By Steele Clarke Smith, III 

Ever heard of CECD? Most people haven’t. It stands for Clinical Endocannabinoid Deficiency, and it’s more important to healthcare than people realize.

CECD is a dysfunction of the human endocannabinoid system (ECS). The ECS is composed of two endocannabinoid receptors, Cannabinoid #1 (CB1) and Cannabinoid #2 (CB2), which also interact with a substance known as cannabidiol (CBD). Located throughout the body, CB1 receptors are concentrated in the brain and central nervous system, while CB2 receptors are more heavily associated with the organs and immune system.

Given the role that the ECS plays in neurogenesis, it’s easy to see how the endocannabinoid receptors can be used to impact psychosomatic issues caused by CECD. Psychosomatic problems are those in which mental issues are manifested as physical symptoms. One example of this is hypochondria, or illness anxiety disorder, which can be described as a chronic fear of being seriously unwell. In such cases, the anxiety is the real illness, with any physical symptoms being posterior to the ones in the mind. [Read more…]

By Katrina Hernandez

Dying has never been so expensive. There’s end-of-life care, the transfer of remains, and other service fees — all before the cost of disposing of the body. How you choose to be laid to rest can be an added stress to family during an already tragic time. There are three main types of end-of-life services, each of which brings unique benefits and associated costs:

Funeral and burial. While the most traditional practice, this is the most time-intensive and expensive option. However, its therapeutic benefits are important for the loved ones of the deceased. It’s a time to remember, honor, respect, and celebrate life, taking place within a few days of passing. For almost all of human history, this has been key for grieving survivors.

On average, a traditional funeral cost $7,360. And while people are increasingly choosing nontraditional options — cremation is becoming more popular — traditional funeral and burial costs aren’t getting any cheaper. The cost has increased by 38.1 percent from the average funeral in 2004, breaking down as follows:

Basic service fees include body removal, embalming, other body preparations, use of the funeral home’s facilities for a viewing and ceremony, a hearse, memorial package, and casket. That average cost of $7,360 assumes you choose the most basic options for all of the above services. Many families make more elaborate plans that can run well over $10,000. For some, it’s well worth it. For others, the cost is simply not feasible. [Read more…]

A large, prominent teaching hospital needed to update its nearly 20-year-old compliance hotline program and lacked the internal staffing and expertise to accomplish this task on its own.

Problem to Solve

If you ever thought health care compliance was costly, consider the far greater costs of non-compliance. According to a recent study on corporate compliance, it is nearly three times as costly to be non-compliant – in terms of fines, settlements, business disruption, productivity loss, revenue loss and more – as it is to maintain a proper compliance framework and culture.

A large, prominent teaching hospital needed to update its nearly 20-year-old compliance hotline program and lacked the internal staffing and expertise to accomplish this task on its own. Recognizing the need to quickly and efficiently ensure that its compliance hotline would meet its future requirements, the hospital turned to Freed Associates (Freed) to accomplish this. [Read more…]

Obsessive-compulsive disorder (OCD) is a chronic psychiatric condition affecting 1.2% of the population in the United States and between 1.1% and 1.8% of the world population. (Hollander et al., 2016). OCD patients suffer from debilitating uncontrollable, recurring thoughts accompanied by the urge to repeat specific behaviors in an effort to alleviate these intrusive thoughts, symptoms which greatly impact both their professional and personal life (Hollander et al., 2016). In addition to the debilitating nature of the disorder for patients themselves, OCD is associated with significant costs and burdens to society as a whole (Goodman, 2016). 

Over the years, the American Psychiatric Association has implemented an OCD treatment algorithm consisting of cognitive behavioral therapy (CBT), selective serotonin reuptake inhibitors (SSRIs), or a combination of the two as first line treatment options (Koran et al., 2007). Unfortunately, many patients do not respond to first line treatments and there can be difficult side effects associated with these therapies.

OCD patients treated with exposure-response prevention therapy (ERP), a type of CBT specialized for treating OCD,  confront triggers that induce obsessive thoughts and work to reduce anxiety surrounding these triggers. Many patients find this therapy extremely anxiety-inducing and do not complete the full course. Those who do find success with ERP are still left with residual symptoms (Whittal et al., 2005).

SSRIs have been the first line pharmacologic option for the treatment of OCD since 1989 (Pittenger & Bloch, 2014). However, despite promising data surrounding this treatment, roughly half of patients treated with SSRIs do not respond (Jenike, 2004), leading clinicians to escalate the dose of the SSRI or try multiple different SSRIs before concluding that a patient is a non-responder (Reddy, Sundar, Narayanaswamy, & Math, 2017). This process can sometimes take years, leaving patients feeling hopeless as they try each new drug. The next line option is augmenting patients’ SSRI treatment with atypical antipsychotics, but the side effects associated with adding an antipsychotic to the treatment regimen are significantly worse than those associated with treatment with an SSRI alone (Haverkampf, 2014). [Read more…]