domingo, 20 de agosto de 2017

Managing the worsening opioid epidemic

Managing the worsening opioid epidemic



Managing the worsening opioid epidemic
     
Policy analysts are deeply concerned about the worsening opioid crisis in the US, and some are proposing radical measures to fight it.

A recently released study in the American Journal of Respiratory and Critical Care Medicinepaints a grim picture of overdose and dependency among opioid users. Researchers from Beth Israel Deaconess Medical Centre in Boston and the University of Chicago report that opioid-related overdose deaths in the US have doubled since 2000 -- a result of addiction to both prescription painkillers like oxycodone and illegal drugs like heroin. Alongside this worsening trend, opioid overdose admissions requiring treatment in hospital intensive care units (ICUs) surged 34 % from 2009 to 2015, the study found. During this same period, the death rate for these ICU patients climbed from 7.3 % to 9.8 %. Drug overdoses are currently the number one killer of Americans under the age of 50.

“When we think of overdoses, we need not to just think about whether people died or survived, but also about the tremendous personal and societal costs” Dr Jennifer Stevens of Harvard Medical School, a lead author of the study, told Reuters.

Some specialists suggest that greater access to traditional opioid substitutes would lead to positive change. “People who use injection drugs should obtain naloxone, the overdose reversal drug, and use drugs with partners who can help them,” says Brendan Saloner, a researcher at the Johns Hopkins Bloomberg School of Public Health in Baltimore. “There is unfortunately a lot of stigma about medication treatments, but they are safe and work,” Saloner added. “Long-term change is possible and recovery is a realistic goal, but it requires time and patience.”

Yet some suggest that standard treatments are failing to address the problem. Instead of providing  methadone and naloxone substitutes, Chelsea Cox, a candidate for a JD and a Master of Health Administration at Dalhousie University, argues that we should de-stigmatise marijuana and make the drug more readily available:

“Patients want access [to medicinal marijuana] … A team from University of California, Berkeley reported that 93% of patients said that they decreased their use of opioids when they also used medical marijuana. These numbers show the need for governments to get on the same page as patients – especially with 142 Americansdying from drug overdoses each day.” 


Bioedge

Saturday, August 19, 2017

President Donald Trump was elected because he promised to break moulds and drain swamps. “And now for something completely different” was basically the platform on which he campaigned. And something completely different is what Americans got.
Now is this difference due to mental illness or to a combination of personality and cunning political strategy? Yale University psychiatrist Dr Bandy Lee believes that it is the former. Trump is both bad and mad. In fact, not only Trump. In an interview with Salon, she said that the Administration and the Republican Party have lost touch with reality.
Is it a good idea for a psychiatrist to politicise her profession? The American Psychiatric Association asks its members to abide by the “Goldwater Rule” which forbids them from making public comment on the health of public figures whom they have not examined. It’s a good rule and Dr Lee is breaking it by publishing a book, The Dangerous Case of Donald Trump in October.
It’s a good rule because it protects the profession. Although half of Americans probably think Trump is mad without the benefit of Dr Lee’s input, the other half, including some psychiatrists, doesn’t. Inevitably many voters will think that Dr Lee is just a shill for the Democrats and that psychiatrists’ opinions can be bought.
What do you think? 


Michael Cook
Editor
BioEdge



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Managing the worsening opioid epidemic

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