Regular readers of the Better Health blog are familiar with the shoddy science behind homeopathy (an outdated system of “medical” treatment that relies on water dilution and shaking to ‘”strengthen” the effects of drugs). But because homeopathic placebos have been marketed so successfully (even receiving paid endorsements from hockey teams), the Ontario government has decided to regulate homeopathic practices.
In this terrific news exposé, reporters ask if it’s appropriate for the government to regulate health scams. In doing so, are they not lending credibility to modern-day snake oil? Check out these videos and let me know what you think. Is there a roll for government in regulating homeopathy?
This is a guest post from Dr. Mary Lynn McPherson.
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FDA Restricts Acetaminophen In Popular Pain Medications
The Food and Drug Administration (FDA) made an announcement yesterday that affects one of the most common pain medications on the market, and as a consequence may affect countless numbers of the 75 million Americans who experience chronic pain (for perspective, that’s more than the number of people suffering from cancer, heart disease and diabetes combined.) The FDA has asked manufacturers of popular prescription pain medications like Vicodin or Percocet to limit the amount of acetaminophen (also known as Tylenol, or APAP) used in these drugs to no more than 325 milligrams per tablet — the equivalent of one regular-strength Tylenol tablet.
The move came because research has shown that acetaminophen can cause liver damage when taken in higher than recommended doses. The problem is that many over-the-counter medications ALSO contain acetaminophen, and patients may take one or more of these common products (like Tylenol) to reduce their fever or get rid of a headache along with their prescription pain relievers.
Before you know it, you could be taking more than the maximum daily dose of acetaminophen which is 4,000 milligrams. I go out of my way to advise people I work with of this warning, but not everyone takes time to talk to the pharmacist and not all pharmacists make themselves readily available. That is why it is critically important that you talk to your pharmacist to make sure that you are not taking more than this amount. The pharmacist is the last stop between you and medication misuse — you could be taking a medication that contains acetaminophen and not even know it. Read more »
When reports arrived that accused gunman Jared Lee Loughner had opened fire in Tucson, Arizona on January 7, journalistic first responders linked the incident to the fierceness of political rhetoric in the United States. Upon reflection, some of the discussion has turned to questions about mental illness, guns, and violence.
And plenty of reflection is required, because the connections are not at all simple. To get a sense of just how complicated they are, we invite you to read the lead article in this month’s Harvard Mental Health Letter entitled, “Mental Illness and Violence.” Strangely (for us) it was prepared for publication a month before the tragedy in Tucson. In light of the shooting, we are making the article available to non-subscribers.
I am not surprised at the outrage expressed in the news or at the impulse to blame. A quick scan of the news, however, shows there is not much agreement about whom to blame. In addition to the alleged perpetrator, one can find explicit and implicit criticisms of politicians for playing to our baser instincts; of media figures, various men and women of zeal, for their disingenuous or manipulative partisanship; of the various community bystanders (police, teachers, doctors, family members, neighbors, friends), whom we imagine could have intervened to prevent tragedy.
The political debate flowing from this incident will continue, as will the endless cycle of blame and defensiveness. But I caution all of us — and especially mental health professionals — not to make clinical judgments about Mr. Loughner. Very few people will or should have access to the kind of information that would allow such judgments. From a public health perspective, however, we should make careful judgments about policies that could reduce risk. Read more »
The media has been buzzing over recent reports of pregnancies occurring in women using Implanon, a single rod progestin-only contraceptive inserted under the skin of the upper arm and lasting for up to three years.
The headlines make it sound horrifying: “Hundreds Become Pregnant Despite Contraceptive Implanon” and “British Pregnancy Scare in UK Implicates Implanon.” I love how terminology can make something so common sound so frightening.
Actually, what happened was that 584 pregnancies occurred in Britain among about 1.3 million women using Implanon, for a failure rate of .04 percent. In other words, the method had an efficacy of over 99 percent. That’s a pretty effective contraceptive if you ask me.
But it should have been better than that
As good as it may seem, this failure rate is significantly higher than most of us would have expected based upon data from clinical trails of Implanon.
I recall being told at an Implanon insertion training just prior to its introduction in the U.S. that in fact, not a single pregnancy had been reported at that point among users of the device in clinical trails. This would put the method up there with sterilization and IUD in terms of efficacy.
So what happened?
How did Implanon go from perfect efficacy to something less than perfect? Read more »
*This blog post was originally published at tbtam*
MedPAC has released another report in which they have tried to explain variation in healthcare utilization among metropolitan statistical areas (MSAs), of which there are approximately 400. MSAs more-or-less correspond to Dartmouth’s 306 hospital referral regions (HRRs), and the conclusions reached by the Dartmouth folks and MedPAC tend to correspond. In commenting about MedPAC’s last report, issued in December 2009, I noted that the major variation was caused by high Medicare expenditures in seven southern states, where patients are poorer and sicker and use much more care.
In their new report, MedPAC went a step beyond measuring expenditures, which they adjusted for prices and other factors in their last report, to measuring the actual units of service, a far better way to assess the healthcare system. MedPAC’s new findings on the distribution of service use in MSAs are graphed below:
Based on this new approach, MedPAC concluded: “Although service use varies less than spending, the amount of service provided to beneficiaries still varies substantially. Specifically, service use in higher use areas (90th percentile) is 30 percent greater than in lower use areas (10th percentile); the analogous figure for spending is about 55 percent. What policies should be pursued in light of these findings is beyond the scope of this paper, which is meant only to inform policymakers on the nature and extent of regional variation in Medicare service use. However, we do note that at the extremes, there is nearly a two-fold difference between the MSA with the greatest service use and the MSA with the least.” Read more »
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