Tag: dying

Reading of the Week: ECT – the New NEJM Review; Also, Ethnicity & Drug Overdoses (JAMA) and Neil Seeman on His Father (CMAJ)

From the Editor

He has tried different medications, and yet he continues to struggle. The months have turned into years. When he was last well, he worked two jobs and was physically active, hoping to run the Boston marathon one day. When I saw him, he explained that he has difficulty following the plot of a TV show. Asked if he had ever considered ECT, his eyes widened. “They still do that?”

In the first selection, we look at a new review paper on ECT from The New England Journal of Medicine. Drs. Randall T. Espinoza (of the University of California, Los Angeles) and Charles H. Kellner (of the Medical University of South Carolina) provide a concise summary of the latest evidence. They conclude: “ECT is a valuable treatment for several severe psychiatric illnesses, particularly when a rapid response is critical and when other treatments have failed.” We consider the paper and the ongoing stigma associated with the treatment.

In the second selection, Joseph R. Friedman and Dr. Helena Hansen (both of the University of California, Los Angeles) draw on American data to consider overdose deaths and ethnicity. The JAMA Psychiatry paper concludes: “In this cross-sectional study, we observed that Black individuals had the largest percentage increase in overdose mortality rates in 2020, overtaking the rate among White individuals for the first time since 1999, and American Indian or Alaska Native individuals experienced the highest rate of overdose mortality in 2020 of any group observed.”

And in the third selection, Neil Seeman (of the University of Toronto) considers the life and death of his father, Dr. Philip Seeman, the celebrated scientist who studied schizophrenia. In this CMAJ essay, he comments on dopamine and his father’s life work. And he also writes about his relationship and dying. “It was that giving ice chips to my father will forever remind me of how the sensation of touch can stir love, fetch memories, and offer solace.”

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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