Keeping Tabs Magazine Volume 6 | Issue 1

Keeping Tabs VOLUME 6 | ISSUE 1

University of Florida College of Pharmacy

Table of Contents Embracing the Journey as a Student Pharmacist

COVID-19 and minority communities

heART

Vaccination education as student pharmacists

Too good to be true? The Rise and Fall of Theranos

Opioid epidemic on the rise due to COVID

Owning a Dog in Pharmacy School

1 3 5 7 9 12 14

Iraq Refugee to PharmD|How My Past Helps Me Connect to Patients 15 Thank You!!

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Embracing the Journey as a Student Pharmacist BY: RUTH ADEYEMI

Why did I decide to be a pharmacist? Why am I putting myself through this much rigor? These are a few of the questions that filled my thoughts at the beginning of my first semester of pharmacy school. Before pharmacy school, as far back as elementary school, my dream has always been to be a pharmacist. As my dream is steadily becoming a reality, I won't stop questioning my decision to accept my first and only pharmacy school offer letter.

Despite the questions that filled my thoughts, something happened halfway through my first semester of pharmacy school. This decision would reshape my thought pattern and show me how to embrace this rigorous, yet beautiful journey.

What was it? In my second month of pharmacy school, I began pledging for Kappa Psi. Kappa Psi is a professional pharmaceutical fraternity with the mission to develop leaders with a passion for service to their community while creating lifelong professional connections.

The pledging process was rigorous, but my fellow pledges and I were able to endure the process by keeping our goal in mind. We realized that we could accomplish our goal by incorporating fun activities, leaning on each other, and prioritizing rest as much as possible.

Soon enough, I began picking up some life lessons during the pledging process that would help me embrace my pharmacy school journey.

The pledging process was rigorous, but my fellow pledges and I were able to endure the process by keeping our goal in mind. We realized that we could accomplish our goal by incorporating fun activities, leaning on each other, and prioritizing rest as much as possible.

Soon enough, I began picking up some life lessons during the pledging process that would help me embrace my pharmacy school journey.

I want to share some of the life lessons I learned while pledging. I hope that through my words, you can find the strength to embrace your journey as a student pharmacist as well.

1) BUILD MEANINGFUL AND IMPACTFUL RELATIONSHIPS Most students and faculty members genuinely want you to succeed. Likewise, when choosing your pharmacy school buddies, make sure you choose the right people. Look for people who will keep you grounded and focused but will also laugh with you when you need to relax.

With great friendships, it is easier to excel in your classes, extracurricular activities, and cocurricular activities. Great friendships provide a constant reminder that you are not alone.

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2) NEVER COMPARE YOURSELF Comparison can shift your focus from your goals to someone else's goals. Of course, it's easy to compare yourself to the person that appears to be doing well and when it appears that you are not. If you focus on being better than who you were yesterday, you will appreciate your journey more and enjoy every experience (even the rigorous ones).

3) STAY POSITIVE I cannot stress the importance of reminding yourself often that you can do this. Before pharmacy school, I found it cheesy to look in the mirror and talk to myself. As a student pharmacist, I've often found myself in front of the mirror more often, and I tell you, it works!

When you feel overwhelmed, repeatedly say to yourself: "I know I am overwhelmed, but I am also brilliant". This will help build your confidence and carry out the task at hand beautifully.

4) MANAGE YOUR ANXIETY/NERVOUSNESS My good friend and pledge class brother, Aicha, told me this during one of our conversations one night: “when you are anxious, it clouds your thinking, and you forget things you knew.” That night changed my whole pharmacy school journey. After that night, I began to repeat her words to myself. The more I repeated the words to myself, the less anxious I became, and the more I could get my work done devoid of anxiety.

5) TAKE TIME OUT TO REST Burnout is real! As much as you want to get good grades and participate in every activity on campus, you won't enjoy the journey if you don't rest enough. As you plan study time, schedule in time for fun and rest, too. It is vital.

6) ENGAGE IN ACTIVITIES OUTSIDE PHARMACY SCHOOL Participate in activities outside of pharmacy like movie nights, cookouts, etc. Finding activities outside of pharmacy school will allow your body to relax and allow you to enjoy pharmacy school, not endure it.

7) KEEP YOUR FAITH IN GOD ACTIVE Last but not least, as a Christian, staying connected to God and doing my devotion has brought me peace and helped me remember that being a pharmacist is my calling. Knowing that alone is enough to keep me focused. If you are a person of Faith, allow it to guide you on this journey.

Pharmacy school is a lot; it requires your time, energy, and mental presence. Truthfully, it can be almost impossible to enjoy the journey. But with a great support system, taking time out to rest, and engaging in activities outside pharmacy school, embracing the journey becomes easier.

Go do great things; I'm rooting for you!!!

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COVID-19 AND MINORITY COMMUNITIES

"American Indians alone are 2.2 times more likely to die and 3.3 times more likely to be hospitalized from COVID19" https://www.cdc.gov/minorityhealth/index.html

WRITTEN BY CLARISA CALLEJAS As we endure a new year, we can reflect on what has arguably been the most brutal two years most of us have ever encountered. Coronavirus (COVID-19) has posed ongoing challenges that we, as healthcare providers, have had to face daily. It began with simply trying to understand COVID-19 and identifying ways we can prevent the spread. That expanded to formulating and approving vaccines and then identifying treatments to those who have been most affected by the virus. Although we have come a long way from where we started, COVID-19 has impacted minority communities at a massive disproportion to the rest of the population. Improper communication, poor accessibility, and lack of education and information created yet another divergency minority communities have had face.

According to the Center for Disease Control and Prevention (CDC), minority groups pose a higher-than-average risk for contracting COVID-19. Minority communities usually refer to American Indian or Alaskan Natives, Asians, Black or African Americans, and Hispanic or PAGE 3

Latinos. American Indians alone are 2.2 times more likely to die and 3.3 times more likely to be hospitalized from COVID-19. When combining each minority, they are on average 1.8 times more likely to die and 2.3 times more likely to be hospitalized. It is hard to fathom why this is happening at such disproportional rates. Further investigation has allowed researchers to identify the most probable causes contributing to this outcome. Education and information surrounding the virus and vaccine has not been well transmitted. Many news sources and social media platforms have spread their own misinformation which has caused panic within the population.

People are scared and understandably so.

This fear of both the virus and vaccine has bestowed skepticism and doubt among those who are most vulnerable.

Concurrently, minorities lack of access to health care, testing, and vaccines has contributed to the divide. Many of these communities tend to be in areas where the quality of care is not affordable or accessible.

Though the vaccines and testing can come at no charge at multiple facilities, many people are unaware there are free resources.

The Census reported in 2017 that for the last several decades Blacks and Hispanics have been in the lowest economic status compared to all other ethnic and racial groups. Lower income means less access to things such as transportation. When people don’t have transportation their obstacle to obtaining testing kits, vaccines, or treatments diminishes yet again. Lower income, lack of

https://theconversation.com/anti-vaxxers-are-weaponising-the-vaccine-hesitancy-of-black-communities-153836

COVID-19 than other populations.

What can we as healthcare providers do to help close this gap in care? Pharmacists are known to be one of the most trusted healthcare providers and are often highly accessible to the public. By simply going to work to answer questions and concerns, we can help better protect our minority communities. As pharmacy students, we gain extensive knowledge on the importance of vaccines and their effectiveness on viruses. For those of us who work in a community setting, we can be additional support, providing education to those who need it most. Although, it is ultimately our patients decision on how they go about their healthcare, we can be a valuable resource of trusted information.

Together, by providing education, information, and administration of vaccines, we can help our minority communities fight COVID-19.

transportation, and misinformation/

Sources

misinterpretation has led people in minority

https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigationsdiscovery/hospitalization-death-by-race-ethnicity.html

communities to have worse outcomes from

https://www.census.gov/content/dam/Census/library/visualizations/2018/demo/p60263/figure1.pdf

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heART

by Greta Apostoli

Art has been around for thousands of years! There are various forms of art: Dancing, writing, painting, drawing, singing, theatre, and countless more. But have you wondered what impact art has on the human physiological systems? Art is one of many vehicles for healing and reducing symptoms of illness. The arts affect the mind, body, and soul.

Drawing has a profound impact on healing an individual’s spirit. Patients from a study reported having “greater love and compassion and a sense of connectedness to themselves, their bodies, and to what is beyond ourselves.”3 Patients who have been hospitalized feel disconnected from themselves because their disease becomes their new identity. By giving them an outlet, patients can express themselves and reclaim their identity.

Drawing allows them to connect with others and shorten their stay in the hospital. Art has the capacity to increase an individual’s quality of life positively.

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Not only does art heal the spirit, but also the mind. Patients undergoing active chemotherapy become depressed and anxious due to the unknown future. A study looked at implementing watercolor painting during patients’ active administration of chemotherapy. Participants were asked to explain their drawings and were later asked to complete the HADS (Hospital and anxiety depression score) questionnaire. Results showed a significant decrease in depression and anxiety scores in all patients.1 In another study called The Pablo Picasso Alzheimer’s Therapy, patients with dementia and Alzheimer’s were taken to a museum to observe paintings. All participants were shown to have increased orientation, mental clarity, and expression.2 Paintings, especially, allow those with dementia to engage fully with others while lessening negative tension by creating new positive tension in the brain. Art helps manage dementia and Alzheimer’s.

Figurative art helps decrease systolic blood pressure in patients with hypertension. A randomized controlled study looked at three groups who observed figurative art, modern art, and art located in office museums. Figurative art significantly decreased systolic blood pressure compared to the other two groups. Blood pressure levels measured before the start of the visit were 116mm Hg, and after the visit, it decreased to 108.7 mmHg for the people in the figurative art group. Modern art reduced systolic blood pressure from 115.9 to 112.17mmHg, and the art in office museums decreased it from 119.8 to 114.9 mmHg.4 Figurative art has a restorative effect on a person’s well-being. Heart rate levels also decreased in all three groups but were not statistically significant. Although figurative art reduces blood pressure, patients should not consider art therapy to replace their blood pressure medication but instead use it in conjunction with their medications.

Art is a powerful vehicle for healing because it affects the mind, body, and soul. Art can heal a broken heart by enabling individuals to release negative emotions, become connected with their inner-self and God, and help manage their diseases. Art creates new neuronal connections leading to positive effects on an individual, elevating them to an improved state of well-being. Art gives patients their voice and allows them to take back their identity, which succumbs during their disease state of being. Art should be used by everyone, not just in the in-patient setting. Next time you’re feeling down or stressed out, let the heART heal you.

References: 1.Bozcuk H, Ozcan K, Erdogan C, Mutlu H, Demir M, Coskun S. A comparative study of art therapy in cancer patients receiving chemotherapy and improvement in quality of life by watercolor painting. Complement Ther Med. 2017;30:67-72. doi:10.1016/j.ctim.2016.11.006 2.Camic PM. Playing in the Mud: Health Psychology, the Arts and Creative Approaches to Health Care. Journal of Health Psychology. 2008;13(2):287-298. doi:10.1177/1359105307086698 3.Ettun R, Schultz M, Bar-Sela G. Transforming pain into beauty: on art, healing, and care for the spirit. Evid Based Complement Alternat Med. 2014;2014:789852. doi:10.1155/2014/789852 4.Mastandrea S, Maricchiolo F, Carrus G, Giovannelli I, Giuliani V, Berardi D. Visits to figurative art museums may lower blood pressure and stress [published online ahead of print, 2018 Mar 5]. Arts Health. 2018;1-10. doi:10.1080/17533015.2018.1443953

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Vaccination education as student pharmacists ALYSSA COX Vaccines are currently a hot topic among the community. Pharmacies are a main area for giving vaccinations as well as providing education to our patients. With the rapid development of the COVID-19 vaccine, many people have become skeptical and are hesitant towards receiving these immunizations. Pharmacists, and pharmacy students, can play a key role in providing factual information about the vaccine and benefits and risks to help guide patients towards making the decision to get vaccinated. Not only does this apply to the COVID-19 vaccine, but also all other vaccines that may be beneficial for each patient.

Knowing the key points about what each vaccine is, who it is indicated for, the dosing schedule, side effects, and who is ineligible for each vaccine can help us provide the most accurate information and guide patients towards being their healthiest self.

The COVID-19 vaccine is a newer vaccine that has increased curiosity within the community. This has given student pharmacists lots of opportunity to answer vaccination questions to help shed light on the benefits of getting vaccinated. It is important to understand the basic information about each vaccine in order to properly give recommendations to our patients. Currently, the CDC recommends COVID-19 vaccines for all eligible people aged 5 years and older with a preference for people to receive an mRNA COVID-19 vaccine (Pfizer and Moderna).

For those aged 5 years and older, they are eligible for the Pfizer vaccine. For those aged 18 years and older, they are eligible for the Pfizer, Moderna, or Janssen vaccine. The Pfizer and Moderna vaccines are 2 dose series as opposed to the Janssen vaccine which is one dose. The CDC now recommends booster doses for all vaccines for ages 12 and up, with mix and match allowed but a preference for mRNA COVID-19 vaccines. For the Janssen COVID-19 vaccine, patients should be informed about the risk and symptoms of thrombosis with thrombocytopenia syndrome in the 2 weeks following vaccine administration. Those who have had a severe allergic reaction after a previous dose or to the components of the COVID-19 vaccine have contraindication for the COVID-19 vaccine. Some common side effects include, pain, redness, and swelling in the arm the vaccine was received. Additionally, patients may experience tiredness, headache, muscle pain, chills, fever, and nausea, although many do not experience any side effects. Overall, the CDC states that the vaccines are safe and effective and should be given as soon as possible to those that are eligible to help reduce the severity and likelihood of the developing COVID-19 infection.

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The influenza vaccine has been around for quite some time, but many people are still resistant to receiving it. The CDC recommends that everyone 6 months and older should receive an annual flu vaccine. The flu shot is the best way to reduce your risk of seasonal flu and its potentially serious complications. While flu vaccine effectiveness can vary each season, each year it still provides important protection. The flu shot is recommended in pregnant women; however, a live vaccine should be avoided. Though some flu vaccines are egg-based, it is unlikely to experience a severe allergic reaction from the vaccine if you have an egg allergy. A previous severe allergy to any influenza vaccine is a contraindication for the vaccine. Those who are 65 years and older should receive a high dose flu shot. Side effects include soreness, redness, and swelling in the arm where the vaccine was given.

Additionally, patients may experience fever, muscle aches, and headache. There may be a small increased risk of developing GuillainBarre Syndrome after receiving an inactivated flu shot. The live vaccines can have mild side effects such as runny nose, congestion, wheezing, and headache but are usually short lived. Overall, the influenza vaccine is considered safe and should be recommended to all eligible patients each year.

Patients can be hesitant about receiving vaccines as well as talking about them. It can be a difficult conversation to have, but it is important to keep the patients’ health and wellbeing in mind. When discussing vaccine information, it is important to be compassionate and show empathy and be sure to embrace all components of their concerns.

Make sure you are asking permission to discuss vaccinations with them and be respectful of their decision to refuse or accept counseling. The use of motivational interviewing can also help patients become more open to conversation and ensure it is a collaborative discussion.

Responding to their questions and concerns to the best of your ability can help patients make the best decision for themselves. Developing a safe and comfortable relationship with your patients while discussing vaccinations is necessary to have a meaningful conversation.

Source : https://www.cdc.gov/vaccines/

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TOO GOOD TO BE TRUE? THE RISE AND FALL OF THERANOS

Kelli Corona

https://www.vox.com/2015/10/26/11620036/theranos-ceo-elizabeth-holmess-five-best-cover-story-appearances

mentor to come aboard the project, but more

In March 2004, 19-year-old Elizabeth Holmes, a sophomore at Stanford University at the time studying chemical engineering, dropped out of school to found Theranos, a company that promised to revolutionize the future of diagnostics and healthcare. The name is a clever blend of the two words “therapy” and “diagnosis.”

impressively, attracted $400 million from venture capitalists. She further assembled an all-star board of support that included former US Secretaries of State Henry Kissinger and George P. Shultz, former President Bill Clinton, and Mexican billionaire Carlos Slim, among others, which helped Theranos’ value soar to a staggering $9+ billion at its peak. Holmes’ stake in it was worth

Motivated by her own phobia of needles, Holmes created Theranos with the purpose of offering an inexpensive, effective, and less painful alternative to the traditional blood test, claiming to be able to screen for a wide array of ailments such as cancer and diabetes with just a few small drops of blood, essentially reproducing effects of a full-scale laboratory. There is a plethora of Silicon Valley companies claiming to make world-changing products, so what made Theranos in particular stand out? One might argue its remarkable origin story-- painting Holmes to be a fearless trailblazer and an innovative force to be reckoned with within the male-dominated tech industry-- was responsible for its initial success. Theranos also vowed to solve a problem that was relatable, taking into consideration that most people will get a blood test at some point in their life. Based on this framework, it wasn’t a surprise that Holmes was often found at the center of beneficial press, emanating the image of Steve Jobs by wearing black turtlenecks on the covers of Forbes and Fortune Magazines. Spanning the next decade, Holmes rallied her own Stanford professor and

half of that, making her one of the youngest selfmade billionaires in history. She was named “the world’s youngest self-made female billionaire” by Forbes, “America’s Coolest Billionaire” by Inc. Magazine, and even made Time Magazine’s list of the “100 most influential people”.

Her pledge to revolutionize the billion-dollar lab industry that she believed was swindling people with expensive, antiquated, and needlessly painful needle jabs resonated with both customers and investors. The Theranos method required “99.9 percent less blood,” according to Holmes and would be taken from the prick of your finger instead of a vein. The sample would be sent to a lab in a “nanotainer” and tested using Theranos’s patented technology, the “Edison Machine”. Theranos also claimed it would be able to deliver results in 4 to 24 hours, which would reduce anxiety associated with waiting.

According to Holmes, the tests would also cost about half of current Medicare and Medicaid reimbursement rates for blood tests.

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In 2013, Theranos even secured a massive deal with Walgreens Pharmacy and struck up a long-term partnership, which further propelled its success and credibility within the healthcare industry. The first Theranos “Wellness Center”, as it was coined, launched in a Walgreens in Palo Alto, California where patients could access the Theranos blood test.

Another 44 wellness centers located in Walgreens pharmacies would soon follow, traversing the states of Arizona, California, and Pennsylvania. Holmes also lobbied multiple state governments to allow patients to order Theranos tests without the need for a doctor’s referral—a move that would theoretically reduce time and cost for patients. By 2015, Holmes had succeeded in this goal and had influenced Arizona’s legislature to pass a law allowing patients to bypass the need for a doctor’s prior approval and order whatever test they wanted. Therefore, Holmes was not only aiming to transform the way traditional blood tests were performed, but also how patients

"[A Theranos] customer, who was pregnant at the time, was falsely told she had miscarried her baby."

exposed the Edison machine as a mere façade.

Carreyrou referred to former Theranos employees,

were able to operate within the healthcare system.

internal emails, and doctors. One former

Many of Theranos’ claims were never actually proven

that Theranos had been rigging the system,

though, which raised suspicions and prompted critics to demand evidence that this technology produced scientifically accurate and diagnosable results. The FDA had never approved Theranos’ technology and Holmes failed to have any peer-

employee even filed a complaint to regulators “failing to report test results that raised questions about the precision of the Edison system”.

This marked only the beginning of the fall of Holmes’ mighty empire, as she and her former

reviewed publications regarding the efficacy of it.

business partner, Ramesh Balwani, were charged

The science behind the “Edison machine” was

counts of wire fraud and conspiracy to commit

regarded as classified information, and Holmes’s description of the process when asked by a reporter from The New Yorker was damningly ambiguous.

She stated: “A chemistry is performed so that a chemical reaction occurs and generates a signal

in 2018 by the U.S. government with multiple wire fraud.

In April 2018, a large database containing three years’ worth of blood-sample lab reports were subpoenaed, which could have assisted in

from the chemical interaction with the sample,

Holmes’ prosecution by determining a pattern of

which is translated into a result, which is then

inaccurate results shown via statistical analyses

reviewed by certified laboratory personnel”. Holmes

on the data. Months later, Theranos had informed

added that, thanks to “miniaturization and

the court that the entire database had been

automation, we are able to handle these tiny

physically destroyed.

samples”.

Overall, an estimated $700 million was lost in the The Wall Street Journal then launched its own

collapse of Theranos. Prosecutors claim that

investigation in October 2015, where reporter John

governments, businesses, and other investors

Carreyrou had sought out to answer some of the

were conned by Holmes’ fraudulent statements

questions critics have been requesting.

and talks. However, these were not the only people who suffered losses, as the very people

Carreyrou eventually discovered that Theranos rarely

this company promised to benefit were now

even used its touted Edison technology for their

victim to incorrect diagnoses. Some had been

tests, as they allegedly mostly used older, already

told they were HIV-positive, and another

well-established technology from companies such as

customer, who was pregnant at the time, was

Siemens, instead. This differed from the company's

falsely told she had miscarried her baby.

claimthat it used these machines only for "certain esoteric and less commonly ordered tests" and

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In August 2021, Holmes’ high-profile criminal trial began. Deliberations so far have spanned 44 hours over the course of six days, involving a jury of 8 men

for each count of wire fraud and each conspiracy count. She has pleaded not guilty on all charges.Enter your email to sign up for the Stress, but less newsletter.

and 4 women, and 29 witnesses the government had called to testify, one of them being former Walgreens CFO, Wade Miquelon. Miquelon told prosecutors that Holmes impressed the company with her promising proposal for in-store blood tests that could be provide results in 30 minutes using their advanced medical device. Walgreens spent $140 million on the endeavor, $40 million of which could be converted to equity in the company and thus made them a vital partner for Theranos.

When allegations came out that Theranos was using standard equipment to run most of its tests, Walgreens had sued them for the initial $140 million investment. Miquelon quotes “My understanding is, the blood would be tested on the Edison device, and the base level testing would be able to do 96 percent of the testing done at labs.” He claims Walgreens was led to believe that the use of standardized third-party devices was used for calibration and accuracy purposes only.

According to the Wall Street Journal, Miquelon stated in his testimony: “This was one of the most exciting companies that we had seen, maybe not just in lab but in general”. Former Safeway CEO,

https://www.nbcnews.com/business/consumer/how-9-billion-blood-testing-startup-theranos-blew-n671751

Steven Burd, also testified and explained how Safeway was initially drawn to Theranos’ substantial promises but became gradually suspicious when the company consistently missed deadlines and experienced delays.

In my opinion, I believe this case could have extensive implications for the tech startup culture

Sources:

and its relationship to the medical world.

Specifically, it emphasizes the importance of making

Allyn, Bobby. “Elizabeth Holmes Promised

data-driven decisions, especially when its being

Miracles by a Finger Prick. Her Fraud Trial Starts

marketed as something that will have real

Tuesday.” NPR, NPR, 30 Aug. 2021,

consequences on real people. The technology used

https://www.npr.org/2021/08/30/1031314018/elizabe

in Theranos’ blood testing devices was sold as a

th-holmes-theranos-fraud-trial.

transformative agent in healthcare, yet it didn’t have any clinically relevant data to support the viability of

Gibney, Alex, Jessie Deeter, Erin Edeiken,

it. This led to its premature release and subsequent

Elizabeth Holmes, Ken Auletta, Lincoln Else,

failure, ultimately costing hundreds of millions of

Antonio Rossi, Andy Grieve, and Will Bates. The

dollars in losses.

Inventor: Out for Blood in Silicon Valley., 2019.

The trial is still ongoing, and deliberations are

Siddiqui, Faiz. “Former Walgreens CFO Testifies

scheduled to continue starting on Monday January 3,

about Pharmacy's Troubled Partnership with

2022. Holmes has been charged with a dozen counts

Blood-Testing Start-up Theranos.” The Washington

of wire fraud and conspiracy to commit wire fraud. If

Post, WP Company, 13 Oct. 2021,

convicted by the jury, Holmes faces up to 20 years in

https://www.washingtonpost.com/technology/202

prison as well as a fine of $250,000 plus restitution

1/10/13/theranos-walgreens-holmes/.

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Opioid epidemic on the rise due to COVID By: Moya Reid

With the COVID pandemic, we are now more isolated than ever before. This is not only messing with people’s ability to do their everyday activities, but also their mental health, bringing along anxiety, depression, and despair. One of the ways that we can see this shift is in the increase in overdose deaths.

During the height of the COVID pandemic, these deaths were up 70% in some places in Central Florida.

Nonetheless, all is not lost as adaptations are constantly being made to account for these ever-changing times.

Due to the nature of this pandemic, isolation is a big part of how to keep yourself and others safe. However, this isolation is also in turn harming people as well leading to deteriorating mental health and an increase in feelings of loneliness and helplessness. This has caused people to start using drugs more frequently and in more harmful ways; the isolation making early intervention less likely to happen.

Part of the reason is that there are a lot of relapses. People are unable to access recovery meetings, leading to blockades in their progress to recovery. Another reason might be inaccessibility to healthcare.

Many people have had a hard time getting in contact with their doctors about their medical needs and as such have turned to street drugs. For those who are on street drugs, there are also instances in which there have been disruptions in their supply; the desperation to procure it leading to lessening the need for reliability and increasing the volatility of use.

There has also been a large increase in stress, whether it be emotional or financial. People’s lives have become very unpredictable, with ever-changing rules and information coming out and having no time to adapt. People are unsure of who to trust and believe, how to protect themselves, and even if the pandemic is as serious as the news makes it out to be. People have also had to Gregorio, Author: Renata Di. “Overdose Calls up 40% during COVID-19 Pandemic; Treatment Centers Seeing Relapses in Long-Time Sober Patients.” Firstcoastnews.com, First Coast News, 23 July 2020, https://www.firstcoastnews.com/article/entertainment/television/programs/gmj/jfrd-averaging-15-overdose-calls-a-day-group-provides-narcan-training-in-response/77Shanoor Seervai, “‘It’s Really, Truly Everywhere’: How the Opioid Crisis Worsened with COVID-19,” June 4, 2021, in The Dose, produced by Shanoor Seervai, Andrea Muraskin, Naomi Leibowitz, and Joshua Tallman, podcast, MP3 audio, 25:05. https://doi.org/10.26099/3d62-cv07fa78a385-d445-4e64-b31c-bcabb57a0925.

Crawford, Author: Heather. “Dea Seeing Surge of Counterfeit Pills Laced with Fentanyl and Meth, and Just One Pill Can Kill.” Firstcoastnews.com, First Coast News, 11 Nov. 2021, https://www.firstcoastnews.com/article/news/specialreports/dea-counterfeit-pills-laced-with-fentanyl-meth-surging/77-c0698bf6-9b82-4540-954f-4452b130c7ec.

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learn how to deal with close relations that they have lost during the pandemic or those who now have lifelong symptoms due to the virus, which might even be themselves. There has also been the constant threat of losing your source of income. Economic stress can be a big cause of harmful drug use. To expand on this, homelessness causes the way people use drugs to be a lot riskier and is a major risk factor of overdose.

The seriousness of the situation is alarming. In the United States, there have been 100, 000 people who died from an overdose from March 2020 to March 2021. In June 2020, Jacksonville Fire and Rescue Department (JFRD) reported administering Narcan 500 times and averaged 15 calls about overdose a day which is a 40% increase from the previous year. In Florida, death by fentanyl increased 81% percent during the first half of 2020, making it one of the most dangerous drugs in the state. For the first time in six years, DEA has had to issue a Public Safety alert due to the alarming increase in counterfeit drugs that are laced with fentanyl and methamphetamine to make them more addictive. It is to be noted that fentanyl is extremely potent. The lethal dose is about the size of the tip of a pencil. The DEA has found that 2 out of 5 counterfeit pills could have enough fentanyl to kill. Not only is fentanyl in counterfeit pills, but it is also being worked into other illegal drugs such as cocaine. What makes this worse is that this is not fentanyl that is usually prescribed, but an analog that is usually even more potent.

It has, however, not all been bad news. The pandemic and the rise in opioid deaths have changed the way that we tackle certain issues. One is a big push for harm reduction strategies. An example of this is providing sterile needles and fentanyl test strips. The Centers for Medicare and Medicaid (CMS) have expanded the use of Telehealth services, including treatment and recovery programs and peer support groups. The Substance Abuse and Mental Health Services Administration (SAMHSA) has been advocating more flexible outpatient opioid treatment options such as a takehome methadone kit instead of having to go to the clinic every day. The DEA has also waived in-person office visits for controlled prescribing, including for buprenorphine.

Additionally, they have extended the availability for a newer long-acting buprenorphine injection or implant. With more knowledge and support, even with the difficulties that COVID has brought, there is still hope that we can gain control of this epidemic.

SAntich, Kate. “Central Florida Drug Od Deaths up 70% during COVID, Report Shows.” Orlandosentinel.com, Orlando Sentinel, 2 Dec. 2020, https://www.orlandosentinel.com/coronavirus/os-ne-coronavirus-dramatic-rise-in-florida-drug-overdoses-during-covid-20201202-u6rognhntrh7foitil4h5kltqi-story.html.

“Opioids and the COVID-19 Pandemic.” Opioids, Indian Health Service, https://www.ihs.gov/opioids/covid19/.

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Owning a Dog in Pharmacy School BY: KENZIE KILMAN

CHIEF

As we progress in some of the most academically rigorous years of our lives, many of us look to find something unrelated from school to de-stress. Maybe it’s a new workout routine or a new hobby. For me and many others, it was getting a dog. Animals are arguably one of the best ways to take our minds off the craziness of our lives. If you’re like me, I was terrified of having a dog while in school. I questioned if I’d be home enough or if I’d have time and energy to feed and walk him every day. Caring for another life takes an enormous amount of commitment and time management. I have taken mental notes over the past three years of dog ownership on what works best for our schedules. Hopefully, I can provide some more insight on what it’s like to own a dog in pharmacy school.

To clarify, I got my dog when he was four years old and entirely trained. Getting an older shelter dog can often mean they are already house trained and know basic commands. This can save a ton of time and relieve feelings of guilt when leaving a puppy home. I have left my dog home alone for ten hours on occasion and that could never be done with a puppy. Puppies need twice as much attention and care compared to older dogs. Rescuing a dog will typically mean they are free or cost a small fee with all health requirements already taken care of. I am not saying getting a pure-bred, newborn puppy in pharmacy school is impossible to manage. However, I think it takes someone who has conquered the time management skills. When I thought about my friends that raised puppies, I realized that they were able to raise a puppy because they did not commit to a full-time pharmacy program. Unlike my friends, I did not have the extra time to raise a puppy with my work and school schedule.

If you’re contemplating where you will find the time to have a dog, try to think about all the times you sit on your phone looking at the never-ending abyss of irrelevant content for hours. Think about the ten minute break that turns into a three hours break in between watching lectures. Those are both examples of extra moments you can dedicate to your dog. With that extra time, you can take your dog to the park, lounge around with them, or teach them a new trick. If you are worried about the extra time it will take in the mornings to walk and feed them, add an extra 20 minutes to your morning and evening routines. You will find that you have a plethora of time for your dog.

As you spend time with a dog, money is quickly spent on their necessities. Before you decided to pick up your new pet, be sure you think about the cost of owning a dog. You should budget for food, vet bills (I highly recommend pet insurance), flea prevention, grooming, and an emergency fund. Once you know you can afford the necessities, see if there is wiggle room for things like dog parks or doggie daycares. Give yourself at least 6 months to actively think about getting a dog (I waited a year).

Again, it is a huge commitment, but it has been worth every moment and was the best decision I made.

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Iraq Refugee to PharmD

How My Past Helps Me Connect to Patients

By Inas Mahdi

https://www.dreamstime.com/royalty-free-stock-image-dustoff-iraq-war-image4132396

In my time

living in the United States, I have learned two things: opportunities are endless, and there is a holiday where people dress up and show up to your house demanding candy. On that particular holiday, the costume I chose to wear embodied bravery and breaking generational trauma. I come from the land of two rivers, rich with culture and thoughtful people, Iraq. Of course, that is not the image that pops in anyone's head when they think of Iraq. They think of war and violence. There is some truth to that, which is why at seven years old, I worried less about my favorite doll and more about whether my school will be there the next day and would not be burned to pieces. Actually, it did burn while my classmates and I were in the middle of math class. Thankfully everyone left in time to escape physical harm, but the incident had taken its emotional toll. Parents stopped sending their children to school out of PAGE 15 fear, and even then, the school was in not in good enough condition to attend.

One thing all children of immigrant parents can agree on is that their parents are hard workers.

My parents pushed through many obstacles to bring us to the United States. I am many things, but I am not someone who fails to seize an opportunity. Coming to the United States opened up a whole new world to me; I suddenly had more options in everything. I had fewer worries, and I could choose to pursue pharmacy with a clear mind. As a first-generation student, beginning a doctorate degree is a significant breakthrough for my family and me. My parents saw in me what they wanted for themselves and felt pride knowing I had a choice in my future. Freedom to choose their future is something they never had; they were forced into most decisions. My dad dropped out of college to take care of his two disabled brothers. My mom left school because everyone kept telling her that education was not worth it and that her husband would provide for the family. Now, my mom could not stop gushing about how "I am the doctor of the family" for weeks. In a way, starting my Pharm D. at twenty years old is an accomplishment in itself, but making my parents happy is the real deal.

Viewing the world from two different perspectives makes me a better student pharmacist. I understand others and relate to them because, in essence, we are not aware of what someone is going through unless they can express their concerns. A patient will only reveal their true feelings if the provider can be attentive and caring to create an environment where the patient is comfortable enough to share. There is a relationship to be built between a pharmacist and their patient. Cultivating this relationship with empathy and compassion significantly improves the patient's point of care. I urge all pharmacy students and pharmacists to find that spot in their hearts where they can express empathy and genuine concern for their patients and their patients' health.

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THANK YOU!!

To our writers: Ruth Adeyemi Greta Apostoli Clarisa Callejas Kelli Corona Alyssa Cox Kenzie Kilman Inas Mahdi Moya Reid Victoria Walker

To our editors and designers: Kenzie Kilman Inas Mahdi Kendrich Panoch Moya Reid Victoria Walker

We could not have done this without YOU. PAGE 17