Tag: Gupta

Reading of the Week: Xylazine – the New NEJM Paper; Also, Probiotics for Depression (JAMA Psych) and the New Drug Crisis (Nat Affairs)

From the Editor

Is xylazine the new fentanyl?

In the first selection, Dr. Rahul Gupta (of the University of Pennsylvania), who serves as the US Director of National Drug Control Policy, and his co-authors write about xylazine in The New England Journal of Medicine. They describe the emergence of this medication, intended for veterinarian uses, as a substance of abuse. They note its presentation and ask research questions. “Our goal is for the designation of xylazine as an emerging threat and subsequent actions to begin to address this threat before it worsens and undermines efforts to reduce illicit fentanyl use in the United States.” We consider the paper and its implications.

In the second selection, from JAMA Psychiatry, Viktoriya L. Nikolova (of King’s College London) and her co-authors look at probiotics – an area of increasing interest for those with mood and anxiety problems. They report on the findings of a small RCT involving people with depression who took an antidepressant but had an incomplete response. “The acceptability, tolerability, and estimated effect sizes on key clinical outcomes are promising and encourage further investigation of probiotics as add-on treatment for people with MDD in a definitive efficacy trial.”

And in the third selection, Charles Fain Lehman (of the Manhattan Institute) comments on the new drug crisis in a long essay for National Affairs. Lehman notes the rise of the synthetic agents (think fentanyl replacing heroin) and its impact on people, particularly in terms of overdoses. “Today’s drug cycle is different from previous ones, measured not just in the number of people addicted, but the number dead. Reducing the growth of that figure, now more than ever, is a vital task for policymakers to undertake.”


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Reading of the Week: The Best of 2018

From the Editor

It’s an annual Reading of the Week tradition. At the end of each year, we pause, take stock, and consider the best selections of the past 12 months.


2018 was an eventful year.

Start here: the federal government legalized the recreational use of cannabis.

We have heard so much about legalization over these past few years, that the event itself seemed almost anti-climactic. But remember: Canada is only the second country in the world to do this.

And 2018 has seen further evidence that stigma continues to fade: governments across the country have committed themselves to increased funding for mental health; more people spoke of their experiences with mental illness; more people talked about previously taboo topics, such as suicide.

And so with an eye on the future, let’s look back at the last year. In this final Reading of 2018, we look at a few memorable selections. Enjoy.

Please note that there will be no Reading for the next two weeks.


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Reading of the Week: Rahael Gupta on Medical Students & Depression (& her Depression)

From the Editor

Once—and I have never shared this before—I stepped into the street on my walk home from the library. I knew that the bus hurtling through the night would not have time to stop before colliding with my darkly dressed frame, fracturing my bones and scattering my belongings. I imagined my head hitting the asphalt and my brain banging around inside of my skull, bruising irreparably with each impact. I imagined the bus driver’s horror as he turned off the ignition with shaking hands and leapt out of the vehicle to locate my body. It would be a catastrophe that the trauma surgeons could not salvage. I would die.

Rahael Gupta is many things. She’s a graduate of Stanford University, and also Columbia. She’s a medical student. She’s a self-described optimistic. She’s a marathon runner.

And she’s a person who has struggled with depression.


In this week’s Reading, we consider her essay in JAMA. It’s moving and clever and important.


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