Harm Reduction

As part of a plan announced last July, FDA has gone after 40 retailers who have violated rules on sales of vaping products to kids.

As part of a new Youth Tobacco Prevention Plan, on April 6th they began a large-scale, undercover nationwide blitz to crack down on the sale of e-cigarettes to minors at both brick-and-mortar and online retailers. The blitz has resulted in 40 warning letters being sent to those companies. These are not just pop-up stores or individual operations, they have caught 7-Eleven...

Through education and taxation, the struggle to end tobacco smoking has made tremendous gains over the last fifty years; some believe that we are entering the final phase of stopping the plague. Public health thinking has evolved too, cigarettes are now considered “nicotine delivery” systems and so they have taken on new forms – from the “low to no” nicotine cigarettes, to gum, patches, and vaporizers.

If we cannot end smoking short of prohibition, and we know how well abstinence only works, then we are compromising by containment, reducing harm while promoting cessation.

As a physician, advising patients to stop smoking remains the standard best practice, but for those who find it more difficult to quit addictive behavior, we are more practical and consider harm...

President Trump’s former National Security Advisor, General H.R. McMaster, lost his father recently to a death being investigated as “suspicious.” Though published accounts indicate the tragic event was deemed by the Department of Health to be due to “blunt impact head trauma” and “ruled an accident,” Philadelphia police in cooperation with the Pennsylvania attorney general’s office are, for not entirely known reasons, in the beginning phases of scrutinizing the incident.

H.R. McMaster Sr. was a resident of a senior living facility in Philadelphia that provides a host of supportive services – it has been reported that he was receiving care there after enduring a stroke. According to...

Fractures due to the declining health of our bones places a substantial burden on patients, at one year 60% require assistance with daily living, 40% are unable to walk independently, and 20-30% are dead. It is a big deal and the only treatable risk factors for reducing the number of falls and improving bone mass. That is the idea behind Calcium and Vitamin D supplements. And there continues to be increasing evidence that these supplements are just not effective. 

The US Preventative Services Task Force is an independent voluntary group who develop evidence-based guidelines for preventative care. This week they updated their previous recommendations regarding the use of Calcium and Vitamin D supplements for patients who have no evidence of bone loss, osteoporosis. The latest...

It's one thing to be on the wrong side of a health issue as important as concussion-caused brain damage. It's quite another to go on the largest sports-talk radio station in the country and be incorrect and misleading about the underlying science.

Yet, that's what Gary Bettman, Commissioner of the National Hockey League, did recently when he was guest on WFAN in New York discussing the topic of head trauma and its link to CTE, or Chronic Traumatic Encephalopathy, an extremely debilitating degenerative brain disease.

During his April 10 discussion not only did Bettman deny that there was a link between head trauma in hockey and CTE, but the league's chief executive also falsely claimed that top researchers at Boston University's Concussion Legacy Foundation haven't yet...

Has an aspirin replaced the apple? Is it true that an aspirin a day keeps the doctor away? The short answer is perhaps; the long answer is complicated. Physicians straddle that divide by simplifying, creating what I refer to as “indication creep” – prescribing medications that afford more psychic than physical benefit. 

The benefit of a daily aspirin for individuals that have already had a heart attack or stroke is well documented, reducing the chance of a second heart attack, stroke or death. But therapeutically, there is no free lunch. Aspirin can cause bleeding, often from a pre-existing ulcer or a tumor, but that isn’t always the case. Higher aspirin dosages increase the bleeding risk; a low dose aspirin (75-162mg) strikes the right balance, with the lowest risk of bleeding...

It should come as no surprise that drug traffickers are quite creative about distributing their du jour illicit product. Most recently, multiple agencies including the U.S. Drug Enforcement Agency (DEA) and Homeland Security, intercepted an operation using legitimate Disney Donald Ducks and Winnie The Poohs as a cover for their imposter shipments of non-ceramic wax figurines replete with 500 lbs. of meth (estimated to be worth $2 million).

Drugs notoriously have been transferred for distribution using all sorts of vehicles intended to bypass discovery radars. The human body has been among the most dangerous ones. When a person swallows a bag of...

In a rapid series of progressively escalating press releases by the Illinois Department of Public Health, it appears that a dangerous synthetic cannabinoid product called K2, spice, synthetic marijuana, legal weed or fake weed has now claimed its latest victim in an outbreak currently totaling 38 people whose severe bleeding is linked to exposure of this substance. The state division just announced the first death in this cluster. Over recent days, the toll of those harmed continues to increase with all being hospitalized for spontaneous excessive bleeding, including but not limited to coughing up blood, urinating blood, bloody stools, bleeding from the eyes, ears,...

Climate change has been with us forever. Leave aside the current rancorous “debate” about the causes of our current climate, is there anything history can teach us about how human society copes when the weather around them change? John Haldon, a historian, and his colleagues mash up history, archeology and palaeoenvironmental [1] science to provide some clues. Society is a complex structure, and the ability to respond to environmental changes has varied over time. By combining information from archeologic findings, sampling our ecological history through techniques like core samples and tree rings (admittedly a simplification) as well as our historical record they believe a more layered understanding of the interaction of society and the environment can be achieved.

The point of...

I had the distinct pleasure of being a reviewer for the 2018-2019 Community Grants program for Komen this Fall. The experience gave me a fresh perspective on the process and affirmed the organization’s dedication to getting it right with respect to women’s health, optimizing breast cancer understanding as well as facilitating early diagnosis, screening, monitoring and treatment. Fulfilling a core commitment to reducing barriers and expanding access, especially for those most challenged and underserved, this funding is particularly important to curtail late stage diagnosis which can adversely impact survival.(1)

Here are some pearls of wisdom I can now pass along.

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