Journal of Legal Medicine最新文献

{"title":"DOJ Overreach: The Criminalization of Physicians.","authors":"Cathleen London","doi":"10.1080/01947648.2022.2147366","DOIUrl":"10.1080/01947648.2022.2147366","url":null,"abstract":"The primary narrative directing opioid policy is that the overdose epidemic is driven by clinician overprescribing, creating patient addicts. This has led to draconian laws and the use of invasive prescription monitoring programs that have harmed patients with chronic pain throughout the country. 1 The black box algorithms mine data and have never been subjected to independent verification. 2 Patients and prescribers alike are flagged as sus-picious. 3 Although opioid prescribing has dropped dramatically since the introduction of prescription monitoring, overdose deaths have risen expo-nentially, driven by the illicit fentanyl market. Despite this, law enforcement continues to focus on the diversion of prescription medication. The drug prohibition policy set by the Department of Justice (DOJ) is a mis-guided attempt to address skyrocketing opioid overdoses. It is their way of trying to fix the issue of the unchecked distribution of opioids. The blame for that falls on the Drug Enforcement Agency (DEA), Congress, and lobbyists. 4 This focus on limiting the prescribing of legal opioids has led to an increasingly lethal illicit opiate supply. The DOJ continues to erroneously cite diversion of licit legitimate prescriptions of opioids as the problem. As a result, doctors have been imprisoned for terms ranging from 20 years to life without parole, all for practicing medicine. Others have had their careers and reputations irreparably harmed.","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10528952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In The Supreme Court of the United States: Docket No. 21-1967.","authors":"Jacey DuBois, Lawson Hamilton","doi":"10.1080/01947648.2022.2087406","DOIUrl":"https://doi.org/10.1080/01947648.2022.2087406","url":null,"abstract":"","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10527417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life After Brain Death.","authors":"Katherine Schiller","doi":"10.1080/01947648.2022.2147367","DOIUrl":"10.1080/01947648.2022.2147367","url":null,"abstract":"I. FROM DEATH TO BRAIN DEATH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .205 A. Death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205 B. The Rise of Patients with Permanent Neurological Injury . . . . . . . . . . . . . . 206 C. Defining “Brain Death” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207 II. CRITICISM OF BRAIN DEATH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .208 A. The Dead Donor Rule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209 B. Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209 C. Moral Concerns about VPOD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210 III. THE UTILITARIAN ARGUMENT FOR VPOD . . . . . . . . . . . . . . . . . . . . . . .211 IV. LEGAL PROTECTIONS FOR VPOD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .214 V. CONCLUSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .215","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10528953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical Dilemma of Physicians Informing Patients of Foreign Organ Transplant Alternatives","authors":"S. Poole, Benjamin Selander, Joseph P. Hardy, W. Havins","doi":"10.1080/01947648.2021.1914488","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914488","url":null,"abstract":"Ethical Dilemma of Physicians Informing Patients of Foreign Organ Transplant Alternatives Sean Poole, OMS-II; spoole3@student.touro.edu Benjamin Selander, OMS-II; Touro bselande@student.touro.edu Joseph P. Hardy, MD, Associate Dean for Clinical Education Weldon Havins, MD, JD, LLM, FCLM, Emeritus Professor Touro University Nevada College of Osteopathic Medicine, NV Ever since the introduction of transplant surgery in the latter half of the 20th century, organ transplantation has improved the lives of thousands of people around the world. However, the demand for organs is steadily rising while the supply remains limited. This inevitably leads well-to-do individuals, placed on lengthy organ waiting lists, to seek organ transplants abroad in less ethical and less legal ways. Many procure these organs in China, where it is believed that non-consenting Falun Gong practitioners are persecuted, placed in detention centers or labor camps and illegally harvested for their organs. There are also issues of illegal brokers taking advantage of vulnerable individuals in developing nations, such as the Philippines and Moldova. However, regardless of how the organs are acquired, “organ tourists” are met with virtually no legal repercussions. The increasing need for organs has created a global issue. This practice, called “organ tourism”, has been condemned, but not criminalized, by the greater international community in the Declaration of Istanbul, created in 2008 and supported by over 150 countries. Though internationally condemned, engagement in “organ tourism” has seen an increase in recent years. There are currently no U.S. laws prohibiting organ tourism, nor are there any mandates requiring physicians to report patients who have participated in organ tourism. Therefore, physicians are faced with an ethical dilemma; in what capacity, if any, to advise their patients regarding organ transplantation abroad. This review utilizes the Army’s 7 Steps in Problem Solving Model to provide a concise and conclusive framework to determine if there exists an ethical obligation for physicians to advise their patients of foreign transplant alternatives. By following the Army’s 7 Steps in Problem Solving Model, certain guiding criteria are established, such as: non-judgmental regard and fiduciary responsibility for patients who return with transplanted organs, deterring hopeful transplant patients from involving 2021 American College of Legal Medicine JOURNAL OF LEGAL MEDICINE 2021, VOL. 41, NO. S1, 36–37 https://doi.org/10.1080/01947648.2021.1914488 themselves in organ transplant systems engaged in crimes against humanity, and considering the greater societal impact of the benefits of organ tourism. This review concludes it is the physicians ethical duty to advise their patients of foreign options to obtain organ transplantation. However, there should be no obligation to inform patients of transplant organ systems which take part in highly unethical practices, such as thos","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80801645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality of COVID-19 and Seasonal Influenza in Southern Nevada and the United States","authors":"Nilsha Khurana, A. Bedi, W. Havins","doi":"10.1080/01947648.2021.1914483","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914483","url":null,"abstract":"Mortality of COVID-19 and Seasonal Influenza in Southern Nevada and the United States Nilsha Khurana, OMS-II; nkhurana@student.touro.edu Avneet Bedi, OMS-II; abedi2@student.touro.edu Weldon E Havins, MD, JD, LLM, FCLM, Professor Emeritus Touro University Nevada College of Osteopathic Medicine In early March 2020, Coronavirus disease 2019 (COVID-19) was declared a national pandemic by the World Health Organization. Many have claimed that COVID-19 is no more serious than the influenza. Although influenza and COVID-19 have some symptoms in common, COVID-19 is a more destructive virus. Because the virus that causes COVID-19 is newly introduced in human populations, there is an urgent need to know more about how the disease impacts human populations. The purpose of this study was to estimate and compare mortality rates between COVID-19 and influenza in Southern Nevada and in the United States. Data for Southern Nevada was collected from Southern Nevada Health District (SNHD) and covered COVID-19 and influenza deaths from 2016-2020. Nationwide data was obtained from the Centers for Disease Control and Prevention (CDC) and covered 2016-2020 for both COVID-19 and influenza. Deaths per 100,000 people, which were attributable to influenza and Coronavirus, were calculated for the Southern Nevada population and for the United States population. After analyzing the data, it was found that there has been an average of 113.19/100,000 COVID deaths in Nevada since the discovery of the virus. On the other hand, for influenza, there has been an average of 1.8/100,000 deaths in Nevada for the past four flu seasons, which typically peaks between December and February. A similar trend is observed nationally. According to the CDC data, it was calculated that nationwide, there are about 111.55/100,000 COVID deaths. Contrarily, there are about 12.46/100,000 influenza-related deaths nationwide. According to the calculations, COVID-19 has a mortality rate higher than reported for influenza, both in Nevada and in the nation. The differences in mortality rates are linked to other important ways that COVID-19 differs from influenza. Because COVID-19 is novel, every individual is therefore susceptible to the virus. Awareness that COVID-19 is not just the flu needs to be made more vigorously. COVID-19 will be a more lethal virus than the influenza strains that seasonally affect world populations. References upon request 2021 American College of Legal Medicine JOURNAL OF LEGAL MEDICINE 2021, VOL. 41, NO. S1, 31 https://doi.org/10.1080/01947648.2021.1914483","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90452431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Turbulent Airflow Costume Compromises Occupational Safety and Infection Control: A Hospital Risk Management Case Report","authors":"Sarah J. Diekman","doi":"10.1080/01947648.2021.1914476","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914476","url":null,"abstract":"Objectives: To inform hospital infection control, risk management, hospital administrators, and healthcare workers about a new and surprising threat to infection control: air-powered costumes Background: Air-powered costumes use a small motor to create positive pressure within the costume This mechanism is similar to Powered Air Purifying Respirator (PAPR) 1 However, unlike a PAPR the air-powered costume does not filter the incoming air through a HEPA filter Nor does it capture the air inside a contained space and filter it before it is released into the environment The affect is that droplets from the person in the costume or from air that is drawn into the costume, which would normally be too heavy to travel farther than 6 feet, are aerosolized by traveling through the turbulent blower These small particles can easily penetrate the thin fabric that makes the costume This creates an infection control problem by aerosolizing the particles and then propelling them with the force of positive pressure \" Case Description: In January of 2021, a Covid-19 outbreak in San Jose, CA, was contact traced back to a surprising source On Christmas day, a worker wishing to lift spirits, unknowingly spread Covid-19 via an air-powered Christmas tree costume The worker did not have symptoms of SARS-COV-2 and did not know they were infected The result is tragic In San Jose, at least 60 people were infected, and one person died \" Conclusion: This case manifests a tragic outcome to what was meant to be a benevolent action All evidence points to lack of information guiding this well-intentioned action What was meant to decrease the stress and burden of the pandemic, became a greater stress and burden Tragically with a loss of life and unknown morbidity Further, there is the potential for a psychologic toll on the person who thought they were helping others, only to learn that they had harmed them Given that these costumes in hospitals are rare, further tragedies such as this one should be preventable Covid-19 is not the only pathogen that could theoretically be spread by this mechanism Hospital should have a policy that restricts the use of these costumes Education about the danger of these costumes should be provided to staff Given that personal may act by finding replacement, risk management and infection control should create an adequate policy to address the mental health needs of staff and patients, while maintain appropriate infection control Now that there is documentation of this methods of pathogenic spread, hospitals may face liability if they fail to establish a reasonable policy and education regarding turbulent flow air-powered costumes","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87881583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-State Retention of Physicians in Nevada Residency Programs","authors":"Eric H. Chai, D. Chan, W. Havins","doi":"10.1080/01947648.2021.1914473","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914473","url":null,"abstract":"","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89290088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing Patterns of XR-Naltrexone for Treating OUD by Nevada Addiction Specialists","authors":"Samia Mouaki-Benani, A. Sheikh, Joseph P. Hardy, W. Havins","doi":"10.1080/01947648.2021.1914481","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914481","url":null,"abstract":"Prescribing Patterns of XR-Naltrexone for Treating OUD by Nevada Addiction Specialists Samia Mouaki-Benani, OMS-II; smouaki@student.touro.edu Ansab Sheikh, OMS-II; asheikh5@student.touro.edu Joseph P. Hardy, MD, Associate Dean for Clinical Education Weldon Havins, MD, JD, LLM, FCLM Touro University Nevada College of Osteopathic Medicine Background: The Opioid crisis is a nationwide epidemic with devastating consequences to American communities and public health. In 2018, 46,802 (70%) of all overdose deaths in the United States, and 372 drug overdose deaths in Nevada, were opioid-related. Medication-assisted treatment (MAT) is an effective “whole-patient” approach to the treatment of opioid use disorder (OUD), combining medications with behavioral therapy and counseling. There are three FDAapproved medications indicated for opioid dependency: naltrexone, methadone, and buprenorphine. Treatment centers rarely offer naltrexone (XR-NTX, or Vivitrol available in injectable extended release form) compared with opioid agonist treatments. The goal of this study is to quantify prescribing patterns of MAT to treat OUD in Nevada and to understand the reasons addiction specialists do or do not prescribe it. Methods: A survey was created with questions designed and sent to practicing Nevada addiction specialists, including physicians (MD and DO), physician assistants, and nurse practitioners in the state of Nevada (Nevada Addiction Specialists hereafter), by mail. Results: Of 309 Nevada Addiction Specialists surveyed, 34 (11%) responded. Almost half (47%) of responding addiction specialists in Nevada prescribed XR-NTX, yet only 9% of OUD patients were treated with XR-NTX. The leading reasons addiction specialists prescribed XRNTX were the frequency of injections and the non-addictive nature of the drug. The leading reasons for not prescribing XR-NTX were its detoxification requirement (35% of respondents), accessibility (29%), and price (24%). Of the Nevada addiction specialists who did not prescribe XR-NTX, 28% were unfamiliar with the drug. Conclusion: The survey results suggest that XR-NTX is appropriate for only a small subset of patients with OUD, as indicated by the CDC and other studies. XR-NTX has potential in highly motivated patients that are 2021 American College of Legal Medicine JOURNAL OF LEGAL MEDICINE 2021, VOL. 41, NO. S1, 27–28 https://doi.org/10.1080/01947648.2021.1914481 willing to abstain from opioid use during the detox period, those willing to pay the higher cost, and patients in the criminal justice system. There may be a need for increasing awareness and education of MAT options earlier in medical training to bridge the gap in knowledge related to the treatments available for patients with OUD. The generalizability of this study is limited by the small number of respondents. References available upon request 28 ABSTRACT","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78952833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Encouraging Online Voter Registration of Nevada Physicians - A Challenge in Apathy?","authors":"S. Tun, H. Luong, W. Havins","doi":"10.1080/01947648.2021.1914492","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914492","url":null,"abstract":"Encouraging Online Voter Registration of Nevada Physicians A Challenge in Apathy? Sein Tun, MS, OMS-II; stun@student.touro.edu Hao Luong, MS, OMS-II; hluong2@student.touro.edu Weldon E Havins, MD, JD, LLM, FCLM, Emeritus Professor Touro University Nevada College of Osteopathic Medicine, Henderson, Nevada Voting is the most basic way a citizen can have his or her voice heard. It is also one of the easiest ways for an individual to participate in changing or maintaining the legislation. Voting registration and participation can allow citizens to have a direct impact on the healthcare system, which is an essential aspect of policy making within the United States’ political system. Physicians are the most equipped with knowledge about the healthcare system, therefore, there is a need to increase voting amongst physician populations. Physicians’ votes and influence on health policy impact not only the medical community but their patients as well. To improve the healthcare system for both physicians and their patients, the candidates chosen to become legislators must align with the views held by their constituents. As registered voters and constituents of an Assemblyperson and a Senator, physicians can actively voice their concerns and ideas that could potentially contribute to new and improved legislation. However, the first and most important step in getting involved is to register to vote. When compared to other higher education professionals such as lawyers, physicians are less active in politics. This needs to be improved because healthcare policy contributes to a large portion of political discussion. In order to promote physician engagement in politics, there must be promotion of registration to vote. One benefit is that it is especially easy to register now because it can be done conveniently online. This study aims to improve physician voter registration outcomes by identifying physicians in Clark County who are not registered voters and contacting them to discuss the importance of voting and how to register online. However, because of limited information available from the National Board of Medical Examiners (NBME) and the National Board of Osteopathic Medical Examiners (NBOME) databases, the only feasible method of contact to physicians is through mailing physical letters to their work offices. The method utilized in this study is not effective because it lacked sufficient time to allow the letters to be received by physicians before the data was 2021 American College of Legal Medicine JOURNAL OF LEGAL MEDICINE 2021, VOL. 41, NO. S1, 47–48 https://doi.org/10.1080/01947648.2021.1914492 analyzed. Although this study could not prove that mailing letters to the physicians’ office of practice is an adequate method, it did show that approximately 74% of physicians in Clark County are registered voters, which is of higher percentage than the general population of Nevada. Nonetheless, this number does not account for other variables that may influen","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86050818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Relationship Between Opioid Prescription Frequency and Deaths From Illicit Opioids","authors":"C. Wyant, Taylor Cornwell-Hinrichs, Joseph P. Hardy, W. Havins","doi":"10.1080/01947648.2021.1914493","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914493","url":null,"abstract":"Investigating the Relationship Between Opioid Prescription Frequency and Deaths From Illicit Opioids Cara Wyant, OMS-II Taylor Cornwell-Hinrichs, MPH, MLIS, OMS-II Joseph P. Hardy, MD, Associate Dean of Clinical Education Weldon Havins, MD, JD, LLM, MA, Emeritus Professor Touro University Nevada College of Osteopathic Medicine In accordance with the global opioid epidemic, the CDC issued guidelines for practitioners prescribing opioids for chronic pain. In response to these guidelines and to the opioid epidemic itself, Nevada issued restrictive legislation on practitioners prescribing opioids: SB 459, AB 474, and AB 239. To investigate the relationships between opioid legislature and opioidrelated death rates, data was obtained from the Nevada Board of Pharmacy and the Clark and Washoe County medical examiner offices. The data demonstrate that there was a significant decrease in prescriptions following the legislation; however, there was no correlation between the legislation and overall rate of opioid-related deaths because there was a subsequent and dramatic rise in deaths from illicit opioids. This suggests that more patients switched to the use of heroin and/or fentanyl as a result in limiting legal opioid prescribing power. A Spearman correlation was calculated (-0.04) and a two-way analysis of variance (ANOVA) was used to compare the time periods of the legislation implementation and the county. There were no interactions between the two counties and law; so, both counties experienced the same trends following these laws. To compare opioid-related deaths to opioid prescription rate for each time period, a t-test with law as the only factor was conducted with combined data from both counties (SB 459 p1⁄4 0.744; AB 474 p1⁄4 0.640; AB 239 p1⁄4 0.704). No significance was found. The COVID-19 Stay at Home order has statistically increased opioid-related deaths (p1⁄4 0.010), albeit it is unknown if this increase is due to Nevadans selfmedicating in response to work stoppages and financial stress, inability to see a practitioner in person, or restrictions involving addiction clinics during the pandemic. The goal of Nevada’s three opioid prescription bills was to reduce the rate of Nevadans dying from opioid overdoses, yet more Nevadans are dying from opioids now than before the bills passed. We recommend three provisions that will allow providers to confidently prescribe appropriate 2021 American College of Legal Medicine JOURNAL OF LEGAL MEDICINE 2021, VOL. 41, NO. S1, 49–50 https://doi.org/10.1080/01947648.2021.1914493 pain management for their patients without fear of sanction from another licensing board’s misunderstandings, allow providers to humanely manage their patients’ legitimate pain, and limit unintended consequences where patients are forced to seek out illicit opioids to control their pain and inadvertently die in the process. These are our recommendations: (1) Base law requirements on guidelines provided by professional or governmen","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88853928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}