”
The study highlights the strain on Philadelphia’s healthcare system, with patients averaging 5.9 hospital admissions for xylazine-associated wounds, and the most extended hospital stay was 75 days, illustrating the demanding nature of this issue in the city.
“Philadelphia’s healthcare system is facing an enormous burden in treating these wounds, and the reality is that this is more than a surgical issue, says Dr. Ilyas. “We are seeing patients with severe infections and devastating wounds, but what makes treatment so difficult is the the interplay between the addiction, socioeconomic challenges, and the underlying mental health conditions.”
The study, The Management of Upper-Extremity Xylazine-Associated Wounds, was conducted by Parker Johnsen, MD; Aaron Jackson, MD; Sara Hope Buchner, MD, Pietro Gentile, MD, and Katharine Criner Woozley, MD, of Cooper University Hospital; Genoveffa R. Morway, DO, of Philadelphia College of Osteopathic Medicine; and Asif M. Ilyas, MD, of Drexel University College of Medicine and the Rothman Opioid Foundation.
The study will appear in The Journal of Hand Surgery and is found online at https://www.sciencedirect.com/science/article/abs/pii/S0363502324005987 The Journal of Hand Surgery is the Official Journal of the American Society for Surgery of the Hand (ASSH), publishes articles related to the diagnosis, treatment, and pathophysiology of diseases and conditions of the hand, wrist, and upper extremity.
About the Rothman Institute Foundation for Opioid Research and Education.
The Rothman Opioid Foundation, for short, is a non-profit 501c3 organization dedicated to raising awareness of the ongoing opioid crisis, educating physicians and patients on safe opioid prescribing and use – respectively, and advising policymakers on sound opioid and pain management policy. Most importantly, the Rothman Opioid Foundation performs and supports the highest quality research on opioids and alternative pain modalities to yield findings that can better inform patients, physicians, and the greater healthcare community in the most evidenced-based pain management strategies while working to mitigate opioid abuse and addiction. https://www.rothmanopioid.org/
February 16Start where you are. Use what you have. Do what you can.
—Arthur Ashe 1943-1993
The advice from the great tennis player and civil rights activist applies particularly well in the world of recovery. At whatever age prospects arrive, there have been lost years and lost opportunities. Where you are is not where you want to be. Nevertheless, we must use what we have to do what we can.
People in recovery from addiction often bemoan the lost years—the wasted years. We hear abundant talk about acceptance and the ultimate in acceptance may come in not battling the seemingly obvious reality that the past is unchangeable. The rest of my life begins today. I need to start where I am. The Eckhart Tolle’s of the world tell us there is ONLY now.
The golfer Ben Hogan had a serious car accident that would have been a career ender for many and a career limiter for others. Hogan battled back and his greatest achievements came after the injuries that were sustained in the car wreck. Toronto Maple Leaf hockey player Bobby Baun fractured his leg in a game in the Stanley Cup finals. Instead of being carted off to the hospital, Baun scored the winning goal by staying and playing after having the leg “frozen.”
“Your present circumstances don’t determine where you can go; they merely determine where you start.”(Nido Qubein, Motivational Speaker, b. 1948) There’s not a lot of choice as far as starting where you are. Where else are you going to start? You either start where you are or you don’t start at all. Absent H.G. Wells and his time machine, these are the only options.
Is there any other choice but to start where I am? Can I make my many scars have value? When I can’t do everything, is it important to do what I can?
February 17Self-control is strength. Calmness is mastery. You have to get to a point where your mood doesn’t shift based on the insignificant actions of someone else. Don’t allow others to control the direction of your life. Don’t allow your emotions to overpower your intelligence.
—Morgan Freeman b. 1937
According to the fact checkers at Snopes.com: “While it’s possible that Freeman might agree with various aspects of the sentiment of the quote, there is no evidence that he ever said these words.” Something quite similar was written many years earlier. “Self-control is strength; Right Thought is mastery; Calmness is power.” (As A Man Thinketh, James Allen, 1903) In any case, the point has been made that any quote’s contents are of greater importance than the source. I LOVE “It’s easier to put on a pair of slippers than to carpet the entire world.” Al Franken, not so much.
James Allen (1864-1912) tells us that “humanity surges with uncontrolled passion, is tumultuous with ungoverned grief, is blown about by anxiety and doubt…” There is a solution: “Only the wise man, only he whose thoughts are controlled and purified, makes the winds and the storms obey him…” These ideas seem to have migrated from the East. Over the years, there has been a glorification of vengeance in American culture. We’re slow in giving that up.
There’s a popular AA slogan EASY DOES IT. In my area, in the 1990s, the following interpretation was often presented. “EASY DOES IT: E-D-I: Emotions Destroy Intelligence.” This echoes the latter part of the Freeman quote.
Are you “quick to anger?” Is the negativity more obvious when other people “lose their chit?” Can an old dog learn new tricks?
February 18The sway of alcohol over mankind is
unquestionably due to its power to stimulate the mystical faculties of human nature, usually crushed to earth by the cold facts and the dry criticisms of the sober hour. Sobriety
diminishes, discriminates, and says no; drunkenness
expands, unites, and says yes.
—Varieties of Religious Experience, William James, p. 282
We know from Wilson’s letters to Carl Jung and from a more lengthy exchange with a Philadelphian who had been treated by Jung, that “Bill revealed a very Jamesian understanding of the affirming, even mystical place of alcohol in the lives of many drinkers who became alcoholics.” (The Collected Ernie Kurtz, p. 66) Kurtz goes on to write that James’s greatest direct contribution to Alcoholics Anonymous was the openness to unconventional spirituality.
James wrote about alcoholism in his massive Principles of Psychology (1890): “How many excuses does the drunkard find when each new temptation comes! It is a new brand of liquor…moreover it is poured out and it is sin to waste it; or they are all drinking and it would be churlishness to refuse; or it is but to enable him to sleep, or just to get through this job of work; or it isn’t drinking, it is because he feels so cold; or it is Christmas day…it is, in fact, anything you like except being a drunkard.” (vol II, p. 565) His younger brother Robertson had a lifelong addiction to alcohol.
Although Bill Wilson attached cofounder status to the Harvard polymath, nowhere in AA’s literature do we find William James’s most famous line about alcoholism: The only radical remedy I know for dipsomania is religiomania. Kurtz says that most alcoholics would rather be drunk than religious. Bill W. understood that.
Were you, at least at one time, remarkably stimulated by drinking? More so than other folks? Did you try to quit drinking and then create ridiculous excuses to drink?
Bob’s newest book, Daily Reflections for Modern Twelve Step Recovery, published in January, is available on Amazon. And his other two books Key Players in AA History, the second edition published in 2023, and The Secret Diaries of Bill W., published in 2023, are also available on Amazon.
Feb. 13, 2025 – Kennedy, 70, has spoken about his addictive personality many times over the years. By his account, his recovery taught him humility and opened his heart toward God. But the redemption stories were preceded by years of darker media accounts about his reckless behavior.
Sonya Stokes, an emergency room physician in the San Francisco Bay Area, braces herself for a daily deluge of patients sick with coughs, soreness, fevers, vomiting, and other flu-like symptoms.
She’s desperate for information, but the Centers for Disease Control and Prevention, a critical source of urgent analyses of the flu and other public health threats, has gone quiet in the weeks since President Donald Trump took office.
“Without more information, we are blind,” she said.
Flu has been brutal this season. The CDC estimates at least 24 million illnesses, 310,000 hospitalizations, and 13,000 deaths from the flu since the start of October. At the same time, the bird flu outbreak continues to infect cattle and farmworkers. But CDC analyses that would inform people about these situations are delayed, and the CDC has cut off communication with doctors, researchers, and the World Health Organization, say doctors and public health experts.
“CDC right now is not reporting influenza data through the WHO global platforms, FluNet [and] FluID, that they’ve been providing information [on] for many, many years,” Maria Van Kerkhove, interim director of epidemic and pandemic preparedness at the WHO, said at a Feb. 12 press briefing.
“We are communicating with them,” she added, “but we haven’t heard anything back.”
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On his first day in office, President Donald Trump announced the U.S. would withdraw from the WHO.
A critical analysis of the seasonal flu selected for distribution through the CDC’s Health Alert Network has stalled, according to people close to the CDC. They asked not to be identified because of fears of retaliation. The network, abbreviated as HAN, is the CDC’s main method of sharing urgent public health information with health officials, doctors, and, sometimes, the public.
A chart from that analysis, reviewed by KFF Health News, suggests that flu may be at a record high. About 7.7% of patients who visited clinics and hospitals without being admitted had flu-like symptoms in early February, a ratio higher than in four other flu seasons depicted in the graph. That includes 2003-04, when an atypical strain of flu fueled a particularly treacherous season that killed at least 153 children.
Without a complete analysis, however, it’s unclear whether this tidal wave of sickness foreshadows a spike in hospitalizations and deaths that hospitals, pharmacies, and schools must prepare for. Specifically, other data could relay how many of the flu-like illnesses are caused by flu viruses — or which flu strain is infecting people. A deeper report might also reveal whether the flu is more severe or contagious than usual.
“I need to know if we are dealing with a more virulent strain or a coinfection with another virus that is making my patients sicker, and what to look for so that I know if my patients are in danger,” Stokes said. “Delays in data create dangerous situations on the front line.”
Although the CDC’s flu dashboard shows a surge of influenza, it doesn’t include all data needed to interpret the situation. Nor does it offer the tailored advice found in HAN alerts that tells health care workers how to protect patients and the public. In 2023, for example, a report urged clinics to test patients with respiratory symptoms rather than assume cases are the flu, since other viruses were causing similar issues that year.
“This is incredibly disturbing,” said Rachel Hardeman, a member of the Advisory Committee to the Director of the CDC. On Feb. 10, Hardeman and other committee members wrote to acting CDC Director Susan Monarez asking the agency to explain missing data, delayed studies, and potentially severe staff cuts. “The CDC is vital to our nation’s security,” the letter said.
Several studies have also been delayed or remain missing from the CDC’s preeminent scientific publication, the Morbidity and Mortality Weekly Report. Anne Schuchat, a former principal deputy director at the CDC, said she would be concerned if there was political oversight of scientific material: “Suppressing information is potentially confusing, possibly dangerous, and it can backfire.”
CDC spokesperson Melissa Dibble declined to comment on delayed or missing analyses. “It is not unexpected to see flu activity elevated and increasing at this time of the year,” she said.
A draft of one unpublished study, reviewed by KFF Health News, that has been withheld from the MMWR for three weeks describes how a milk hauler and a dairy worker in Michigan may have spread bird flu to their pet cats. The indoor cats became severely sick and died. Although the workers weren’t tested, the study says that one of them had irritated eyes before the cat fell ill — a common bird flu symptom. That person told researchers that the pet “would roll in their work clothes.”
After one cat became sick, the investigation reports, an adolescent in the household developed a cough. But the report says this young person tested negative for the flu, and positive for a cold-causing virus.
Corresponding CDC documents summarizing the cat study and another as-yet unpublished bird flu analysis said the reports were scheduled to be published Jan. 23. These were reviewed by KFF Health News. The briefing on cats advises dairy farmworkers to “remove clothing and footwear, and rinse off any animal biproduct residue before entering the household to protect others in the household, including potentially indoor-only cats.”
The second summary refers to “the most comprehensive” analysis of bird flu virus detected in wastewater in the United States.
Jennifer Nuzzo, director of the Pandemic Center at Brown University, said delays of bird flu reports are upsetting because they’re needed to inform the public about a worsening situation with many unknown elements. Citing “insufficient data” and “high uncertainty,” the United Kingdom raised its assessment of the risk posed by the U.S. outbreak on dairies.
“Missing and delayed data causes uncertainty,” Nuzzo said. “It also potentially makes us react in ways that are counterproductive.”
Another bird flu study slated for January publication showed up in the MMWR on Feb. 13, three weeks after it was expected. It revealed that three cattle veterinarians had been unknowingly infected last year, based on the discovery of antibodies against the bird flu virus in their blood. One of the veterinarians worked in Georgia and South Carolina, states that haven’t reported outbreaks on dairy farms.
The study provides further evidence that the United States is not adequately detecting cases in cows and people. Nuzzo said it also highlights how data can supply reassuring news. Only three of 150 cattle veterinarians had signs of prior infections, suggesting that the virus doesn’t easily spread from the animals into people. More than 40 dairy workers have been infected, but they generally have had more sustained contact with sick cattle and their virus-laden milk than veterinarians.
Instead, recently released reports have been about wildfires in California and Hawaii.
“Interesting but not urgent,” Nuzzo said, considering the acute fire emergencies have ended. The bird flu outbreak, she said, is an ongoing “urgent health threat for which we need up-to-the-minute information to know how to protect people.”
“The American public is at greater risk when we don’t have information on a timely basis,” Schuchat said.
This week, a federal judge ordered the CDC and other health agencies to “restore” datasets and websites that the organization Doctors for America had identified in a lawsuit as having been altered. Further, the judge ordered the agencies to “identify any other resources that DFA members rely on to provide medical care” and restore them by Feb. 14.
In their letter, CDC advisory committee members requested an investigation into missing data and delayed reports. Hardeman, an adviser who is a health policy expert at the University of Minnesota, said the group didn’t know why data and scientific findings were being withheld or removed. Still, she added, “I hold accountable the acting director of the CDC, the head of HHS, and the White House.”
Hardeman said the Trump administration has the power to disband the advisory committee. She said the group expects that to happen but proceeded with its demands regardless.
“We want to safeguard the rigor of the work at the CDC because we care deeply about public health,” she said. “We aren’t here to be silent.”
This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
Nothing sweeps us off our feet like a health policy valentine. Readers showed their love this season, writing poetic lines about surprise medical bills, bird flu, the cost of health care, and more.
Here are some of our favorites, starting with the grand prize winner, whose entry was turned into a cartoon by staff illustrator Oona Zenda.
1st Place
Runner-Up
What to make for my valentine? Maybe a cake on which we can dine! But raw milk and flu-ish eggs won’t do. Perhaps some fluoridated water in lieu?
