Safe Consumption Sites Reduce The Stress on Hospitals and Emergency Departments
Jeffrey A. SingerI wrote previously about a secret safe consumption site that has been providing services in an undisclosed location since 2014. The harm reduction organization operating it has agreed to share its data with researchers providing the researchers keep the name and location of the site confidential. This is because the federal “Crack House Statute” makes safe consumption sites illegal in the U.S.The researchers published theirfirst report in 2017. They reported that in the site ’s first 2 years of operation there were 2,574 injections among more than 100 participants, most of whom were injecti...
Source: Cato-at-liberty - January 15, 2022 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Two Small Pharma Firms Join The Struggle To Give Women Access to OTC Birth Control Pills
Jeffrey A. SingerTheNew York Timesreports today that two small oral contraceptive makers, Cadence and HRA Pharma, have been seeking to make their birth control pills over ‐the‐counter since 2016. The Food and Drug Administration has taken five years “dialoguing” with the pharmaceutical firms but has yet to give them “clearance” to formally apply for the switch. TheTimes article cites an FDA spokesperson as saying the agency hopes to reach a decision within 10 months of the companies submitting a formal application.As I have writtenhere, birth control pills are available over ‐the‐...
Source: Cato-at-liberty - December 14, 2021 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
New York City Joins Philadelphia ’s and Rhode Island’s Effort to Create Safe Consumption Sites in Defiance of Federal Law
Jeffrey A. SingerThe City of New Yorkannounced today that it has authorized two safe consumption sites (sometimes called “overdose prevention sites”), both of which will be operated by a pair of non ‐profits. One will be in East Harlem and the other will operate in Washington Heights.This comes about 6 months after Rhode Island ’s governor signedlegislation authorizing a safe consumption site pilot program that becomes effective in early 2022. The City of Philadelphia has been trying without success to establishSafehouse, after the project was challenged by federal prosecutors. This past October t...
Source: Cato-at-liberty - November 30, 2021 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Dr. Wakeman ’s Excellent Exposition on the Overdose Crisis
Jeffrey A. SingerSarah Wakeman, MD is the Medical Director of the Massachusetts General Hospital Substance Use Disorder Project and an Associate Professor of Medicine at Harvard University Medical School. She has a wealth of experience treating addiction and has published research on thecomparative effectiveness of various treatment modalities for opioid use disorder.Dr. Wakeman recently gave aninterview to theHarvard Gazette in response to therecent news that overdose deaths for the 12 months ending April 30, 2021 reached a stunning 100,000, 75 percent of which were opioid ‐related, with 85 percent of opioi...
Source: Cato-at-liberty - November 30, 2021 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
My Unpublished Letter to the Editor on the Tragic Drug Overdose Report
Jeffrey A. SingerOn November 18 theWall Street Journalran a front page story entitled “Drug Overdose Deaths, Fueled by Fentanyl, Hit Record High in U.S. ” It reported on provisional data from the Centers for Disease Control and Prevention that reveal a heartbreaking 100,306 drug overdose deaths for the 12 months running through April 2021, a 29 percent increase over the previous 12 month period.Thereport released by the CDC on November 17 stated that 75,673 of the more than 100,000 overdose deaths were opioid ‐related, up from 56,064 the previous year. The remainder of overdose deaths involved cocai...
Source: Cato-at-liberty - November 23, 2021 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
988: A New Lifeline for Mental Health Emergencies
By BEN WHEATLEY
Miles Hall, a 23-year-old Black man experiencing a psychotic episode, was shot and killed by police after 911 received calls of a disturbance in his Walnut Creek, California neighborhood. His mother Taun Hall had taken steps to warn the local police that her son had been diagnosed with schizoaffective disorder and that he might be prone to mental health crises. She believed she had done enough to ensure that, in the event of a crisis, her son would be treated with care. But when the crisis came, authorities viewed Miles’ behavior through the lens of public safety, not through the lens of mental health,...
Source: The Health Care Blog - November 22, 2021 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Policy Politics CAHOOTS California California Department of Health Services Mental Health Miles Hall Miles Hall Foundation Source Type: blogs
The Spillover Effects of Oxycontin's Introduction on Crime
Yongbo Sim (Rutgers University), The Spillover Effects of Oxycontin's Introduction on Crime, SSRN (2021): Since the late 1990s, the U.S. has experienced a substantial rise in drug overdose and overdose deaths due to the increased use of opioid drugs. This... (Source: HealthLawProf Blog)
Source: HealthLawProf Blog - November 3, 2021 Category: Medical Law Authors: Katharine Van Tassel Source Type: blogs
Systemic racism and Indigenous deaths in health care
Ni cta ni akohikon: That hurts me. Carol pe ntamici: Carol, come see me. Ni taci sa micta mackikikatakoiin: They are overdosing me on drugs. Wipatc tca: Do it quickly. Those were the chilling words of Joyce Echaquan, broadcasting live from Facebook on September 28, 2020 at 10:27 am (English translation provided). On September 26, 2020, JoyceRead more …Systemic racism and Indigenous deaths in health care originally appeared inKevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - October 23, 2021 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/benjamin-brookwell" rel="tag" > Benjamin Brookwell < /a > < /span > Tags: Policy Public Health & Source Type: blogs
We Use Too Many Medications: Be Very Afraid of Interactions
By HANS DUVEFELT
I happened to read about the pharmacodynamics of parenteral versus oral furosemide when I came across a unique interaction between this commonest of diuretics and risperidone: Elderly dementia patients on risperidone have twice their expected mortality if also given furosemide. I knew that all atypical antipsychotics can double mortality in elderly dementia patients, but was unaware of the additional risperidone-furosemide risk. Epocrates only has a nonspecific warning to monitor blood pressure when prescribing both drugs.
This is only today’s example of an interaction I didn’t have at ...
Source: The Health Care Blog - October 21, 2021 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Medical Practice Physicians Primary Care Hans Duvefelt Medical Ethics medication pharmaceuticals Pharmacy Source Type: blogs
A national catastrophe
In the NYT,Mike Baker and Danielle Ivory offer an in-depth report on how the insane right-wing response to the Covid-19 pandemic has decimated the nation ' s public health infrastructure. You really need to use one of your free reads on this, it ' s too much to summarize. But the keystone is this:When the pandemic first hit the northern edge of Washington ’s Olympic Peninsula, Dr. Berry was a popular family physician and local health officer, trained in biostatistics and epidemiology at Johns Hopkins University. She processed Covid-19 test kits in her garage and delivered supplies to people in quarantine, leading a mobil...
Source: Stayin' Alive - October 18, 2021 Category: American Health Source Type: blogs
A New Seizure in a Healthy 20-something
A 20-something year old who is the picture of good health presented with a new onset seizure. A witness described what sounded like a 3 minute tonic-clonic seizure. Her seizure workup was negative and she was scheduled for an outpatient MRI and EEG.Because she was persistently tachycardic, an ECG was recorded. At the time her K was 3.2 mEq/L:Here is the interpretation by the computer, confirmed by the over-reading physician:JUNCTIONAL TACHYCARDIAINTRAVENTRICULAR CONDUCTION DELAY [130+ ms QRS DURATION]ABNORMAL ECGP-R Interval 116 msQRS Interval 158 msQT Interval 422 msQTC Interval 485 msP Axis 25...
Source: Dr. Smith's ECG Blog - October 14, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
Roger Chou ’s Undisclosed Conflicts of Interest: How the CDC’s 2016 Guideline for Prescribing Opioids for Chronic Pain Lost Its Clinical and Professional Integrity
by Chad D. Kollas MD, Terri A. Lewis PhD, Beverly Schechtman and Carrie Judy“I ' m present. Uh … I do have a conflict. I receive funding to conduct reviews on opioids, and I ' ll be recusing myself after the um, director ' s, uh, um, um, uh … update.”- Dr. Roger Chou, Center for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control (NCIPC) Board of Scientific Counselors (BSC) Meeting Friday, July 16, 2021.IntroductionFor those familiar with the controversial relationship between the anti-opioid advocacy group, Physicians for Responsible Opioid Prescribing (PROP, recently renamed, He...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 17, 2021 Category: Palliative Care Tags: CDC judy kollas lewis opioid pain schechtman Source Type: blogs
Roger Chou s Undisclosed Conflicts of Interest: How the CDCs 2016 Guideline for Prescribing Opioids for Chronic Pain Lost Its Clinical and Professional Integrity
by Chad D. Kollas MD, Terri A. Lewis PhD, Beverly Schechtman and Carrie JudyI ' m present. Uh I do have a conflict. I receive funding to conduct reviews on opioids, and I ' ll be recusing myself after the um, director ' s, uh, um, um, uh update.- Dr. Roger Chou, Center for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control (NCIPC) Board of Scientific Counselors (BSC) Meeting Friday, July 16, 2021.IntroductionFor those familiar with the controversial relationship between the anti-opioid advocacy group, Physicians for Responsible Opioid Prescribing (PROP, recently renamed, Health Pro...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 17, 2021 Category: Palliative Care Tags: CDC judy kollas lewis opioid pain schechtman Source Type: blogs
Wide and weird
Written by Clare Gunn MD, peer reviewed by Smith, Meyers, BraceyA 74-year-old female presented to the ER after a trip and fall (unclear if purely mechanical or due to possible unsteadiness) causing her to cut her leg. Due to chronic anticoagulation for atrial fibrillation, she could not stop the bleeding, so she came the ED. On arrival she is found to be hypoxemic requiring four liters of oxygen via nasal cannula. While getting her leg wound repaired, the patient was also evaluated for hypoxemia and tachycardia and was found to have this ECG:What do you think?Here was her most recent prior ECG on file for comparison:...
Source: Dr. Smith's ECG Blog - August 27, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
August 2021: Adulterant in Fentanyl Complicates OD
A 38-year-old woman with opioid use disorder presented to the emergency department after an unintentional overdose. EMS said the patient was found with decreased respirations, and she was given 2 mg intranasal naloxone. She was awake, alert, and oriented x 3 in the emergency department.She reported that she used one bundle of fentanyl/heroin a day intravenously and that she had recently been hospitalized for four weeks for a wound infection. She stated that she used her usual dosage of fentanyl/heroin on discharge, not realizing how much her tolerance had decreased.She also said the fentanyl contained “tranq" (xy...
Source: The Tox Cave - August 2, 2021 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
