States look to regulate weed alternatives like delta-8 : Shots

Delta-8 products are set for testing at Virginia Commonwealth University’s forensic science lab. These products come in different forms and packaging, many of which are designed to look like candies or cereal.

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Crixell Matthews/VPM News


Delta-8 products are set for testing at Virginia Commonwealth University’s forensic science lab. These products come in different forms and packaging, many of which are designed to look like candies or cereal.

Crixell Matthews/VPM News

Michelle Peace will sometimes dip into a convenience store and emerge with a handful of hemp products like delta-8. They come in gummies, tinctures, vape cartridges and joints and they’re designed to get you high.

Despite knowing glances from cashiers, Peace isn’t headed to a party. She’s the director of the laboratory for forensic toxicology research at Virginia Commonwealth University, and she’s bringing her collection to the lab to see what’s inside. In some cases, no one else is checking.

Hemp products that can get you high have proliferated online and at corner stores, even in places where marijuana remains illegal. The products, marketed under names like delta-8 and delta-10, have been a lifeline for the struggling hemp industry. Even critics of the products acknowledge some companies maintain high standards for their products, with credible lab testing and careful quality control.

Dr. Peace shows off one of the delta-8 products, highlighting the specific aspects of the packaging that have the potential to confuse consumers.

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Dr. Peace shows off one of the delta-8 products, highlighting the specific aspects of the packaging that have the potential to confuse consumers.

Crixell Matthews/VPM News

But federal regulators aren’t monitoring what’s in the products. Peace and other researchers have found problems ranging from irregular dosing to heavy metals. Some edibles have packaging and labels that mimic common candy or cereal (“Stony Patch THC Gummies” or “Fruity Pebblez”), and there’s been a spike in calls to poison control centers related to delta-8. Newer products, like THC-O, can be even more potent, according to Peace.

“Delta-8 is like, ‘Look at me, look at me,’ and there’s a monster behind the bush,” Peace said.

Still, a recent federal appeals court verdict appeared to uphold the legality of delta-8 products on the federal level. In the absence of clear federal regulations or guidance, lawmakers in states like Colorado and Oregon have

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Nursing homes use lawsuits to demand friends and family pay off medical debts : Shots

Lucille Brooks, a retiree who lives in Pittsford, New York, was sued in 2020 for nearly $8,000 by a nursing home that had taken care of her brother. The nursing home dropped the case after she showed she had no control over his money or authority to make decisions for him.

Heather Ainsworth for KHN


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Heather Ainsworth for KHN


Lucille Brooks, a retiree who lives in Pittsford, New York, was sued in 2020 for nearly $8,000 by a nursing home that had taken care of her brother. The nursing home dropped the case after she showed she had no control over his money or authority to make decisions for him.

Heather Ainsworth for KHN

ROCHESTER, N.Y. — Lucille Brooks was stunned when she picked up the phone before Christmas two years ago and learned a nursing home was suing her.

“I thought this was crazy,” recalled Brooks, 74, a retiree who lives with her husband in a modest home in the Rochester suburbs. Brooks’ brother had been a resident of the nursing home. But she had no control over his money or authority to make decisions for him. She wondered how she could be on the hook for his nearly $8,000 bill.

Brooks would learn she wasn’t alone. Pursuing unpaid bills, nursing homes across this industrial city have been routinely suing not only residents but their friends and family, a KHN review of court records reveals. The practice has ensnared scores of children, grandchildren, neighbors, and others, many with nearly no financial ties to residents or legal responsibility for their debts.

The lawsuits illuminate a dark corner of America’s larger medical debt crisis, which a KHN-NPR investigation found has touched more than half of all U.S. adults in the past five years.

Litigation is a frequent byproduct. About 1 in 7 adults who have had health care debt say they’ve been threatened with a lawsuit or arrest, according to a nationwide KFF poll conducted for this project. Five percent say they’ve been sued.

The nursing home industry has quietly developed what consumer attorneys and patient advocates say is a pernicious strategy of pursuing family and friends of patients despite federal law that was enacted to protect them from debt collection. “The level of aggression that nursing homes are using to collect unpaid debt is severely increasing,” said Lisa Neeley, a Massachusetts elder law attorney.

In Monroe

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Emergency contraception pills are safe, but not always available : Shots

The 2021 study found that 32% of pharmacies did not have levonorgestrel, a hormone that can prevent pregnancy after unprotected sex, in stock at all, and of the pharmacies that did have it on the shelf, 70% of them kept it in a locked box.

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The 2021 study found that 32% of pharmacies did not have levonorgestrel, a hormone that can prevent pregnancy after unprotected sex, in stock at all, and of the pharmacies that did have it on the shelf, 70% of them kept it in a locked box.

Seth Herald/AFP via Getty Images

Imagine this scenario that untold numbers of women find themselves in each year. Maybe you had unprotected intercourse, or the condom broke, or maybe you accidentally missed taking a birth control pill or two. You don’t want to get pregnant, so you rush to the pharmacy for emergency contraception. All the while, the clock is ticking.

“These medications are incredibly time sensitive,” says Dr. Sonya Borrero, a professor of medicine at the University of Pittsburgh who focuses on reproductive health equity. She says emergency contraception pills need to be taken within five days after unprotected sex — “but the sooner, the better.”

Surveys show that roughly a quarter of American women have, at some point in their lives, used emergency contraception pills to prevent an unintended pregnancy. This type of contraception is effective, safe and legal throughout the United States. And yet researchers are finding it’s not always available when people need it.

Take, for example, levonorgestrel, a form of emergency contraception better known under the brand name Plan B, although it’s also available in generic versions with names including My Way, Take Action and My Choice, to name a few. Borrero says Plan B is supposed to be available over the counter, on the shelf, stocked for all ages.

But when Borrero sent a team of medical students to pharmacies across western Pennsylvania to see what these stores actually had on hand, they found a third of pharmacies didn’t stock Plan B at all. And when they did have it, “most of the time it wasn’t really on the shelf. It was either behind the counter or in one of those locked boxes,” which means a customer would have to ask someone to hand them the emergency contraception. She says

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Turnaway Study offers insights on the impact of losing access to abortion : Shots

With Roe v. Wade primed to be overruled, people seeking abortions could soon face new barriers in many states. Researcher Diana Greene Foster documented what happens when someone is denied an abortion in The Turnaway Study.

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With Roe v. Wade primed to be overruled, people seeking abortions could soon face new barriers in many states. Researcher Diana Greene Foster documented what happens when someone is denied an abortion in The Turnaway Study.

Malte Mueller/Getty Images

Though it’s impossible to know exactly what will happen to abortion access if Roe v. Wade is overturned, demographer Diana Greene Foster does know what happens when someone is denied an abortion. She documented it in her groundbreaking yearslong research project, The Turnaway Study and her findings provide insight into the ways getting an abortion – or being denied one – affects a person’s mental health and economic wellbeing.

For over 10 years, Dr. Foster and her team of researchers tracked the experiences of women who’d received abortions or who had been denied them because of clinic policies on gestational age limits.

The research team regularly interviewed each of nearly 1,000 women for five years and found those who’d been denied abortion experienced worse economic and mental health outcomes than the cohort that received care. And 95% of study participants who received an abortion said they made the right decision.

The idea for the Turnaway Study emerged from a 2007 Supreme Court abortion case, Gonzales v. Carhart. In the majority opinion upholding a ban on a specific procedure used rarely in later abortions, Justice Anthony Kennedy speculated that abortions led to poor mental health. “While we find no reliable data to measure the phenomenon, it seems unexceptionable to conclude some women come to regret their choice to abort the infant life they once created and sustained,” he wrote. “Severe depression and loss of esteem can follow.”

Dr. Diana Greene Foster is the lead researcher on the interdisciplinary team behind The Turnaway Study.

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Simon & Schuster

Kennedy’s speculation — and admitted lack of evidence — captured Foster’s attention, “because you can’t make policy based on assumptions of what seems reasonable without talking to a representative sample of people who actually wanted an abortion,” she said. The Turnaway Study fact-checked the justice’s guess, finding that not having a wanted

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Hit with $7,146 for two hospital bills, a family sought health care in Mexico : Shots

Claudia and Jesús Fierro of Yuma, Ariz., review their medical bills. They pay $1,000 a month for health insurance yet still owed more than $7,000 after two episodes of care at the local hospital.

Lisa Hornak for Kaiser Health News


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Lisa Hornak for Kaiser Health News


Claudia and Jesús Fierro of Yuma, Ariz., review their medical bills. They pay $1,000 a month for health insurance yet still owed more than $7,000 after two episodes of care at the local hospital.

Lisa Hornak for Kaiser Health News

The Fierro family of Yuma, Ariz., had a string of bad medical luck that started in December 2020.

That’s when Jesús Fierro Sr. was admitted to the hospital with a serious case of COVID-19. He spent 18 days at Yuma Regional Medical Center, where he lost 60 pounds. He came home weak and dependent on an oxygen tank.

Then, in June 2021, his wife, Claudia Fierro, fainted while waiting for a table at the local Olive Garden restaurant. She felt dizzy one minute and was in an ambulance on her way to the same medical center the next. She was told her magnesium levels were low and was sent home within 24 hours.

The family has health insurance through Jesús Sr.’s job, but it didn’t protect the Fierros from owing thousands of dollars. So when their son Jesús Fierro Jr. dislocated his shoulder, the Fierros — who hadn’t yet paid the bills for their own care — opted out of U.S. health care and headed south to the U.S.-Mexico border.

And no other bills came for at least one member of the family.

The patients: Jesús Fierro Sr., 48; Claudia Fierro, 51; and Jesús Fierro Jr., 17. The family has Blue Cross and Blue Shield of Texas health insurance through Jesús Sr.’s employment with NOV, formerly National Oilwell Varco, an American multinational oil company based in Houston.

Medical services: For Jesús Sr., 18 days of inpatient care for a severe case of COVID-19. For Claudia, fewer than 24 hours of emergency care after fainting. For Jesús Jr., a walk-in appointment for a dislocated shoulder.

Total bills: Jesús Sr. was charged $3,894.86. The total bill was $107,905.80 for COVID-19 treatment. Claudia was charged $3,252.74, including $202.36 for treatment from an out-of-network physician. The total bill was $13,429.50 for less than one day of treatment. Jesús Jr. was charged $5 (70 pesos)

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Never-ending costs: When resolved medical bills keep popping up : Shots

Suzanne and Jim Rybak, inside the craft room where their son, Jameson, would encourage Suzanne to make colorful beach bags, received a $4,928 medical bill months after it was supposedly resolved.

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Suzanne and Jim Rybak, inside the craft room where their son, Jameson, would encourage Suzanne to make colorful beach bags, received a $4,928 medical bill months after it was supposedly resolved.

By Gavin McIntyre/Kaiser Health News

Every now and then, Suzanne Rybak and her husband, Jim, receive pieces of mail addressed to their deceased son, Jameson. Typically, it’s junk mail that requires little thought, Suzanne said.

But on March 5, an envelope for Jameson came from McLeod Health.

Jim saw it first. He turned to his wife and asked, “Have you taken your blood pressure medication today?”

He knew showing her the envelope would resurface the pain and anger their family had experienced since taking Jameson to McLeod Regional Medical Center in Florence, S.C., two years ago.

As KHN previously reported, Jameson was experiencing withdrawal symptoms from quitting opioids. Suzanne feared for her son’s life and took him to McLeod’s emergency room on March 11, 2020.

There, they encountered a paucity of addiction treatment and the potential for high medical costs — two problems that plague many families affected by the opioid crisis and often lead to missed opportunities to save lives.

Jameson was not offered medications to treat opioid use disorder in the ER, nor was he given referrals to other treatment facilities, Suzanne said. The hospital wanted to admit him, but, being uninsured, Jameson feared a high bill. The hospital didn’t inform him of its financial assistance policy, Suzanne said. And he decided to leave.

Three months later, Jameson, 30, died of an overdose in his childhood bedroom.

Months of red tape

In the following months, the Rybaks received bills from McLeod Health addressed to Jameson. He owed $4,928, the bills said. Suzanne called and wrote to hospital administrators until September 2020, when the bill was resolved under the health system’s financial assistance program.

That was the last they had heard from McLeod Health until the new envelope arrived March 5 — one week before the two-year anniversary of Jameson’s ER visit. That visit was what Suzanne calls “the beginning of the end for my son.”

When the Rybaks opened the envelope,

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