Harm Reduction

Patients who experience life-altering hospitalizations -- in this case, strokes -- are often discharged not to home, but to either inpatient rehabilitation facilities (IRF) or skilled nursing facilities (SNF). A new study shows that patients sent to IRFs do better than those assigned to SNFs. But as always, the story is more complicated.
Like ACSH itself, ACSH advisor Dr. Jeffrey Singer is a proponent of harm reduction. Here's his take on a report, issued by the health and medicine panel of the National Academy of Sciences, Engineering and Medicine (NASEM), titled "Opportunities to Improve Opioid Use Disorder and Infectious Disease Services." Not surprisingly, Dr. Singer calls for needle exchange, methadone use, and the use of prescribing pre‐​exposure HIV prophylaxis (PrEP) and post‐​exposure prophylaxis (PEP).
It’s been 50 years since cleaning up the air in the United States began in earnest. Skies are much clearer now than in the mid-20th century. Leaded gasoline is gone, power plants have been abandoning coal and sulfur dioxide has dropped by 91%. Despite these growing improvements, why have epidemiologists been unable to show the demonstrable public health benefits that their computer models predict? 
For a health issue, who doesn’t love a good screening test? Some love them, either assuring or sending them to find the underlying problem. Physicians have more of a love-hate relationship. But the quiet truth is that few screening tests for general populations, in terms of reducing mortality, are productive.
“There has been considerable time passed (5-10 years) from the initial alarm and subsequent legislation at all levels of government concerning the presumed links to traffic accidents/deaths with increased texting while driving.  Was there ever any evidence that texting while driving resulted in increased accidents/deaths?  Or, did texting while driving just replace other distractions for those same drivers, who would have had their accidents anyway?”
The ALA does not approve of e-cigarettes, despite the fact that thousands of smokers have used them to quit. Is their reluctance to acknowledge the utility of e-cigarettes due to a financial conflict?
For many years, one's family motto has been “often wrong, never in doubt.” Overconfidence is a cognitive problem, present to lesser and greater degrees in us all. And it grows in the presence of two conditions.
The “pivotal regulatory science” used in setting air pollution standards are epidemiological studies measuring the effects of particulate matter on our health. The recently proposed changes to improve the transparency of regulatory science at the EPA have brought these studies to the fore.
In the face of unethical behavior, we treat corporations differently than we treat individuals. Corporate crisis managers, using our cognitive biases, know how to deflect blame.
While Facebook has drawn massive criticism over manipulative political ads, the social media giant also runs advertisements around vaccinations, which is another divisive policy topic. A new study gives us a glimpse of the ads' content, targets and purchasers.
Healthcare consolidation involves economies of scale and standardization. Neither is a guarantee of better outcomes. For patients on dialysis, in fact, consolidation has made their care worse.
U.S. drug policies are just plain nuts. Pain patients can't get opioids because they're "bad." But your miniature poodle could walk into ... pretty much any store and waltz out with vaping solutions of CBD oil or maybe even THC because they're "good." But now fentanyl -- the real cause of most overdose deaths -- is showing up in vaping solutions. Can't make this up.