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Reading of the Week: “Taking On the Scourge of Opioids” – Dr. Sally Satel’s New Essay

From the Editor

Today, the addicted are not inner-city minori­ties, though big cities are increasingly reporting problems. Instead, they are overwhelmingly white and rural, though middle- and upper-class individuals are also affected. The jarring visual of the crisis is not an urban ‘gang banger’ but an overdosed mom slumped in the front seat of her car in a Walmart parking lot, toddler in the back.

So writes Dr. Sally Satel, an addiction psychiatrist, about the opioid epidemic.

Dr. Satel is writing about the United States, but these problems are also seen north of the 49th parallel. Canadians remain the second highest per-capita consumers of opioids in the world; for the record, only our southern neighbours best us. And, like in the U.S., opioid use has soared in recent years – and so has misuse.

Opioids: little pills, big problems

How did we get here? And where do we go?

This week’s selection: a new essay by Dr. Satel. Drawing on the words of Nicholas Eberstadt, she describes “a new plague for a new century.” Dr. Satel writes about the roots of this drug problem and considers options moving forward.

DG

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Reading of the Week: Pushing Past the Headlines – Substances & Health Services, and Medically Assisted Death & Cost Savings

From the Editor

It makes sense that those with substance use problems and mental illness consume more health resources – but how much more? As Canadians opt for medical assistance in dying, what will the impact be on health spending?

Readings don’t necessarily follow a theme. But this week, we push past newspaper headlines to consider two topical issues in more detail, tapping the latest in the literature.

Pushing past the headlines

In the first paper, Graham et al. consider health costs and utilization for people with mental health and/or substance use problems. Spoiler alert: these individuals are much more likely to use health services, resulting in higher costs. That’s not exactly a surprise, but Graham et al. provide a detailed analysis in an area that has been understudied.

In the second paper, drawing from Dutch data, Trachtenberg and Manns estimate the savings from medically assisted death.

Both papers are timely. Both reach interesting conclusions.

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Reading of the Week: To Screen or Not to Screen – Pregnancy & Depression Screening

From the Editor

“Panel Calls for Depression Screenings During and After Pregnancy”

A government health-care panel making a revision to a past recommendation seems pretty ‘inside baseball’ – and hardly the stuff of international headlines. Last week, though, the decision of the U.S. Preventive Services Task Force to now recommend the screening of pregnant and post-partum women for depression was reported from New York to New Delhi.

For the record, The New York Times story (whose headline appears above) ran on the front page.

Why the change and what are the implications?

To screen or not to screen…

This week’s Reading looks at the big decision and we consider: is it a big bust?

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