Harm Reduction

“The doctor tested for everything” is a common refrain heard in many realms within medicine. As are its permutations. 

Heck, it is how these direct-to-consumer genetic testing companies pitch themselves—and, so successfully, I might add. Despite the fact “everything” is not possible to test for, the science for many of them is not there and spontaneous and acquired mutations are reality, the truth of their limitations typically never hits center stage in their marketing plans. 

Chasing “what ifs” usually perpetuates fear, anxiety and misplaced concern or worry. It is a false perception that such tests control our futures. While we worry so about what may happen, we tend to lose our ability to cope with what actually does —especially if one of these gimmicks said it was...

E-cigarettes are "effective in helping people quit smoking" and "95% safer than smoking."* Additionally, there are "no health risks to bystanders."

What evil, conniving, greedy, Big Tobacco-loving, propaganda-spewing group of shills says that? The UK's National Health Service (NHS).

On its website, the NHS discusses a report issued by Public Health England (another UK government agency) that examined the available evidence on e-cigarettes. The report is unambiguous in...

The King County Health Department, which serves mostly the city of Seattle and its suburbs, has recently earned a reputation for being driven by politics rather than by evidence-based medicine or common sense.

Last month, the county decided that crisis pregnancy centers that don't perform abortions aren't "real healthcare." According to its website, Care Net -- a crisis pregnancy center in the Puget Sound region -- performs pregnancy tests, STD screens, and ultrasounds and provides prenatal education. Because such crisis centers are often faith-based, what they don't do is perform or encourage abortions.

That's anathema to Seattle, a city whose residents and politicians have little use for religion or...

When I saw Prevalence of Pubic Hair Grooming-Related Injuries and Identification of High-Risk Individuals in the United States, a review of injury and morbidity published in JAMA Dermatology this week, I was reminded of a line by blue collar comic Ron White, “I had the right to remain silent, but not the ability.” The study provides windows into both the culture of peer-reviewed journals and American society. It reports a web-based poll of 7570 adults, part of a demographically constructed panel that evaluates marketing and consumer information. Here are the results:

  • 7570 respondents, 55.5% male, 68.1% Caucasian, mean age 41.9, 63.2% married or living with partner
  • 76% groomed pubic...

There are tons of mommy forums and mommy blogs that are influential and followed by a great many women. Some provide really great advice, some are humorous and some share stories of triumphs and tribulations.  I think that is great.  I, personally, belong to a group of physician moms.  What I don't think is great is when someone with zero training to do so, imparts medical advice to their readers. 

I am not entirely sure why this is so, but I have a sneaking suspicion many people feel that what they read on the internet is equivalent to "doing their research."  I cannot stand hearing this because inevitably it is followed up with a statement where you end up either offending the individual or drawing blood from having to bite your tongue.   

One of these sore points, for...

You would have to be living under a rock to be unaware of the opioid crisis going on today. 

It is at an all time high in the US and shows no sign of slowing down. In fact, the epidemic has gotten so bad that members of the White House's Commission on Combating Drug Addiction called on the President this week to "declare a national emergency." 

The numbers are staggering with the Centers for Disease Control (CDC) estimating that 142 U.S. citizens die every day from a drug overdose. At the heart of these deaths are opioids such as Percocet, OxyContin, heroin, and fentanyl.

What we are currently doing to stop the crisis is, obviously, not working.

We, as a society, have not made an effort...

Under the new director, Dr. Scott Gottlieb, the Food and Drug Administration just announced a new "comprehensive regulatory plan" to decrease the plague of tobacco-related deaths. While we're pleased to see the FDA continue to pay attention to this totally preventable cause of death, we're not sure that the steps they've outlined will all be effective in doing so.

One of the more questionable aspects of the new plan is the possible encouragement of producing cigarettes with lower nicotine levels as a way to make them less addictive. While we certainly agree that nicotine is highly...

Nicotine is one of the most addictive and widely used drugs in the world, bar none. And that's a big part of why it's so difficult for smokers to quit cigarettes. Of course, that's not the whole story, since there are replacement products that supply the drug without the damaging effects of inhaling smoke. However, these don't seem to be as satisfying since they don't mimic the movements and mode of nicotine delivery that accompany cigarette smoking.

Enter the electronic cigarette, or e-cig. The device can look like a cigarette (or cigar or pipe), but instead of burning tobacco, it provides a nicotine-containing vapor that the user inhales, thus getting a "hit" in the same way one would get from smoking. So, as a harm-reduction tool — to get smokers away from the deleterious...

There is good news and bad news from the 2016 National Youth Tobacco Survey, published in the Morbidity and Mortality Weekly Report.

The bad news is that teenagers are still smoking and 3.9 million of them are current tobacco users (having a tobacco product in the past 30 days) - a number made even more upsetting by the fact that nine out of ten cigarette smokers first try smoking by age 18. As we have long said, smoking is a pediatric disease and if we can end it in kids, few adults will take it up.

The good news is that that use dropped from 4.7 million in 2015.

The usage of most products decreased to some extent but there was a significant decrease in the usage of vaping products...

During the 1990s and 2000s, opponents of the legalization of marijuana (be it recreational or medical) argued that it served as a "gateway" to harder drugs.

While the gateway hypothesis cannot be entirely ruled out, it is also unlikely to be true. Most people who smoke marijuana do not move on to injecting heroin or snorting cocaine. The likelier explanation is that when people decide to do something rebellious, they begin by picking the "low-hanging fruit," such as alcohol, tobacco, or pot.

Put another way, if a person who uses hard drugs first started with marijuana, that does not mean that marijuana caused him to use those hard drugs. Just because A...