When naloxone isn't enough: How technology can save lives when people use drugs when they're alone5/9/2023 Published May 4, 2023 | Originally published on MedicalXpress Breaking News-and-Events When Ju Park was studying epidemiology in graduate school, she volunteered with a harm reduction organization that trained local community members on how to prevent a drug overdose. She traveled around the state to demonstrate how the medication naloxone can be used to reverse an overdose from opioids if administered in a timely manner.
After one session, a mother whose daughter had a substance abuse disorder approached Park to share a heartbreaking story: The daughter, who had been in and out of rehabilitation centers, recently experienced a relapse. She locked herself into a bathroom alone, overdosed on drugs, and died. The mother expressed gratitude for the naloxone training and told Park that she was eager to do more to help other families dealing with addiction. Park couldn't bear to tell the woman what she was thinking: Training bystanders how to administer naloxone wouldn't have saved her daughter, because nobody had been present to help. "It made me wonder: What are we doing to help people who are using drugs alone and in secret?" recalled Park, who is now an assistant professor of epidemiology (research) at Brown University's School of Public Health and an assistant professor of medicine (research) at Brown's Warren Alpert Medical School. That question continued to preoccupy Park as she established the Harm Reduction Innovation Lab at Rhode Island Hospital with the mission to develop, implement and evaluate interventions to promote the health and well-being of people who use drugs. TO CONTINUE READING: https://www.mdlinx.com/news/when-naloxone-isn-t-enough-how-technology-can-save-lives-when-people-use-drugs-when-they-re-alone/5Eienzx2HxwHLrSHx33A1J?show_order=2&utm_campaign=reg_daily-alert_230509_daily-nl-am-v3_registered-users-a90&utm_source=iterable&utm_medium=email
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SCIENCE, HEALTH & TECHNOLOGY Apr 25, 2019 |
For more information, contact Lou Corpuz-Bosshart Zero-tolerance messaging tuned out by most teenagers For many parents, talking to their children about substance use is like navigating a field of landmines. It’s difficult to know exactly what to say and how to say it. But a new study from researchers at the University of British Columbia and University of Calgary is showing the way forward. Emily Jenkins, a UBC professor of nursing who studies youth substance use, and her colleagues interviewed 83 teenagers across B.C. Interestingly, they found that a harm reduction message resonated the most with teens, instead of the typical “don’t do drugs” talk.Emily Jenkins “Teens told us that they generally tuned out abstinence-only or zero-tolerance messaging because it did not reflect the realities of their life,” said Jenkins. “Either they or their peers were already using substances, or substance use was happening in their own family circles.” Harm reduction is a philosophy and set of practices that acknowledge that substance use – be it drugs, cigarettes or alcohol – is a part of life. It aims to reduce the harmful effects of substance use, rather than simply ignoring or condemning it. “Youth were more receptive when their parents talked – in a non-judgmental way – about substance use or could point to resources or strategies to help minimize the harms of use. This approach seemed to work better in preserving family relationships and youth health,” said Jenkins. Some teens who used substances despite their families’ zero-tolerance approach reported feeling disconnected from their families. One participant, who consumed alcohol occasionally, experienced difficulties with her mother, who never drank. “When she was a teenager she never did any of that…so to her, that’s like, I’m going to hell,” she said. Another participant whose family took a zero-tolerance position found himself unable to help a friend who was struggling with cannabis use and whose family also shunned substance use of any kind. “I just can’t help him if his dad’s not going to say anything,” he told the researchers. However, teens still valued setting limits, the study showed. “An overly lenient approach to substance use did not work either,” said Jenkins. “One participant who drank alcohol frequently said she was ‘sick of it’ but did not know how to scale back her drinking as her parents ‘don’t really care about what I do. I could go home drunk and they won’t do anything.’” The study, published this month in Harm Reduction, surveyed youth ages 13-18 in urban, suburban and rural areas in B.C. “The numbers show that the greatest levels of substance use and related harms occur amongst young people, yet youth perspectives are often missing when we formulate parental approaches to substance use,” said Jenkins. “This study goes beyond the typical approach, which features adult perspectives, and brings youth knowledge and expertise, a critical missing element in substance use programming.” TO CONTINUE READING: https://news.ubc.ca/2019/04/25/teens-prefer-harm-reduction-messaging-on-substance-use/ Officials said the formal designation was a sign of the grave danger posed by xylazine, which can cause horrific wounds and, when mixed with fentanyl, increase the likelihood of overdose.
By Jan Hoffman April 12, 2023 New York Times The White House on Wednesday designated a common animal tranquilizer that is increasingly mixed into street fentanyl as an “emerging drug threat,” a formal move that requires the administration to create strategies to enhance law enforcement efforts, health interventions and data collection to combat it. This is the first time that the White House’s Office of National Drug Control Policy has ever identified a substance for that designation, a mark of the gravity of the danger that it considers to be posed by the drug, xylazine. Xylazine was approved for veterinary procedures, primarily in cattle and horses, 50 years ago but has never been sanctioned for medical use in humans. Known popularly as tranq or tranq dope, it is a powerful and addictive sedative that slows breathing and heart rate, increases the risk of fatal overdose and often produces severe skin ulcers and abscesses that have led to amputations. “Many communities are not even aware of the threat in their backyard,” Dr. Rahul Gupta, the head of the drug control office, who is often referred to as the national drug czar, said in a briefing with reporters. TO CONTINUE READING: https://www.nytimes.com/2023/04/12/health/tranq-dope-xylazine.html Agency Continues to Take Critical Steps to Reduce Drug Overdose Deaths Being Driven Primarily by Illicit Opioids
For Immediate Release: March 29, 2023 FDA News Release Today, the U.S. Food and Drug Administration approved Narcan, 4 milligram (mg) naloxone hydrochloride nasal spray for over-the-counter (OTC), nonprescription, use – the first naloxone product approved for use without a prescription. Naloxone is a medication that rapidly reverses the effects of opioid overdose and is the standard treatment for opioid overdose. Today’s action paves the way for the life-saving medication to reverse an opioid overdose to be sold directly to consumers in places like drug stores, convenience stores, grocery stores and gas stations, as well as online. The timeline for availability and price of this OTC product is determined by the manufacturer. The FDA will work with all stakeholders to help facilitate the continued availability of naloxone nasal spray products during the time needed to implement the Narcan switch from prescription to OTC status, which may take months. Other formulations and dosages of naloxone will remain available by prescription only. Drug overdose persists as a major public health issue in the United States, with more than 101,750 reported fatal overdoses occurring in the 12-month period ending in October 2022, primarily driven by synthetic opioids like illicit fentanyl. “The FDA remains committed to addressing the evolving complexities of the overdose crisis. As part of this work, the agency has used its regulatory authority to facilitate greater access to naloxone by encouraging the development of and approving an over-the-counter naloxone product to address the dire public health need,” said FDA Commissioner Robert M. Califf, M.D. “Today’s approval of OTC naloxone nasal spray will help improve access to naloxone, increase the number of locations where it’s available and help reduce opioid overdose deaths throughout the country. We encourage the manufacturer to make accessibility to the product a priority by making it available as soon as possible and at an affordable price.” TO CONTINUE READING: https://www.fda.gov/news-events/press-announcements/fda-approves-first-over-counter-naloxone-nasal-spray BY EMILY ALPERT REYESSTAFF WRITER
MARCH 9, 2023 1:14 PM PT LA Times The Biden administration is seeking billions of dollars for a new push to wipe out hepatitis C, a virus that has continued to kill thousands of people annually in the U.S. despite the existence of extremely effective medications that can cure the infection within months. The five-year program, outlined as part of a broader budget proposal Thursday by White House officials, has been estimated to have a net cost of $5 billion over a decade, said Dr. Francis Collins, a special advisor to the president for special projects. It would require an upfront investment now estimated at more than $11 billion over five years, which Collins said would be offset by government savings from preventing liver failure and other conditions that result from hepatitis C — and therefore avoiding the costs of treating them. The exact costs would hinge on negotiations with drugmakers, who would be paid a lump sum to make an unlimited supply of direct-acting antiviral pills available to patients on Medicaid, as well as those who are uninsured, incarcerated or treated through the Indian Health Service, said Collins, the former director of the National Institutes of Health. Such “subscription” deals have already been tested in some states in an effort to expand access to the lifesaving medication. White House officials said the medicines can now cost roughly $20,000 per patient, but researchers have found curing patients can ultimately save money that would later be spent treating liver ailments. TO CONTINUE READING: https://www.latimes.com/world-nation/story/2023-03-09/biden-seeks-billions-to-wipe-out-a-hepatitis-c WASHINGTON — The Biden administration will request “significant investments” to help eliminate hepatitis C in the United States in its forthcoming budget proposal, according to Francis Collins, the former NIH director leading the project.
Collins declined to provide too many further details before the official budget request later this week, but Rep. Hank Johnson, (D-Ga.), who joined Collins at a STAT event on the subject Tuesday, suggested the request could potentially be as big as $10 billion over five years. Collins also pointed out that the plan “fits nicely” with President Biden’s broader cancer moonshot, an initiative aimed at halving the cancer rate in 25 years, since hepatitis C is one of the leading causes of liver cancer. “I would like, if it’s possible, to be as bold as possible, and contemplate not just an effort that would improve the situation, but that would eliminate hepatitis C in the United States,” Collins said at the event. “That’s a scary word, and obviously would require a huge investment, to try to reach everybody.” He also said he’s hoping the initiative would be funded as “mandatory” spending, which would ensure it would not need to be renewed each year by Congress. Johnson, too, referenced a potential request for mandatory spending. The Biden administration is expected to release more details about its federal budget later this week. TO CONTINUE READING: https://www.statnews.com/2023/03/07/francis-collins-budget-eliminating-hep-c/ Key Takeaways
Xylazine’s impact in recent years is undeniable. For example, deaths related to xylazine in Pennsylvania jumped from 2 percent to 26 percent from 2015 to 2020, while xylazine was involved in 19 percent of all overdose deaths in Maryland in 2021.[2] Deaths related to xylazine may also be underreported, as many forensic labs and toxicology tests do not test for xylazine. Its popularity comes down to how cheap it is to access and how strong its effects are. According to Abid Nazeer, MD, a psychiatrist and senior medical advisor for Symetria Recovery, “Xylazine’s popularity is connected to its ability to potentially extend the effect of other drugs, such as heroin and fentanyl.” Xylazine can also be bought very cheaply by dealers, who can order it online, Nazeer tells MDlinx. TO CONTINUE READING: https://www.mdlinx.com/article/lethal-street-drug-resistant-to-naloxone-gains-popularity/6Sl08mQtC5IoZK7QjkqjSA? Feb. 10, 2023 -By Jamelle Bouie, New York Times Over the past year, we have seen a sweeping and ferocious attack on the rights and dignity of transgender people across the country.
In states led by Republicans, conservative lawmakers have introduced or passed dozens of laws that would give religious exemptions for discrimination against transgender people, prohibit the use of bathrooms consistent with their gender identity and limit access to gender-affirming care. In lashing out against L.G.B.T.Q. people, lawmakers in at least eight states have even gone as far as to introduce bans on “drag” performance that are so broad as to threaten the ability of gender-nonconforming people simply to exist in public. Some of the most powerful Republicans in the country want to go even further. Donald Trump has promised to radically limit transgender rights if he is returned to the White House in 2024. In a video address to supporters, he said he would push Congress to pass a national ban on gender-affirming care for transgender youth and restrict Medicare and Medicaid funding for hospitals and medical professionals providing that care. TO CONTINUE READING: https://www.nytimes.com/2023/02/10/opinion/trump-desantis-transgender-rights.html?auth=login-google1tap&login=google1tap By Noah Weiland, NY Times Feb. 10, 2023, 5:00 a.m. ET
President Biden has endorsed “harm reduction,” which aims to cut down on overdoses by encouraging safer drug use. But the organizations carrying out that strategy are severely underfunded. OSCEOLA, Iowa — So many of Deborah Krauss’s friends and neighbors have died of drug overdoses during the pandemic that she said she felt as if she had been living inside of a dream. The longest she has gone without someone dying, she noted, is three weeks. Her calendar grew cluttered with funerals. “I lost count at 40,” she recalled on a recent evening in a Des Moines office as she organized supplies to help people consume drugs more safely. “And it just keeps happening.” The next day, Ms. Krauss was on the road, parked outside a Walmart in the small Iowa town of Osceola, her trunk brimming with boxes of syringes, fentanyl test strips and overdose-reversing medication. A former hair stylist, she recalled the stress of grooming an ex-boyfriend’s facial hair to make him presentable at his funeral after he died from an overdose in 2018. Ms. Krauss, 38, is one of the few practitioners in Iowa of a public health strategy known as “harm reduction,” a wide-ranging set of policies that President Biden and many federal and local health officials and physicians have made central to their efforts to curtail record-breaking overdose deaths. The strategy does not seek to cut people off from drug use. Instead, it aims to give them tools to use drugs in a safer manner, like the supplies in Ms. Krauss’s trunk. In his State of the Union address on Tuesday, Mr. Biden, the first president to endorse the strategy, highlighted the federal government’s attention to some of the core features of harm reduction work, including a provision in a recently enacted spending package that makes it easier for doctors to prescribe buprenorphine, an effective addiction medication that Ms. Krauss works to get to drug users. During his speech, Mr. Biden recognized the father of a 20-year-old from New Hampshire who died from a fentanyl overdose, citing the more than 70,000 Americans dying each year from the potent synthetic . TO CONTINUE: https://www-nytimes-com.cdn.ampproject.org/c/s/www.nytimes.com/2023/02/10/us/politics/harm-reduction-overdoses-iowa.amp.html Less than one third of infants born to mothers with the virus were screened for HCV. January 26, 2023 • By Sukanya Charuchandra Active hepatitis C virus (HCV) infection during pregnancy is associated with premature birth, and a high viral load increases the risk of vertical transmission, according to findings published in the Journal of Hepatology. However, only a minority of infants born to mothers with HCV are screened for the infection, as is recommended by treatment guidelines.
Previous studies have shown that the mother-to-child HCV transmission rate is around 6%. But the viral load level needed for transmission and the impact of hepatitis C on pregnancy outcomes are not well understood. Tatyana Kushner, MD, of the Icahn School of Medicine at Mount Sinai in New York City, and colleagues conducted a retrospective study to better understand vertical transmission of hepatitis C and its impact on pregnancy outcomes. Using administrative healthcare data, the team identified 2,170 pregnancies among 1,636 women in Ontario who acquired hepatitis C before pregnancy. In 1,780 of these cases (82%), the women continued to test positive for HCV RNA during their pregnancies, indicating active infection. Women who tested positive for HCV RNA during pregnancy were more likely to deliver their babies prematurely than those who did not have active HCV infection (18% versus 12%, respectively). The former group was also at greater risk for intrahepatic cholestasis of pregnancy (blocked bile flow) and postpartum hemorrhage. However, women with active HCV infection during pregnancy were less likely to develop gestational diabetes than those who had cleared the virus. Less than a third (29%) of the newborns born to women with hepatitis C were screened for HCV after birth. Of those who were screened, the mother-to-child transmission rate was 3.5%. Women with an HCV RNA level of at least 6.0 log, or about 1,000,000 copies, had more than a threefold greater likelihood of vertical transmission. TO CONTINUE READING: https://www.hepmag.com/article/hepatitis-c-pregnancy-linked-worse-outcomes |
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