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Embracing healing: The rise of medical cannabis in Australia

<p>In recent years, Australia has made significant strides in healthcare, particularly in the realm of alternative medicine. One such breakthrough gaining widespread recognition is the availability and utilisation of medical cannabis. <a href="https://www.oversixty.com.au/health/body/how-nurses-are-changing-the-conversation-around-medicinal-cannabis" target="_blank" rel="noopener">As attitudes shift and research unfolds</a>, the once-stigmatised plant is emerging as a source of genuine hope and relief for patients across the country.</p> <p>Medical cannabis, derived from the cannabis plant, contains compounds known as cannabinoids, notably THC (tetrahydrocannabinol) and CBD (cannabidiol), which possess therapeutic properties. While recreational use remains a contentious issue, the medicinal potential of cannabis cannot be overlooked.</p> <p>In Australia, its legal status has evolved; in October 2016 the Australian Government changed the law to allow organisations to grow cannabis for research and to make pharmaceutical products, allowing patients to access cannabis-based products under specific conditions.</p> <p>One of the most significant benefits of medical cannabis is its ability to alleviate symptoms and improve the quality of life for patients suffering from various medical conditions. From chronic pain and epilepsy to nausea induced by chemotherapy, medical cannabis offers relief where traditional treatments can fall short or have significant long-term side effects. For people with debilitating illnesses, this alternative therapy can open doors to a life with reduced discomfort and enhanced well-being.</p> <p>Moreover, the availability of medical cannabis fosters a more patient-centric approach to healthcare. By recognising the diverse needs of individuals and offering alternative treatment options, healthcare professionals empower patients to take control of their health journey. This shift towards personalised medicine acknowledges that what works for one person may not work for another, and cannabis-based treatments provide another tool in the arsenal of healthcare interventions.</p> <p>Australia's embrace of medical cannabis also extends to research and innovation. With an increasing number of clinical trials and studies exploring its efficacy and safety, the medical community is uncovering new insights into the potential applications of cannabis-based therapies. This commitment to scientific inquiry ensures that medical cannabis is integrated into healthcare practices responsibly and ethically.</p> <p>Furthermore, the legalisation of medical cannabis opens doors for economic growth and innovation. Australia's burgeoning cannabis industry has the potential to create jobs, stimulate investment and drive technological advancements in cultivation, processing and distribution. By capitalising on this emerging market, Australia can position itself as a global leader in medical cannabis research and production.</p> <p>Take the example of <a href="https://www.montu.com.au/" target="_blank" rel="noopener">Montu</a>, a Melbourne-based medical cannabis company that in November was <a href="https://www.montu.com.au/_files/ugd/0ee6ca_f78badef1cf64ccba22263ed6b5ea5d0.pdf" target="_blank" rel="noopener">named the fastest-growing tech company</a> in the entire country for the second consecutive year. The groundswell of public and investor support for such a company – whose stated mission is to deploy technology to create a better medical cannabis ecosystem for suppliers, practitioners, pharmacies and the patients they serve – is testament to the rapidly growing popularity of medical cannabis as a viable everyday resource for health and wellbeing. </p> <p>Companies like Montu that are streamlining and regulating access to medical cannabis via a growing network of medical practitioners are playing a vital role in getting help for those who need it most. Even though Montu was only formed in 2019, with its first products entering the market in 2020, the evolution of its company ecosystem has been dramatic to say the least. Now with a diverse range of companies under its umbrella, Montu is using innovative solutions to enhance the patient experience – from their "Leafio" dispensing system bridging the gap between suppliers and pharmacies, to their growing variety of products and brands, to their "Alternaleaf" telehealth service that connects patients with expert clinicians, and their high-end "Saged" professional online learning portal for healthcare professionals, this integrated approach is shaping a future where medical cannabis is accessible, efficient and tailored to meet the diverse needs of patients and healthcare providers alike.</p> <p>Perhaps most importantly of all, the availability of medical cannabis promotes harm reduction by offering a safer alternative to potentially addictive pharmaceutical drugs. For patients struggling with opioid dependence or other addictive substances, cannabis-based treatments provide a non-addictive option for managing symptoms, reducing the risk of substance abuse and overdose.</p> <p>The legalisation of medical cannabis in Australia marked a pivotal moment in the nation's healthcare landscape. With growing recognition of the therapeutic potential of cannabis-derived treatments, Australia has taken decisive steps to ensure that patients in need have access to this alternative therapy.</p> <p>Through rigorous regulation and oversight, the legal framework surrounding medical cannabis balances patient safety with the need for compassionate care, allowing individuals suffering from debilitating conditions to explore new avenues of treatment.</p> <p>This landmark decision not only reflected a shift in societal attitudes towards cannabis but also underscored Australia's commitment to evidence-based medicine and the well-being of its citizens.</p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">As attitudes towards cannabis evolve and its medicinal benefits become more widely recognised, Australia stands at the forefront of a healthcare revolution – one of </span>hope, healing and a future where patients can experience relief and improved quality of life.</p> <p><em>Image: Getty</em></p>

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Attempts to access Kate Middleton’s medical records are no surprise. Such breaches are all too common

<p><a href="https://theconversation.com/profiles/bruce-baer-arnold-1408">Bruce Baer Arnold</a>, <em><a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p>The <a href="https://www.abc.net.au/news/2024-03-20/claim-hospital-staff-tried-to-access-kate-middleton-health-info/103608066">alleged</a> data breach involving Catherine, Princess of Wales tells us something about health privacy. If hospital staff can apparently access a future queen’s medical records without authorisation, it can happen to you.</p> <p>Indeed it may have already happened to you, given many breaches of health data go under the radar.</p> <p>Here’s why breaches of health data keep on happening.</p> <h2>What did we learn this week?</h2> <p>Details of the alleged data breaches, by <a href="https://www.mirror.co.uk/news/royals/breaking-kate-middleton-three-london-32401247">up to three staff</a> at The London Clinic, emerged in the UK media this week. These breaches are alleged to have occurred after the princess had abdominal surgery at the private hospital earlier this year.</p> <p>The UK Information Commissioner’s Office <a href="https://ico.org.uk/about-the-ico/media-centre/news-and-blogs/2024/03/ico-statement-in-response-to-reports-of-data-breach-at-the-london-clinic/">is investigating</a>. Its report should provide some clarity about what medical data was improperly accessed, in what form and by whom. But it is unlikely to identify whether this data was given to a third party, such as a media organisation.</p> <h2>Health data isn’t always as secure as we’d hope</h2> <p>Medical records are inherently sensitive, providing insights about individuals and often about biological relatives.</p> <p>In an ideal world, only the “right people” would have access to these records. These are people who “need to know” that information and are aware of the responsibility of accessing it.</p> <p>Best practice digital health systems typically try to restrict overall access to databases through hack-resistant firewalls. They also try to limit access to specific types of data through grades of access.</p> <p>This means a hospital accountant, nurse or cleaner does not get to see everything. Such systems also incorporate blocks or alarms where there is potential abuse, such as unauthorised copying.</p> <p>But in practice each health records ecosystem – in GP and specialist suites, pathology labs, research labs, hospitals – is less robust, often with fewer safeguards and weaker supervision.</p> <h2>This has happened before</h2> <p>Large health-care providers and insurers, including major hospitals or chains of hospitals, have a <a href="https://www.theguardian.com/australia-news/2023/dec/22/st-vincents-health-australia-hack-cyberattack-data-stolen-hospital-aged-care-what-to-do">worrying</a> <a href="https://www.afr.com/technology/medical-information-leaked-in-nsw-health-hack-20210608-p57z7k">history</a> of <a href="https://www.innovationaus.com/oaic-takes-pathology-company-to-court-over-data-breach/">digital breaches</a>.</p> <p>Those breaches include hackers accessing the records of millions of people. The <a href="https://www.theguardian.com/world/2022/nov/11/medical-data-hacked-from-10m-australians-begins-to-appear-on-dark-web">Medibank</a> data breach involved more than ten million people. The <a href="https://www.hipaajournal.com/healthcare-data-breach-statistics/">Anthem</a> data breach in the United States involved more than 78 million people.</p> <p>Hospitals and clinics have also had breaches specific to a particular individual. Many of those breaches involved unauthorised sighting (and often copying) of hardcopy or digital files, for example by nurses, clinicians and administrative staff.</p> <p>For instance, this has happened to public figures such as <a href="https://www.latimes.com/archives/la-xpm-2008-mar-15-me-britney15-story.html">singer</a> <a href="https://journals.lww.com/healthcaremanagerjournal/abstract/2009/01000/health_information_privacy__why_trust_matters.11.aspx">Britney Spears</a>, actor <a href="https://www.nytimes.com/2007/10/10/nyregion/10clooney.html">George Clooney</a> and former United Kingdom prime minister <a href="https://www.theguardian.com/uk-news/2024/mar/20/when-fame-and-medical-privacy-clash-kate-and-other-crises-of-confidentiality">Gordon Brown</a>.</p> <p>Indeed, the Princess of Wales has had her medical privacy breached before, in 2012, while in hospital pregnant with her first child. This was no high-tech hacking of health data.</p> <p>Hoax callers from an Australian radio station <a href="https://theconversation.com/did-2day-fm-break-the-law-and-does-it-matter-11250">tricked</a> hospital staff into divulging details over the phone of the then Duchess of Cambridge’s health care.</p> <h2>Tip of the iceberg</h2> <p>Some unauthorised access to medical information goes undetected or is indeed undetectable unless there is an employment dispute or media involvement. Some is identified by colleagues.</p> <p>Records about your health <em>might</em> have been improperly sighted by someone in the health system. But you are rarely in a position to evaluate the data management of a clinic, hospital, health department or pathology lab.</p> <p>So we have to trust people do the right thing.</p> <h2>How could we improve things?</h2> <p>Health professions have long emphasised the need to protect these records. For instance, medical ethics bodies <a href="https://www.bmj.com/content/350/bmj.h2255">condemn</a> medical students who <a href="https://www.abc.net.au/news/2014-04-14/picture-sharing-app-for-doctors-raises-privacy-concerns/5389226">share</a> intimate or otherwise inappropriate images of patients.</p> <p>Different countries have various approaches to protecting who has access to medical records and under what circumstances.</p> <p>In Australia, for instance, we have a mix of complex and inconsistent laws that vary across jurisdictions, some covering privacy in general, others specific to health data. There isn’t one comprehensive law and set of standards <a href="https://theconversation.com/governments-privacy-review-has-some-strong-recommendations-now-we-really-need-action-200079">vigorously administered</a> by one well-resourced watchdog.</p> <p>In Australia, it’s mandatory to report <a href="https://www.oaic.gov.au/privacy/notifiable-data-breaches">data breaches</a>, including breaches of health data. This reporting system is currently <a href="https://theconversation.com/governments-privacy-review-has-some-strong-recommendations-now-we-really-need-action-200079">being updated</a>. But this won’t necessarily prevent data breaches.</p> <p>Instead, we need to incentivise Australian organisations to improve how they handle sensitive health data.</p> <p>The best policy <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1475-4932.12693">nudges</a> involve increasing penalties for breaches. This is so organisations act as responsible custodians rather than negligent owners of health data.</p> <p>We also need to step-up enforcement of data breaches and make it easier for victims to sue for breaches of privacy – princesses and tradies alike.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226303/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/bruce-baer-arnold-1408">Bruce Baer Arnold</a>, Associate Professor, School of Law, <em><a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/attempts-to-access-kate-middletons-medical-records-are-no-surprise-such-breaches-are-all-too-common-226303">original article</a>.</em></p> <p><em>Images: Getty</em></p>

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Taking expensive medicines or ones unavailable in Australia? Importing may be the answer

<p><em><a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L. Johnson</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/kirsten-staff-1494356">Kirsten Staff</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>The cost-of-living crisis may be driving some Australians to look for cheaper medicines, especially if those medicines are not subsidised or people don’t have a Medicare card. Options can include buying their medicines from overseas, in a process called “<a href="https://www.tga.gov.au/products/unapproved-therapeutic-goods/personal-importation-scheme">personal importation</a>”.</p> <p>Others also use this option to import medicine that is not available in Australia.</p> <p>Here’s what’s involved and what you need to know about the health and legal risks.</p> <h2>Cost-of-living crisis bites</h2> <p>Many Australians, particularly those with long-term illnesses, are finding it increasingly hard to afford health care.</p> <p>The <a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/latest-release#barriers-to-health-service-use">Australian Bureau of Statistics</a> reports the proportion of people who delayed or did not see a GP due to cost doubled in 2022-23 (7%) compared with 2021-22 (3.5%).</p> <p>A <a href="https://australianhealthcareindex.com.au/wp-content/uploads/2022/11/Australian-Healthcare-Index-Report-Nov-22.pdf">survey</a> published in 2022 of over 11,000 people found more than one in five went without a prescription medicine due to the cost.</p> <p>For those with a Medicare card it’s usually best (and cheapest) to get medicines locally, especially if you also have a concession card. However, for some high-cost medicines, personal importation may be cheaper. That’s when an individual arranges for medicine to be sent to them directly from an overseas supplier.</p> <p>A 2023 study found <a href="https://www.publish.csiro.au/AH/AH23143?jid=AHv47n6&amp;xhtml=5AA1F839-38C8-45E8-A458-79DCDB7597FB">1.8%</a> of Australians aged 45 or older had imported prescription medicines in the past 12 months. That indicates potentially hundreds of thousands of Australians are importing prescription medicines each year.</p> <p>Almost half of the survey respondents indicated they would consider importing medicines to save money.</p> <h2>What’s involved?</h2> <p>Australia’s drug regulator, the Therapeutic Goods Administration (TGA), allows individuals to import up to three months’ supply of medicines for their own personal use (or use by a close family member) under the <a href="https://www.tga.gov.au/products/unapproved-therapeutic-goods/personal-importation-scheme">personal importation scheme</a>.</p> <p>This often involves ordering a medicine through an overseas website.</p> <p>If the medicine would require a prescription in Australia, you must also have a legally valid prescription to import it.</p> <p>Selling or supplying these medicines to others outside your immediate family is strictly prohibited.</p> <h2>How could this help?</h2> <p>For some high-cost medicines, personal importation may be cheaper than having the medicine dispensed in Australia. This is most likely for medicines not subsidised by the <a href="https://www.pbs.gov.au/info/about-the-pbs">Pharmaceutical Benefits Scheme</a> (the PBS). People who do not hold a Medicare card may also find it cheaper to import certain medicines as they do not have access to PBS-subsidised medicines.</p> <p>For example, for people with a specific type of leukaemia, treatment with sorafenib is not covered by the PBS. For these patients it could be up to about ten times more expensive to have their treatment dispensed in Australia as it is to import. That’s because there is a cheaper generic version available overseas.</p> <p>Personal importation may also allow you to access medicines that are available overseas but are not marketed in Australia.</p> <h2>What are the risks?</h2> <p>All medicines carry risks, and medicine sold online can pose additional dangers. The TGA does not regulate medicines sold overseas, so the safety and quality of such medicines can be uncertain; they may not be produced to <a href="https://www.tga.gov.au/what-tga-regulates">Australian standards</a>.</p> <p>While similar regulatory agencies exist in other countries, when ordering medicines from overseas websites it can be difficult to determine if the product you are buying has been assessed to ensure it is safe and will do what it says it will do.</p> <p>The medicines purchased could be counterfeit or “fake”. Products bought through unverified or overseas websites may have undisclosed ingredients, contain a dose that differs from that on the label, or lack the active ingredient entirely.</p> <p><a href="https://www.tga.gov.au/importing-therapeutic-goods">Not all medicines</a> can be legally imported through the personal importation scheme. Certain medicines are never allowed to be imported into Australia, and others can only be imported by a medical professional on behalf of a patient.</p> <p>So if you attempt to import a restricted medicine, the Australian Border Force <a href="https://www.abf.gov.au/entering-and-leaving-australia/can-you-bring-it-in/categories/medicines-and-substances">may seize it</a>. Not only would you lose your medicine, but you could also receive a fine or face <a href="https://www.tga.gov.au/news/blog/can-i-import-medicine-personal-use#:%7E:text=If%20you%20try%20to%20import,a%20fine%20or%20jail%20time.">jail time</a>.</p> <p>As with any purchase from an overseas business, there is also a risk you may lose your money and you might not be protected by Australian consumer laws.</p> <p>If you do choose to import medicines by buying them from an overseas website, you should also consider what could happen if delivery is delayed and you don’t get your medicine in time.</p> <h2>Where can I get more advice?</h2> <p>If you are thinking about importing medicines you should first discuss this with a health professional, such as your GP or pharmacist.</p> <p>They can help you determine if personal importation is permitted for the medicine you need. You can also discuss if this is the best option for you.</p> <p>If you are having difficulty covering the cost of your medicines your doctor or pharmacist can also explore other potential alternatives to ensure you are receiving the most cost-effective treatment available in Australia.</p> <h2>Where do I go online?</h2> <p>If you then decide to import, here are some reputable sites to help navigate the global online medicines market:</p> <ul> <li> <p><a href="https://everyone.org/">everyone.org</a> helps people everywhere in the world access the latest medicines not available in their own countries</p> </li> <li> <p><a href="https://buysaferx.pharmacy/">Alliance for Safe Online Pharmacies</a> is a not-for-profit organisation that collates information on how to find safe online pharmacies based in different regions of the world</p> </li> <li> <p><a href="https://www.pharmacychecker.com/accredited-online-pharmacies/">PharmacyChecker</a> has also collated a list of trusted online pharmacies that ship medicines internationally.</p> </li> </ul> <p>Australian government websites about importing medicines include those from <a href="https://www.tga.gov.au/news/blog/can-i-import-medicine-personal-use">the TGA</a> and on what to consider when buying medicines online from <a href="https://www.healthdirect.gov.au/buying-medicines-online#overseas">overseas</a>.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219394/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348"><em>Jacinta L. Johnson</em></a><em>, Senior Lecturer in Pharmacy Practice, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/kirsten-staff-1494356">Kirsten Staff</a>, Senior Lecturer in Pharmacy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/taking-expensive-medicines-or-ones-unavailable-in-australia-importing-may-be-the-answer-219394">original article</a>.</em></p>

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Why it’s a bad idea to mix alcohol with some medications

<p><em><a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jasmine-lee-1507733">Jasmine Lee</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/kellie-charles-1309061">Kellie Charles</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Anyone who has drunk alcohol will be familiar with how easily it can lower your social inhibitions and let you do things you wouldn’t normally do.</p> <p>But you may not be aware that mixing certain medicines with alcohol can increase the effects and put you at risk.</p> <p>When you mix alcohol with medicines, whether prescription or over-the-counter, the medicines can increase the effects of the alcohol or the alcohol can increase the side-effects of the drug. Sometimes it can also result in all new side-effects.</p> <h2>How alcohol and medicines interact</h2> <p>The chemicals in your brain maintain a delicate balance between excitation and inhibition. Too much excitation can lead to <a href="https://www.medicalnewstoday.com/articles/324330">convulsions</a>. Too much inhibition and you will experience effects like sedation and depression.</p> <p><iframe id="JCh01" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/JCh01/1/" width="100%" height="400px" frameborder="0"></iframe></p> <p>Alcohol works by increasing the amount of inhibition in the brain. You might recognise this as a sense of relaxation and a lowering of social inhibitions when you’ve had a couple of alcoholic drinks.</p> <p>With even more alcohol, you will notice you can’t coordinate your muscles as well, you might slur your speech, become dizzy, forget things that have happened, and even fall asleep.</p> <p>Medications can interact with alcohol to <a href="https://awspntest.apa.org/record/2022-33281-033">produce different or increased effects</a>. Alcohol can interfere with the way a medicine works in the body, or it can interfere with the way a medicine is absorbed from the stomach. If your medicine has similar side-effects as being drunk, those <a href="https://www.drugs.com/article/medications-and-alcohol.html#:%7E:text=Additive%20effects%20of%20alcohol%20and,of%20drug%20in%20the%20bloodstream.">effects can be compounded</a>.</p> <p>Not all the side-effects need to be alcohol-like. Mixing alcohol with the ADHD medicine ritalin, for example, can <a href="https://www.healthline.com/health/adhd/ritalin-and-alcohol#side-effects">increase the drug’s effect on the heart</a>, increasing your heart rate and the risk of a heart attack.</p> <p>Combining alcohol with ibuprofen can lead to a higher risk of stomach upsets and stomach bleeds.</p> <p>Alcohol can increase the break-down of certain medicines, such as <a href="https://www.sciencedirect.com/science/article/abs/pii/S0149763421005121?via%3Dihub">opioids, cannabis, seizures, and even ritalin</a>. This can make the medicine less effective. Alcohol can also alter the pathway of how a medicine is broken down, potentially creating toxic chemicals that can cause serious liver complications. This is a particular problem with <a href="https://australianprescriber.tg.org.au/articles/alcohol-and-paracetamol.html">paracetamol</a>.</p> <p>At its worst, the consequences of mixing alcohol and medicines can be fatal. Combining a medicine that acts on the brain with alcohol may make driving a car or operating heavy machinery difficult and lead to a serious accident.</p> <h2>Who is at most risk?</h2> <p>The effects of mixing alcohol and medicine are not the same for everyone. Those most at risk of an interaction are older people, women and people with a smaller body size.</p> <p>Older people do not break down medicines as quickly as younger people, and are often on <a href="https://www.safetyandquality.gov.au/our-work/healthcare-variation/fourth-atlas-2021/medicines-use-older-people/61-polypharmacy-75-years-and-over#:%7E:text=is%20this%20important%3F-,Polypharmacy%20is%20when%20people%20are%20using%20five%20or%20more%20medicines,take%20five%20or%20more%20medicines.">more than one medication</a>.</p> <p>Older people also are more sensitive to the effects of medications acting on the brain and will experience more side-effects, such as dizziness and falls.</p> <p>Women and people with smaller body size tend to have a higher blood alcohol concentration when they consume the same amount of alcohol as someone larger. This is because there is less water in their bodies that can mix with the alcohol.</p> <h2>What drugs can’t you mix with alcohol?</h2> <p>You’ll know if you can’t take alcohol because there will be a prominent warning on the box. Your pharmacist should also counsel you on your medicine when you pick up your script.</p> <p>The most common <a href="https://adf.org.au/insights/prescription-meds-alcohol/">alcohol-interacting prescription medicines</a> are benzodiazepines (for anxiety, insomnia, or seizures), opioids for pain, antidepressants, antipsychotics, and some antibiotics, like metronidazole and tinidazole.</p> <p>It’s not just prescription medicines that shouldn’t be mixed with alcohol. Some over-the-counter medicines that you shouldn’t combine with alcohol include medicines for sleeping, travel sickness, cold and flu, allergy, and pain.</p> <p>Next time you pick up a medicine from your pharmacist or buy one from the local supermarket, check the packaging and ask for advice about whether you can consume alcohol while taking it.</p> <p>If you do want to drink alcohol while being on medication, discuss it with your doctor or pharmacist first.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223293/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/nial-wheate-96839"><em>Nial Wheate</em></a><em>, Associate Professor of the School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jasmine-lee-1507733">Jasmine Lee</a>, Pharmacist and PhD Candidate, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/kellie-charles-1309061">Kellie Charles</a>, Associate Professor in Pharmacology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, Associate Professor of Pharmacology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-its-a-bad-idea-to-mix-alcohol-with-some-medications-223293">original article</a>.</em></p>

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Taking more than 5 pills a day? ‘Deprescribing’ can prevent harm – especially for older people

<p><em><a href="https://theconversation.com/profiles/emily-reeve-1461339">Emily Reeve</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L Johnson</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/janet-sluggett-146318">Janet Sluggett</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>, and <a href="https://theconversation.com/profiles/kate-ohara-1462183">Kate O'Hara</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p>People are living longer and with more <a href="https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance/contents/health-functioning/health-disability-status">chronic health conditions</a> – including heart disease, diabetes, arthritis and dementia – than ever before. As societies continue to grow older, one pressing concern is the use of multiple medications, a phenomenon known as <a href="https://www.who.int/docs/default-source/patient-safety/who-uhc-sds-2019-11-eng.pdf">polypharmacy</a>.</p> <p>About <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50244">1 million older Australians</a> experience polypharmacy and this group is increasing. They may wake up in the morning and pop a pill for their heart, then another one or two to control blood pressure, a couple more if they have diabetes, a vitamin pill and maybe one for joint pain.</p> <p>Polypharmacy is usually <a href="https://www.safetyandquality.gov.au/sites/default/files/2021-04/fourth_atlas_2021_-_6.1_polypharmacy_75_years_and_over.pdf">defined</a> as taking five or more different medications daily. In aged care homes, <a href="https://doi.org/10.1016/j.archger.2022.104849">90% of residents</a> take at least five regular medications every single day. That can put their health at risk with increased costs for them and the health system.</p> <h2>Adding up over time</h2> <p>As people age, the effects of medications can change. Some medications, which were once beneficial, might start to do more harm than good or might not be needed anymore. About <a href="https://www.psa.org.au/wp-content/uploads/2020/02/Medicine-Safety-Aged-Care-WEB-RES1.pdf">half of older Australians</a> are taking a medication where the likely harms outweigh the potential benefits.</p> <p>While polypharmacy is sometimes necessary and helpful in managing multiple health conditions, it can lead to unintended consequences.</p> <p><a href="https://www.nps.org.au/living-with-multiple-medicines/costs">Prescription costs</a> can quickly add up. Taking multiple medications can be difficult to manage particularly when there are specific instructions to crush them or take them with food, or when extra monitoring is needed. There is also a risk of <a href="https://www.nps.org.au/consumers/understanding-drug-interactions">drug interactions</a>.</p> <p>Medications bought “over the counter” without a prescription, such as vitamins, herbal medications or pain relievers, can also cause <a href="https://onlinelibrary.wiley.com/doi/abs/10.5694/mja11.10698">problems</a>. Some people might take an over-the-counter medication each day due to previous advice, but they might not need it anymore. Just like prescription medications, over-the-counter medications add to the overall burden and cost of polypharmacy as well as drug interactions and side effects.</p> <p>Unfortunately, the more medications you take, the more likely you are to have <a href="https://www.nps.org.au/consumers/managing-your-medicines#risks-of-taking-multiple-medicines">problems with your medications</a>, a reduced quality of life and increased risk of falls, hospitalisation and death. Each year, <a href="https://www.psa.org.au/wp-content/uploads/2019/01/PSA-Medicine-Safety-Report.pdf">250,000 Australians</a> are admitted to hospital due to medication-related harms, many of which are preventable. For example, use of multiple medications like sleeping pills, strong pain relievers and some blood pressure medications can cause drowsiness and dizziness, potentially resulting in a <a href="https://betterhealthwhileaging.net/preventing-falls-10-types-of-medications-to-review/">fall</a> and broken bones.</p> <h2>Prescribing and deprescribing are both important</h2> <p>Ensuring safe and effective use of medications involves both prescribing, and <a href="https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/silver-book/part-a/deprescribing">deprescribing</a> them.</p> <p><a href="https://www.australiandeprescribingnetwork.com.au/474-2/">Deprescribing</a> is a process of stopping (or reducing the dose of) medications that are no longer required, or for which the risk of harm outweighs the benefits for the person taking them.</p> <p>The process involves reviewing all the medications a person takes with a health-care professional to identify medications that should be stopped.</p> <p>Think of deprescribing as spring cleaning your medicine cabinet. Just like how you tidy up your house and get rid of objects that are causing clutter without being useful, deprescribing tidies up your medication list to keep only the ones truly required.</p> <h2>But care is needed</h2> <p>The process of deprescribing requires close monitoring and, for many medications, slow reductions in dose (tapering).</p> <p>This helps the body adjust gradually and can prevent sudden, unpleasant changes. Deprescribing is often done on a trial basis and medication can be restarted if symptoms come back. Alternatively, a safer medication, or non-drug treatment may be started in its place.</p> <p>Studies show deprescribing is a safe process when managed by a health-care professional, both for people living at <a href="https://link.springer.com/article/10.1007/s11606-020-06089-2">home</a> and those in <a href="https://doi.org/10.1016/j.jamda.2018.10.026">residential aged care</a>. You should always talk with your care team before stopping any medications.</p> <p>Deprescribing needs to be a team effort involving the person, their health-care team and possibly family or other carers. Shared decision-making throughout the process empowers the person taking medications to have a say in their health care. The team can work together to clarify treatment goals and decide which medications are still serving the person well and which can be safely discontinued.</p> <p>If you or a loved one take multiple medications you might be eligible for a free visit from a pharmacist (<a href="https://www.nps.org.au/assets/NPS/pdf/NPSMW2390_Anticholinergics_HMR_Factsheet.pdf">a Home Medicines Review</a>) to help you get the best out of your medications.</p> <h2>What’s next?</h2> <p>Health care has traditionally focused on prescribing medications, with little focus on when to stop them. Deprescribing is not happening as often as it should. <a href="https://www.australiandeprescribingnetwork.com.au/">Researchers</a> are working hard to develop tools, resources and service models to support deprescribing in the community.</p> <p>Health-care professionals may think older adults are not open to deprescribing, but about <a href="https://academic.oup.com/biomedgerontology/article/77/5/1020/6352400">eight out of ten people</a> are willing to stop one or more of their medications. That said, of course some people may have concerns. If you have been taking a medication for a long time, you might wonder why you should stop or whether your health could get worse if you do. These are important questions to ask a doctor or pharmacist.</p> <p>We need more <a href="https://shpa.org.au/news-advocacy/MedsAware">public awareness</a> about polypharmacy and deprescribing to turn the tide of increasing medication use and related harms. <!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/211424/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/emily-reeve-1461339">Emily Reeve</a>, Senior Research Fellow in the Centre for Medicine Use and Safety , <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L Johnson</a>, Senior Lecturer in Pharmacy Practice, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/janet-sluggett-146318">Janet Sluggett</a>, Enterprise Fellow, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>, and <a href="https://theconversation.com/profiles/kate-ohara-1462183">Kate O'Hara</a>, PhD student, Clinical Pharmacology and Toxicology, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/taking-more-than-5-pills-a-day-deprescribing-can-prevent-harm-especially-for-older-people-211424">original article</a>.</em></p>

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"I fell asleep in the fire escape": Grant Denyer's pain meds confession

<p>Grant Denyer has opened up about the "horrific" time he was on strong pain medication, which at the peak of his reliance, led him to wander off in only his underwear and socks. </p> <p>The former<em> Sunrise</em> presenter recalled the incident on the <em>Jess Rowe Show Podcast</em> and how it left his then-girlfriend Chezzi, with "PTSD" after she spent four hours looking for him in the Sydney CBD.</p> <p>The pair were staying at a hotel in Sydney’s Chinatown when the incident occurred. </p> <p>“I wanted some scotch one night, for whatever reason, and just went wandering around town in my undies, got lost in the fire escape on the way back to the apartment,” he said in the podcast. </p> <p>“I did not know where my apartment was and fell asleep in the fire escape.</p> <p>“It took Chez three or four hours to find me.”</p> <p>In another part of the interview he opened up on the effects of the medication. </p> <p>“When you are under the influence of that kind of power of medication and in that much pain, when you close your eyes at night you go into your worst nightmares immediately and it is every night,” he explained. </p> <p>“So I would come down and think there was a home invasion, I would be crawling down with a broken back to fight off people I thought were there attacking and raping Chez.</p> <p>“This would happen daily.”</p> <p>He added that the pain meds left him in such a daze that whenever he woke up couldn't "differentiate what was real and what wasn’t.”</p> <p>At the time, Denyer had a reliance on both endone and morphine following a monster truck accident in 2008 which left him with a severe spinal injury.  </p> <p>The former <em>Sunrise </em>presenter was training for the Monster Truck Championships at Dapto Showground when the accident occurred, and had only been dating Chezzi for "a couple of weeks", which forced her "straight into carer nurse mode”.</p> <p>Denyer also opened up about the incident on the couple's podcast <em>It’s All True?</em></p> <p>“As soon as you close your eyes you go into your worst nightmares. The things that you are afraid of the most are the first things that happen the moment you fall asleep and you start dreaming.</p> <p>“It is traumatic as every time you sleep and then when you wake up you can’t tell what is real and what isn’t," he said in 2020.</p> <p>Chezzi also explained her side of the story and said that when she found him in the fire exit, he was covered in filth. </p> <p>“It was pretty gross and it broke my heart,” she said.</p> <p>Despite the challenges, the couple's love has prevailed as the pair have been married since 2009 and share three daughters, Sunday, Sailor and Scout.</p> <p><em>Images: Instagram</em></p>

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Taking an antidepressant? Mixing it with other medicines – including some cold and flu treatments – can be dangerous

<p><em><a href="https://theconversation.com/profiles/treasure-mcguire-135225">Treasure McGuire</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>In the depths of winter we are more at risk of succumbing to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7522168/">viral respiratory infections</a> – from annoying sore throat, common cold and sinusitis, to the current resurgence of respiratory syncytial virus (RSV), influenza and COVID.</p> <p>Symptoms of upper respiratory tract infection range in severity. They can include fever, chills, muscle or body aches, cough, sore throat, runny or stuffy nose, earache, headache, and fatigue. Most antibiotics target bacteria so are <a href="https://pubmed.ncbi.nlm.nih.gov/32495003/">not effective</a> for viral infections. Many people seek relief with over-the-counter medicines.</p> <p>While evidence varies, guidelines suggest medicines taken by mouth (such as cough syrups or cold and flu tablets) have a <a href="https://pubmed.ncbi.nlm.nih.gov/25420096/">limited but potentially positive</a> short-term role for managing upper respiratory infection symptoms in adults and children older than 12. These include:</p> <ul> <li>paracetamol or ibuprofen for pain or fever</li> <li>decongestants such as phenylephrine or pseudoephedrine</li> <li>expectorants and mucolytics to thin and clear mucus from upper airways</li> <li>dry cough suppressants such as dextromethorphan</li> <li>sedating or non-sedating antihistamines for runny noses or watery eyes.</li> </ul> <p>But what if you have been prescribed an antidepressant? What do you need to know before going to the pharmacy for respiratory relief?</p> <h2>Avoiding harm</h2> <p>An audit of more than 5,000 cough-and-cold consumer enquiries to an Australian national medicine call centre found questions frequently related to drug-drug interactions (29%). An 18-month analysis showed 20% of calls <a href="https://pubmed.ncbi.nlm.nih.gov/26590496/">concerned</a> potentially significant interactions, particularly with antidepressants.</p> <p>Australia remains in the “<a href="https://www.aihw.gov.au/mental-health/topic-areas/mental-health-%20prescriptions#Prescriptionsbytype">top ten</a>” antidepressant users in the <a href="https://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_PHMC">OECD</a>. More than <a href="https://www.aihw.gov.au/mental-health/topic-areas/mental-health-prescriptions">32 million</a> antidepressant prescriptions are dispensed on the Pharmaceutical Benefits Scheme each year.</p> <p>Antidepressants are commonly prescribed to manage symptoms of anxiety or depression but are also used in chronic pain and incontinence. They are classified primarily by how they affect chemical messengers in the nervous system.</p> <p>These classes are:</p> <ul> <li><strong>selective serotonin reuptake inhibitors (SSRI)</strong> such as fluoxetine, escitalopram, paroxetine and sertraline</li> <li><strong>serotonin and noradrenaline reuptake inhibitors (SNRI)</strong> such as desvenlafaxine, duloxetine and venlafaxine</li> <li><strong>tricyclic antidepressants (TCA)</strong> such as amitriptyline, doxepin and imipramine</li> <li><strong>monoamine oxidase inhibitors (MAOI)</strong> such as tranylcypromine</li> <li><strong>atypical medicines</strong> such as agomelatine, mianserin, mirtazapine, moclobemide, reboxetine and vortioxetine</li> <li><strong>complementary medicines</strong> including St John’s wort, S-adenosyl methionine (SAMe) and L-tryptophan</li> </ul> <p>Medicines within the same class of antidepressants have similar actions and side-effect profiles. But the molecular differences of individual antidepressants mean they may have different interactions with medicines taken at the same time.</p> <h2>Types of drug interactions</h2> <p>Drug interactions can be:</p> <ul> <li><strong>pharmacokinetic</strong> – what the body does to a drug as it moves into, through and out of the body. When drugs are taken together, one may affect the absorption, distribution, metabolism or elimination of the other</li> <li><strong>pharmacodynamic</strong> – what a drug does to the body. When drugs are taken together, one may affect the action of the other. Two drugs that independently cause sedation, for example, may result in excessive drowsiness if taken together.</li> </ul> <p>There are many <a href="https://wchh.onlinelibrary.wiley.com/doi/pdf/10.1002/pnp.429">potential interactions</a> between medications and antidepressants. These include interactions between over-the-counter medicines for upper respiratory symptoms and antidepressants, especially those taken orally.</p> <p>Concentrations of nasal sprays or inhaled medicines are generally lower in the blood stream. That means they are less likely to interact with other medicines.</p> <h2>What to watch for</h2> <p>It’s important to get advice from a pharmacist before taking any medications on top of your antidepressant.</p> <p>Two symptoms antidepressant users should monitor for shortly after commencing a cough or cold medicine are central nervous system effects (irritability, insomnia or drowsiness) and effects on blood pressure.</p> <p>For example, taking a selective SSRI antidepressant and an oral decongestant (such as pseudoephedrine or phenylephrine) can cause irritability, insomnia and affect blood pressure.</p> <p>Serotonin is a potent chemical compound produced naturally for brain and nerve function that can also constrict blood vessels. Medicines that affect serotonin are common and include most antidepressant classes, but also decongestants, dextromethorphan, St John’s wort, L-tryptophan, antimigraine agents, diet pills and amphetamines.</p> <p><a href="https://reference.medscape.com/drug-interactionchecker">Combining drugs</a> such as antidepressants and decongestants that both elevate serotonin levels can cause irritability, headache, insomnia, diarrhoea and blood pressure effects – usually increased blood pressure. But some people experience orthostatic hypotension (low blood pressure on standing up) and dizziness.</p> <p>For example, taking both a serotonin and SNRI antidepressant and dextromethorphan (a cough suppressant) can add up to high serotonin levels. This can also occur with a combination of the complementary medicine St John’s Wort and an oral decongestant.</p> <p>Where serotonin levels are too high, <a href="https://pubmed.ncbi.nlm.nih.gov/15666281/">severe symptoms</a> such as confusion, muscle rigidity, fever, seizures and even death have been reported. Such symptoms are rare but if you notice any of these you should stop taking the cold and flu medication straight away and seek medical attention.</p> <h2>Ways to avoid antidepressant drug interactions</h2> <p>There are a few things we can do to prevent potentially dangerous interactions between antidepressants and cold and flu treatments.</p> <p><strong>1. Better information</strong></p> <p>Firstly, there should be more targeted, consumer-friendly, <a href="https://www.webmd.com/interaction-checker/default.htm">online drug interaction information</a> available for antidepressant users.</p> <p><strong>2. Prevent the spread of viral infections as much as possible</strong></p> <p>Use the non-drug strategies that have worked well for COVID: regular hand washing, good personal hygiene, social distancing, and facemasks. Ensure adults and children are up to date with immunisations.</p> <p><strong>3. Avoid potential drug interactions with strategies to safely manage symptoms</strong></p> <p>Consult your pharmacist for strategies most appropriate for you and only use cold and flu medications while symptoms persist:</p> <ul> <li>treat muscle aches, pain, or a raised temperature with analgesics such as paracetamol or ibuprofen</li> <li>relieve congestion with a nasal spray decongestant</li> <li>clear mucus from upper airways with expectorants or mucolytics</li> <li>dry up a runny nose or watery eyes with a non-sedating antihistamine.</li> </ul> <p>Avoid over-the-counter cough suppressants for an irritating dry cough. Use a simple alternative such as honey, steam inhalation with a few drops of eucalyptus oil or a non-medicated lozenge instead.</p> <p><strong>4. Ask whether your symptoms could be more than the common cold</strong></p> <p>Could it be influenza or COVID? Seek medical attention if you are concerned or your symptoms are not improving. <!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/208662/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/treasure-mcguire-135225">Treasure McGuire</a>, Assistant Director of Pharmacy, Mater Health SEQ in conjoint appointment as Associate Professor of Pharmacology, Bond University and as Associate Professor (Clinical), <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/taking-an-antidepressant-mixing-it-with-other-medicines-including-some-cold-and-flu-treatments-can-be-dangerous-208662">original article</a>.</em></p>

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Medical Research Future Fund has $20 billion to spend. Here’s how we prioritise who gets what

<p><em><a href="https://theconversation.com/profiles/adrian-barnett-853">Adrian Barnett</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/philip-clarke-1149967">Philip Clarke</a>, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a></em></p> <p>The <a href="https://www.health.gov.au/our-work/medical-research-future-fund">Medical Research Future Fund</a> (MRFF) is a A$20 billion fund to support Australian health and medical research. It was set up in 2015 to deliver practical benefits from medical research and innovation to as many Australians as possible.</p> <p>Unlike the other research funding agencies, such the National Health and Medical Research Council (NHMRC), most of the MRFF funding is priority-driven. It seeks to fund research in particular areas or topics rather than using open calls when researchers propose their own ideas for funding.</p> <p>As the <a href="https://www.smh.com.au/politics/federal/not-how-you-run-a-1b-scheme-science-fund-backers-lead-chorus-for-reform-20230619-p5dhni.html">Nine newspapers</a> outlined this week, researchers have criticised the previous Coalition government’s allocation of MRFF funds. There is widespread consensus the former health minister had <a href="https://www.theage.com.au/politics/federal/a-centre-never-built-and-a-hospital-that-missed-out-the-coalition-s-unusual-20b-research-fund-20230619-p5dhng.html">too much influence</a> in the allocation of funds, and there was limited and sometimes no competition when funding was directly allocated to one research group.</p> <p>The current Health Minister, Mark Butler, has instituted a <a href="https://www.innovationaus.com/billion-dollar-medical-research-grants-process-under-review/">review</a>. So how should the big decisions about how to spend the MRFF be made in the future to maximise its value and achieve its aims?</p> <h2>Assess gaps in evidence</h2> <p>Research priorities for the MRFF are set by the <a href="https://www.health.gov.au/committees-and-groups/australian-medical-research-advisory-board-amrab?language=und">Australian Medical Research Advisory Board</a>, which widely consults with the research sector.</p> <p>However, most researchers and institutions will simply argue more funding is needed for their own research. If the board seeks to satisfy such lobbying, it will produce fragmented funding that aligns poorly with the health needs of Australians.</p> <p>A better approach would be to systematically assemble evidence about what is known and the key evidence gaps. Here, the board would benefit from what is known as a “<a href="https://pubmed.ncbi.nlm.nih.gov/15484602/">value of information</a>” framework for decision-making.</p> <p>This framework systematically attempts to quantify the most valuable information that will reduce the uncertainty for health and medical decision-making. In other words, it would pinpoint which information we need to allow us to better make health and medical decisions.</p> <p>There have been <a href="https://pubmed.ncbi.nlm.nih.gov/30288400/">attempts</a> to use this method in Australia to help inform how we prioritise hospital-based research. However, we now need to apply such an approach more broadly.</p> <h2>Seek public input</h2> <p>A structured framework for engaging with the public is also missing in Australia. The public’s perspective on research prioritisation has often been overlooked, but as the ultimate consumers of research, they need to be heard.</p> <p>Research is a highly complex and specialised endeavour, so we can’t expect the public to create sensible priorities alone.</p> <p>One approach used overseas has been developed by the <a href="https://www.jla.nihr.ac.uk/">James Lind Alliance</a>, a group in the United Kingdom that combines the public’s views with researchers to create agreed-on priorities for research.</p> <p>This is done using an intensive process of question setting and discussion. Priorities are checked for feasibility and novelty, so there is no funding for research that’s impossible or already done.</p> <p>The priorities from the James Lind Alliance process can be surprising. The top priority in the area of <a href="https://www.jla.nihr.ac.uk/priority-setting-partnerships/irritable-bowel-syndrome/top-10-priorities.htm">irritable bowel syndrome</a>, for example, is to discover if it’s one condition or many, while the second priority is to work on bowel urgency (a sudden urgent need to go to the toilet).</p> <p>While such everyday questions can struggle to get funding in traditional systems that often focus on novelty, funding research in these two priority areas could lead to the most benefits for people with irritable bowel syndrome.</p> <h2>Consider our comparative advantages</h2> <p>Australia is a relatively small player globally. To date, the MRFF has allocated around <a href="https://www.health.gov.au/resources/publications/medical-research-future-fund-mrff-grant-recipients?language=und">$2.6 billion</a>, just over 5% of what the United States allocates through the National Institute of Health funding in a <a href="https://www.who.int/observatories/global-observatory-on-health-research-and-development/monitoring/investments-on-grants-for-biomedical-research-by-funder-type-of-grant-health-category-and-recipient">single year</a>.</p> <p>A single research grant, even if it involves a few million dollars of funding, is unlikely to lead to a medical breakthrough. Instead, the MRFF should prioritise areas where Australia has a comparative advantage.</p> <p>This could involve building on past success (such as the research that led to the HPV, or human papillomavirus, vaccine to prevent cervical cancer), or where Australian researchers can play a critical role globally.</p> <p>However, there is an area where Australian researchers have an absolute advantage: using research to improve our own health system.</p> <p>A prime example would be finding ways to improve dental care access in Australia. For example, a randomised trial of different ways of providing insurance and dental services, similar to the <a href="https://www.rand.org/health-care/projects/hie.html">RAND Health Insurance Experiment</a> conducted in the United States in the 1970s.</p> <p>This could provide the evidence needed to design a sustainable dental scheme to complement Medicare. Now that is something the MRFF should consider as a funding priority.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/209977/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/adrian-barnett-853">Adrian Barnett</a>, Professor of Statistics, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/philip-clarke-1149967">Philip Clarke</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/medical-research-future-fund-has-20-billion-to-spend-heres-how-we-prioritise-who-gets-what-209977">original article</a>.</em></p>

Money & Banking

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People with long COVID continue to experience medical gaslighting more than 3 years into the pandemic

<p><em><a href="https://theconversation.com/profiles/simran-purewal-1405366">Simran Purewal</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kaylee-byers-766226">Kaylee Byers</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kayli-jamieson-1431392">Kayli Jamieson</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>, and <a href="https://theconversation.com/profiles/neda-zolfaghari-1431577">Neda Zolfaghari</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p>It’s increasingly clear that the <a href="https://www.worldometers.info/coronavirus/country/canada/">SARS-CoV-2 virus is not going away</a> any time soon. And for some patients, their symptoms haven’t gone away either.</p> <p>In January 2023, our team of researchers at the <a href="https://pipps.ca/">Pacific Institute on Pathogens, Pandemics and Society</a> published a <a href="https://pipps.cdn.prismic.io/pipps/bd160219-3281-4c5d-b8be-57c301e7f99b_Long+Covid+Brief+Feb+2023.pdf">research brief</a> about how people seek out information about long COVID. The brief was based on a scoping review, a type of study that assesses and summarizes available research. Our interdisciplinary team aims to understand the experiences of people with long COVID in order to identify opportunities to support health care and access to information.</p> <h2>Lingering long COVID</h2> <p>Long COVID (also called <a href="https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/symptoms/post-covid-19-condition.html">Post COVID-19 condition</a>) is an illness that occurs after infection with COVID-19, lasting weeks to months, and even years. First coined by a <a href="https://doi.org/10.1016%2Fj.socscimed.2020.113426">patient on Twitter</a>, the term also represents a collective movement of people experiencing the long-term effects of COVID-19 and advocating for care. <a href="https://science.gc.ca/site/science/sites/default/files/attachments/2023/Post-Covid-Condition_Report-2022.pdf">Around 15 per cent</a> of adults who have had COVID still have symptoms after three months or more.</p> <p>Long COVID affects systems <a href="https://doi.org/10.1016/j.socscimed.2021.114619">throughout the body</a>. However, symptom fluctuations and limited diagnostic tools make it challenging for health-care providers to diagnose, especially with <a href="https://doi.org/10.1038/s41579-022-00846-2">over 200 symptoms</a> that may present in patients. Perhaps because long COVID presents itself in many different ways, the illness has <a href="https://doi.org/10.1016/j.socscimed.2021.114619">been contested</a> across the medical field.</p> <p>To identify opportunities to reduce barriers to long COVID care, our team has explored how patients and their caregivers access <a href="https://pipps.cdn.prismic.io/pipps/bd160219-3281-4c5d-b8be-57c301e7f99b_Long+Covid+Brief+Feb+2023.pdf">information about long COVID</a>. We have found that one of the most significant barriers faced by patients is <a href="https://doi.org/10.1177/20552076211059649">medical gaslighting</a> by the people they have turned to for help.</p> <h2>Lack of validation leads to stigma</h2> <p><a href="https://doi.org/10.1136/bmj.o1974">Medical gaslighting</a> occurs when health-care practitioners dismiss or falsely blame patients for their symptoms. While new information about long COVID has become more readily available, some patients continue to face gaslighting and feel that their symptoms are <a href="https://doi.org/10.1016%2Fj.ssmqr.2022.100177">treated less seriously</a> by some health-care professionals.</p> <p>This dismissal can <a href="https://doi.org/10.1111/hex.13602">erode trust</a> in the health-care system and can also lead to <a href="https://doi.org/10.1111/hex.13518">stigma and shame</a>.</p> <p>Preliminary findings from our ongoing study with long COVID patients indicate that, when medical practitioners do not validate a patient’s condition, this extends into community networks of family and friends who may also dismiss their symptoms, contributing to further stigmatization at home.</p> <p>Medical gaslighting can present additional barriers to treatment, such as not being referred to specialists or long COVID clinics. This can, in turn, compound other symptoms such as fatigue, and <a href="https://doi.org/10.1192/bjo.2022.38">exacerbate the psychological symptoms of long COVID</a>, such as depression and anxiety.</p> <p>Medical gaslighting isn’t new. It has been documented by patients with other chronic conditions, such as <a href="https://doi.org/10.5772/intechopen.107936">myalgic encephalomyelitis or chronic fatigue syndrome</a>. And while this is common for patients with <a href="https://doi.org/10.1001/amajethics.2021.512">non-visible illnesses</a>, medical gaslighting is more commonly experienced by <a href="https://doi.org/10.1111/1467-9566.13367">women and racialized people</a>.</p> <p>Long COVID patients also note gender biases, as women with prolonged symptoms feel they are not believed. This is particularly worrisome, as studies have found that <a href="https://doi.org/10.1001/jama.2020.17709">women are disproportionately more likely to experience long COVID</a>.</p> <h2>Where do we go from here?</h2> <p>While long COVID information is constantly shifting, it’s clear that patients face many barriers, the first of which is having their illness minimized or disregarded by others. To ensure that patients have access to compassionate care, we suggest:</p> <p><strong>1. Educating physicians on long COVID</strong></p> <p>Because definitions of long COVID, and its presentation, vary widely, primary care physicians need support to recognize and acknowledge the condition. General practitioners (GPs) must also provide patients with information to help manage their symptoms. This requires actively listening to patients, documenting symptoms and <a href="https://doi.org/10.1136/bmj.m3489">paying close attention to symptoms that need further attention</a>.</p> <p>Training physicians on the full range of symptoms and referring patients to available supports would reduce stigma and assist physicians by reducing their need to gather information themselves.</p> <p><strong>2. Raise awareness about long COVID</strong></p> <p>To increase awareness of long COVID and reduce stigma, public health and community-based organizations must work collaboratively. This may include a public awareness and information campaign about long COVID symptoms, and making support available. Doing so has the potential to foster community support for patients and improve the mental health of patients and their caregivers.</p> <p><strong>3. Ensure information is accessible</strong></p> <p>In many health systems, GPs are <a href="https://doi.org/10.1186/s12913-019-4419-0">gatekeepers to specialists</a> and are considered trusted information sources. However, without established diagnostic guidelines, patients are left to <a href="https://doi.org/10.2196/37984">self-advocate</a> and prove their condition exists.</p> <p>Because of negative encounters with health-care professionals, patients turn to social media platforms, including long COVID <a href="https://doi.org/10.7861%2Fclinmed.2020-0962">online communities</a> on Facebook. While these platforms allow patients to validate experiences and discuss management strategies, patients should not rely only on social media given the <a href="https://doi.org/10.3389/fpubh.2022.937100">potential for misinformation</a>. As a result, it is crucial to ensure information about long COVID is multi-lingual and available in a wide range of formats such as videos, online media and physical printouts.</p> <p>The <a href="https://science.gc.ca/site/science/en/office-chief-science-advisor/initiatives-covid-19/post-covid-19-condition-canada-what-we-know-what-we-dont-know-and-framework-action">recent recommendations of the Chief Science Advisor of Canada</a> to establish diagnostic criteria, care pathways and a research framework for long COVID are a positive development, but we know patients need support now. Improving long COVID education and awareness won’t resolve all of the issues faced by patients, but they’re foundational to compassionate and evidence-based care.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/203744/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/simran-purewal-1405366">Simran Purewal</a>, Research Associate, Health Sciences, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kaylee-byers-766226">Kaylee Byers</a>, Regional Deputy Director, BC Node of the Canadian Wildlife Health Cooperative; Senior Scientist, Pacific Institute on Pathogens, Pandemics and Society, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kayli-jamieson-1431392">Kayli Jamieson</a>, Master's Student in Communication, Research Assistant for Pacific Institute on Pathogens, Pandemics and Society, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>, and <a href="https://theconversation.com/profiles/neda-zolfaghari-1431577">Neda Zolfaghari</a>, Project Coordinator, Pacific Institute on Pathogens, Pandemics and Society, and the Pandemics &amp; Borders Project, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/people-with-long-covid-continue-to-experience-medical-gaslighting-more-than-3-years-into-the-pandemic-203744">original article</a>.</em></p>

Caring

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9 medical reasons your short-term memory is getting worse

<p><strong>What is short-term memory?</strong></p> <p>Short-term memory is the type of memory you need to accomplish your immediate goals, explains Dr Patrick Lyden, chair of the department of neurology at Cedars-Sinai Hospital. That may be working your way through tasks during the workday, remembering someone’s name, email, or phone number, or recalling where you tossed your keys when you got home.</p> <p><strong>Where is it located in the brain?</strong></p> <p>When someone rattles off their phone number, you file it away in brain circuits that include the hippocampus (your memory centre) and the amygdala (your emotional hub). Depending on how important the short-term memory item may be (your address, someone you call all the time), it can be converted into long-term memory, says Dr Lyden.</p> <p><strong>How does short-term memory work?</strong></p> <p>Short-term memory isn’t just about being able to quickly recall new info; there are three phases. “You have to register the information, store the information, and retrieve the information,” says Dr Lyden. Registering means that you’re paying attention in the first place. Storing the info means you’ve filed it away in your brain. Retrieval is the ability to access the memory again. Any of these steps can break down, he says.</p> <p><strong>Is your memory okay?</strong></p> <p>Many people assume they have a memory problem when the explanation is something else entirely, says Dr Lyden. Maybe you’re not paying attention because you’re gazing at your phone or texting, for example. The first step to figuring out if something is going on is to “pay closer attention,” he says. Repeat the new information three times to commit it to memory.</p> <p><strong>When it may be time to worry</strong></p> <p>If you can’t pass the “pay attention test” despite repeating the information, your next step, advises Dr Lyden, is to determine if your problem is storing new memories or retrieving them. If you’re having a problem remembering a new acquaintance’s name, ask them to give you three choices – like Carrie, Lauren, or Janet. If your problem is storing new memories, you won’t be able to remember. But if your problem is retrieval, you’ll remember that her name is Janet once you hear the correct name.</p> <p>Having trouble with retrieving a short-term memory isn’t as serious as being unable to store them. “The storage problem is a serious problem, and you should see a neurologist,” he says.</p> <p><strong>Inactivity</strong></p> <p>Blood flow is good for your brain – it keeps it young. “Exercising boosts blood flow to your brain. If you stay active, you’ll have a better memory,” says Dr Daniel G. Amen, author of <em>Memory Rescue: Supercharge Your Brain, Reverse Memory Loss, and Remember What Matters Most</em>. Dr Lyden suggests daily exercise and it doesn’t have to be intense. “A one-kilometre run daily is better than a 10-kilometre run one day a week,” he says.</p> <p><strong>Substance abuse</strong></p> <p>According to Dr Amen, marijuana a toxin that impairs memory. “Marijuana lowers every area of the brain and ages it. On average, pot smokers have brains three years older than non-smokers,” he says. Alcohol abuse can also harm your memory.</p> <p><strong>Mental health conditions</strong></p> <p>People tend to miss their own depression. But if you’re suffering from depression, anxiety, or chronic stress, get help or your memory can also pay the price. “These conditions may all hurt the brain,” says Dr Amen. Getting relief will not only improve your life and outlook but save your brain.</p> <p><strong>Lack of sleep</strong></p> <p>When considering short-term memory loss causes, poor sleep is a big one. “If you don’t sleep seven hours a night or more, you’ll be in trouble. Your brain cleans itself at night. When you don’t get enough, it’s like the garbage collectors didn’t come to clean up,” says Dr Amen.</p> <p><strong>Dementia</strong></p> <p>Before you panic, there’s some good news: “The vast majority of people who are healthy will not have a degenerative neurological condition causing short-term memory loss,” says Dr Lyden. But dementia or Alzheimer’s is a possibility in some groups. If you’re over 60 and have risk factors like diabetes, high blood pressure, or obesity, then you may be more prone to problems and need to be evaluated, he says.</p> <p><strong>Medication</strong></p> <p>If you lead a healthy lifestyle, eat right, exercise, and go easy on alcohol and other substances that can harm memory, yet you still feel like your memory if failing, talk to your doctor about your medications – prescription and over-the-counter, advises Dr Lyden. Cholesterol drugs, painkillers, high blood pressure pills, and sleeping pills are among the drugs that can trigger memory issues.</p> <p><strong>Hypothyroidism</strong></p> <p>When you have an under-active thyroid, everything in your body runs slower. Your digestion will slow and you can become constipated; cell growth slows and can lead to hair loss; your metabolism becomes sluggish, triggering weight gain. And you may be plagued by muddied thinking or forgetfulness. Often, medication to restore thyroid hormones can help alleviate symptoms and help you feel better all over.</p> <p><strong>A poor diet</strong></p> <p>Inflammation is bad for your body and your brain. “The higher the inflammation levels in your body, the worse your memory will be,” says Dr Amen. Eating an anti-inflammatory diet, like the Mediterranean diet, and avoiding foods that increase it (highly processed foods, loads of sugar) is key. He also recommends taking fish oil and probiotics.</p> <p><strong>Lyme disease</strong></p> <p>Lyme disease is transmitted through a tick bite, and causes early symptoms like fever, chills, headache, and fatigue, according to the Centers for Disease Control and Prevention (CDC). Later on, without treatment, some people also may notice short-term memory problems. Dr Amen points out this may include trouble with attention, focus, and organisation. Keep in mind that the types of tick that carry the bacteria are not native to Australia and it’s not likely you can catch Lyme disease in Australia.</p> <p><strong>When to seek help</strong></p> <p>Along with the self-test mentioned earlier, think about how you perceive your short-term memory. Ask yourself: Is it getting progressively worse? Is it worse than 10 years ago? Are other people noticing a problem? “Those are things you should take seriously,” says Dr Amen.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/9-medical-reasons-your-short-term-memory-is-getting-worse-2?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

Mind

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“Game-changer”: Michael J Fox shares huge medical news

<p dir="ltr">Michael J Fox has shared news of a medical breakthrough into Parkinson’s disease.</p> <p dir="ltr">The 61-year-old – who was diagnosed with the disease in 1991 – was thrilled to share the news, despite suffering a “terrible year”.</p> <p dir="ltr">Fox told <a href="https://www.statnews.com/2023/04/12/michael-j-fox-parkinsons-biomarker/" target="_blank" rel="noopener"><em>Stat News</em></a> that he had broken multiple bones after a fall, including some in his hand and face, but has said that in some ways he is “feeling better”.</p> <p dir="ltr">Despite his own personal battle, the <em>Back to the Future</em> star was overjoyed to share the breakthrough in Parkinson’s research.</p> <p dir="ltr">The study – funded by Fox’s charity organisation that aims to find a cure for Parkinson’s – found that a key Parkinson's pathology can now be identified by examining spinal fluid from living patients, allowing earlier intervention.</p> <p dir="ltr">“It’s all changed. It can be known and treated early on. It’s huge,” he said</p> <p dir="ltr">“This is the thing. This is the big reward. This is the big trophy.”</p> <p dir="ltr">The findings, published in <em>The Lancet Neurology</em>, are the result of a 1,123-person study that Fox’s foundation has put hundreds of millions of dollars into since it began in 2010.</p> <p dir="ltr">An editorial in the medical journal has also called this research “a game-changer in Parkinson’s disease diagnostics, research, and treatment trials”.</p> <p dir="ltr">In late 2022 the actor opened up about his struggle with Parkinson’s in his emotional acceptance speech for the <a href="https://www.oversixty.com.au/health/caring/michael-j-fox-reveals-more-details-about-his-struggle-with-parkinson-s" target="_blank" rel="noopener">Jean Hershel Humanitarian Award</a>.</p> <p dir="ltr">In the speech he said that the hardest part “was grappling with the certainty of the diagnosis and the uncertainty of the situation,” but has since felt relieved after an “outpouring of support” from the public and his peers.</p> <p><em>Image: Frazer Harrison for Getty Images</em></p>

Caring

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Is my medicine making me feel hotter this summer? 5 reasons why

<p>If you’re really feeling the heat this summer, it might be down to more than the temperature outside.</p> <p>Some types of medicines can increase your core body temperature or make you feel hotter than you really are. Some can affect your body’s ability to cool down.</p> <p>Here’s what you need to know about heat intolerance and medicines.</p> <h2>What is heat intolerance?</h2> <p>Some people simply dislike the feeling of feeling hot, while others feel hot at temperatures most people find comfortable. Both are examples of <a href="https://www.medicalnewstoday.com/articles/325232#symptoms">heat intolerance</a>.</p> <p>Typical symptoms during warm weather include excessive sweating (or not sweating enough), exhaustion and fatigue, nausea, vomiting or dizziness, and changes in mood.</p> <p>A number of factors can cause heat intolerance.</p> <p>This includes the disorder <a href="https://my.clevelandclinic.org/health/diseases/6004-dysautonomia">dysautonomia</a>, which affects people’s autonomic nervous system – the part of the body that regulates the automatic functions of the body, including our response to heat. </p> <p>Conditions such as diabetes, alcohol misuse, <a href="https://theconversation.com/what-causes-parkinsons-disease-what-we-know-dont-know-and-suspect-57579">Parkinson’s disease</a>, the autoimmune disease <a href="https://theconversation.com/explainer-what-is-guillain-barre-syndrome-and-is-it-caused-by-the-zika-virus-53884">Guillain-Barré syndrome</a> and <a href="https://theconversation.com/explainer-what-are-mitochondria-and-how-did-we-come-to-have-them-83106">mitochondrial disease</a> can cause dysautonomia. People in old age, those with some neurological conditions, or people less physically fit may also have it.</p> <p>But importantly, medications can also contribute to heat intolerance.</p> <h2>1. Your body temperature rises</h2> <p>Some medicines directly increase your body temperature, which then increases the risk of heat intolerance. </p> <p>These include <a href="https://bpspubs.onlinelibrary.wiley.com/doi/epdf/10.1111/bph.15465">stimulant medications</a> to treat ADHD (attention deficit hyperactivity disorder), such as methylphenidate, dexamfetamine and lisdexamfetamine.</p> <p><a href="https://www.healthdirect.gov.au/antipsychotic-medications">Antipsychotic medications</a> (such as clozapine, olanzapine and quetiapine) used to treat mental health conditions, such as schizophrenia and bipolar disorder, are other examples. </p> <p>These ADHD and antipsychotic medicines raise your temperature by acting on the hypothalamus, the region of the brain essential for cooling.</p> <p>The drug levothyroxine, used to treat an under-active thyroid, also increases your body temperature, this time by <a href="https://www.ncbi.nlm.nih.gov/books/NBK500006/">increasing your metabolism</a>.</p> <h2>2. Your blood flow is affected</h2> <p>Other medicines constrict (tighten) blood vessels, decreasing blood flow to the skin, and so prevent heat from escaping this way. This means your body can’t regulate its temperature as well in the heat. </p> <p>Examples include <a href="https://www.healthdirect.gov.au/beta-blockers">beta-blockers</a> (such as metoprolol, atenolol and propranolol). These medications are used to treat conditions such as high blood pressure, angina (a type of chest pain), tachycardia (fast heart rate), heart failure, and to prevent migraines. </p> <p><a href="https://www.nhs.uk/conditions/decongestants/">Decongestants</a> for blocked noses (for example, pseudoephedrine and phenylephrine), triptans for migraines (such as sumatriptan and zolmitriptan) and the ADHD medications mentioned earlier can also act to decrease blood flow to the skin.</p> <h2>3. You can get dehydrated</h2> <p>Other medicines can cause dehydration, which then makes you more susceptible to heat intolerance. The best examples are <a href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/diuretics/art-20048129">diuretics</a> such as furosemide, hydrochlorothiazide, acetazolamide and aldosterone.</p> <p>These are used to control high blood pressure and heart failure by forcing your kidneys to remove more fluid from your body. </p> <p>Laxatives, such as senna extract and bisacodyl, also remove water from your body and so have a similar effect.</p> <h2>4. You can sweat less</h2> <p>Other medicines have a drying effect. This can be needed for medicines to do their job (for instance, to dry up a runny nose). For others, it is an unwanted side effect. </p> <p>This drying reduces the amount you sweat, making it harder to lose heat and regulate your core temperature. A number of medicines have these effects, including:</p> <ul> <li>some antihistamines (such as promethazine, doxylamine and diphenhydramine)</li> <li>certain antidepressants (such as amitriptyline, clomipramine and dothiepin)</li> <li>medicines used to treat <a href="https://www.healthdirect.gov.au/urinary-incontinence#:%7E:text=Urinary%20incontinence%2C%20or%20poor%20bladder%20control%2C%20is%20very%20common%20in,to%20cure%20or%20improve%20it.">urinary incontinence</a> (for example, oxybutynin and solifenacin) </li> <li>nausea medicine (prochlorperazine)</li> <li>medicines for stomach cramps and spasms (for instance, hyoscine) </li> <li>the antipsychoptics chlorpromazine, olanzapine, quetiapine and clozapine.</li> </ul> <h2>5. You don’t feel thirsty</h2> <p>Finally, some medicines, such as the antipsychotics haloperidol and droperidol, can aggravate heat intolerance by reducing your ability to feel thirsty. </p> <p>If you don’t feel thirsty, you drink less and are therefore at risk of dehydration and feeling hot.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/is-my-medicine-making-me-feel-hotter-this-summer-5-reasons-why-199085" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Body

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Researchers puzzled by results of anti-inflammatory medications for osteoarthritis

<p>Researchers in the US are calling for a re-evaluation of the way some well known painkillers are prescribed after research showed they may actually lead to a worsening of inflammation over time in osteoarthritis-affected knee joints.</p> <p>NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) such as ibuprofen and naproxen are designed to reduce inflammation for the estimated 2.2 million Australians suffering from the sometimes debilitating effects of osteoarthritis.</p> <p>Osteoarthritis is a degenerative condition affecting joints in the body – most commonly hips, knees, ankles, spine and hands – which results from the degradation of cartilage on the ends of bones within the joints. As the cartilage wears away, the bones rub together resulting in swelling, pain and restricted movement.</p> <p>To combat this pain and swelling, NSAIDs are commonly prescribed, however the long-term impact of this type of medication is unclear, including its effect on the progression of the condition.</p> <p>“To date, no curative therapy has been approved to cure or reduce the progression of knee osteoarthritis,” said the study’s lead author, Johanna Luitjens, from the Department of Radiology and Biomedical Imaging at the University of California, San Francisco. “NSAIDs are frequently used to treat pain, but it is still an open discussion of how NSAID use influences outcomes for osteoarthritis patients.</p> <p>Surprisingly the report says: “…the impact of NSAIDs on synovitis, or the inflammation of the membrane lining the joint, has never been analysed using MRI-based structural biomarkers.”</p> <p>The study compared 793 participants with moderate to severe osteoarthritis of the knee who did not use NSAIDs, with 277 patients who received sustained treatment with NSAIDs for more than a year. Each patient underwent Magnetic Resonance Imaging (MRI) scans of the joint, which were then repeated after four years.</p> <p>The researchers were able to assess the images for indications of inflammation and arthritis progression including cartilage thickness and composition.</p> <p>The data showed the group using NSAIDs, had worse joint inflammation and cartilage quality than those not using NSAIDs, at the time of the initial MRI scan. And the follow-up imaging showed the conditions had worsened for the NSAID group.</p> <p>“In this large group of participants, we were able to show that there were no protective mechanisms from NSAIDs in reducing inflammation or slowing down progression of osteoarthritis of the knee joint,” said Luitjens.</p> <p>According to Luitjens, the common practice of prescribing NSAIDs for osteoarthritis should be revisited as there doesn’t appear to be any evidence they have a positive impact on joint inflammation nor do they slow or prevent synovitis or degenerative changes in the joint.</p> <p>There is also a possibility that NSAIDs simply mask the pain. Despite adjusting the study’s model for individual levels of patient physical activity, “patients who have synovitis and are taking pain-relieving medications may be physically more active due to pain relief, which could potentially lead to worsening of synovitis,” said Luitjens.</p> <p>Luitjens hopes future studies will better characterise NSAIDs and their impact on osteoarthritic inflammation. With one in three people over the age of 75 in Australia suffering from osteoarthritis and an estimated one in 10 women and one in 16 men set to develop it in the future, unlocking treatment options for this crippling condition is an imperative.</p> <p><strong>This article originally appeared on <a href="https://cosmosmagazine.com/science/osteoarthritis-puzzled-antiinflammatory/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Clare Kenyon.</strong></p> <p><em>Image: Shutterstock</em></p>

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10 items you MUST carry in your travel medical kit

<p>Health concerns are the last thing you want to be dealing with when on holidays, but unfortunately accidents can still happen when we are travelling.</p> <p>This is why a travel medical kit is one of the most important things you will pack.</p> <p>From simple first aid measures to equipment that will help you in instances where something more serious is occurring, a well-stocked travel medical kit is the hallmark of every sensible traveller. Here are 10 items you must include in your travel medical kit.  </p> <p>We’ve also included some additional tips at the bottom of the article.</p> <p><strong>1. Adhesive dressings (Band-Aids)</strong> – When travelling we’re particularly susceptible to minor cuts. Adhesive dressings ensure these nicks and scrapes don’t get infected.</p> <p><strong>2. Antihistamine</strong> – These are essential, especially if you’re someone who suffers from allergies, as they allow you to control allergic reactions in foreign environments.</p> <p><strong>3. Bandages</strong> – Use bandages to create support structures for strained limbs, reduce swellings, hold dressings in place, and even as a makeshift sling.</p> <p><strong>4. Instant cold pack</strong> – These handy devices are especially useful when it comes time to deal with any swelling issues or untoward skin reactions encountered abroad.</p> <p><strong>5. Antibacterial gel</strong> – If you’re in a situation when you need a pair of clean hands, antibacterial gel makes it possible without the need of water access.</p> <p><strong>6. Oral rehydration salts</strong> – Dehydration can quickly turn into a big issues overseas, so having a few oral rehydration salts on hand can get you out of a serious bind. </p> <p><strong>7. Safety pins</strong> – The practicality of safety pins knows no bounds, especially if you find yourself in a situation where you need to keep bandages or slings in place.</p> <p><strong>8. Thermal blanket</strong> – In an emergency situation a thermal blanket can help control body temperature and ultimately avoid the likelihood of someone going into shock.</p> <p><strong>9. Thermometer</strong> – It’s also quite useful to have a thermometer at hand just in case. Go for a digital design that’s easier to read in an emergency situation.</p> <p><strong>10. Tweezers</strong> – If you ever need to remove splinters when you’re overseas or do running repairs to adhesive dressings, a pair of tweezers becomes quite useful.</p> <p><strong>Additional tips and pointers:</strong></p> <ul> <li>Keep you travel medical kit in a dry, cool storage location if possible.</li> <li>Make sure it’s in an easily accessible part of your suitcase or backpack, and make sure everyone you are travelling with knows where to find it.</li> <li>Before you head off, double check the contents of your kit ensuring any creams are up to date, bandages and dressings are properly sealed and all items are working properly.</li> </ul> <p><strong>Related links:</strong></p> <p><a href="http://www.oversixty.co.nz/travel/travel-tips/2016/03/teen-saves-flying-sheffield-to-essex-via-germany/"><span style="text-decoration: underline;"><em><strong>Teen saves money by flying from Sheffield to Essex via Germany</strong></em></span></a></p> <p><a href="http://www.oversixty.co.nz/travel/travel-tips/2016/05/controversial-idea-to-shorten-airport-queues/"><span style="text-decoration: underline;"><em><strong>Controversial idea to shorten airport queues</strong></em></span></a></p> <p><a href="http://www.oversixty.co.nz/travel/travel-tips/2016/05/5-ways-to-avoid-being-stuck-in-the-middle-seat/"><strong><em><span style="text-decoration: underline;">5 ways to avoid the middle seat on planes</span></em></strong></a></p>

Domestic Travel

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Cost of prescription meds to be slashed

<p>From the beginning of 2023, the price of prescription medications will be slashed in a new cost-of-living measure by the federal government.</p> <p>Australians' co-payment for scripts under the Pharmaceutical Benefits Scheme (PBS) will be capped at $30 as opposed to the current maximum co-payment of $42.50. </p> <p>That will save people who have multiple regular medications hundreds of dollars each year.</p> <p>The measure will also help prevent people having to decide between spending their money on medicines or other essentials.</p> <p>Measures won’t come into effect until January 1, with the Albanese government tabling the bill in parliament on Wednesday.</p> <p>Health Minister Mark Butler said almost a million Australians delayed or avoided filling prescriptions, citing recent research.</p> <p style="box-sizing: inherit; margin: 0px 0px 5px; padding: 0px; border: 0px; font-size: 16px; vertical-align: baseline; color: #323338; font-family: Roboto, Rubik, 'Noto Kufi Arabic', 'Noto Sans JP', sans-serif; background-color: #ffffff; outline: none !important;">“This change will put close to $200 million back in the pockets of Australians each year."</p> <p style="box-sizing: inherit; margin: 0px 0px 5px; padding: 0px; border: 0px; font-size: 16px; vertical-align: baseline; color: #323338; font-family: Roboto, Rubik, 'Noto Kufi Arabic', 'Noto Sans JP', sans-serif; background-color: #ffffff; outline: none !important;"><em>Image: Getty</em></p>

Money & Banking

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"Backbone of our unit": Tributes pour in for Aussie medic killed in Ukraine

<p dir="ltr">A young Aussie medic from Queensland has been killed by Russian artillery fire in the Ukraine, leaving his family mourning the tragic loss of their son.</p> <p dir="ltr">27-year-old Jed William Danahay, from the rural town of East Nanango was killed in Eastern Ukraine on August 24 – with his death confirmed by the Department of Foregin Affairs – while working as a combat medic, assisting frontline troops when they were injured.</p> <p dir="ltr">At the time, Danahay was driving the medical vehicle when he was targeted by Russian forces and subsequently caught in an artillery attack.</p> <p dir="ltr">The family of the victim, his two older brothers and parents, have described his incredible character and desire to help others.</p> <p dir="ltr">“Jed lived his life trying to help other people, in his short time on this earth Jed did more things than most of us will ever do in a lifetime,” the Danahay family said in a statement.</p> <p dir="ltr">They described his adventurous nature, which led him on many journeys around the world.</p> <p dir="ltr">“Jed died doing what he believed in, helping people who needed it. He was at his heart an optimist and always believed that things should be better.</p> <p dir="ltr">“Jed’s comrades in Ukraine described him as the backbone of their unit, a hero and someone who they could all trust their lives to.</p> <p dir="ltr">“He will be missed dearly by his friends and family.”</p> <p dir="ltr">The family concluded by saying if anyone wants to help, they encourage them to support the Ukrainian people.</p> <p dir="ltr"><em>Image: DFAT</em></p>

Caring

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New medical emergency hits Guy Sebastian trial

<p dir="ltr">Guy Sebastian’s trial against his former manager faces more delays after another medical emergency unfolded just days after the presiding judge suddenly passed away.</p> <p dir="ltr">One of the jurors was rushed to hospital after suffering a severe allergic reaction during the lunch break - prompting the new judge to question whether it is practical for the trial to continue, as reported by <em><a href="https://7news.com.au/entertainment/celebrity/guy-sebastians-ex-manager-trial-resumes-c-6811553" target="_blank" rel="noopener">7News</a></em>.</p> <p dir="ltr">Judge Timothy Gartelmann announced that he would be taking over the trial on Monday, and with several jurors handing him notes raising concerns about future commitments, he said he would deliberate overnight once he found out about the welfare of the ill juror.</p> <p dir="ltr">“I will then make a decision about whether or not it is practical for individual jurors and indeed the trial itself to continue,” he said.</p> <p dir="ltr">Sebastian’s former manager, Titus Emmanuel Day, has pleaded not guilty to 50 charges, including allegedly embezzling money owed to Sebastian through royalties and performance fees, as well as 50 alternative counts of larceny.</p> <p dir="ltr"><a href="https://www.oversixty.com.au/finance/legal/guy-sebastian-fronts-court" target="_blank" rel="noopener">Beginning his testimony</a> on Wednesday, May 4, the <em>Voice </em>judge testified that Day promised him 10 percent equity in his company 6 Degrees - which Day managed him through for nearly a decade - in recognition of his importance as a “foundation client” in the company’s success.</p> <p dir="ltr">Email exchanges tendered in court also showed that Day told Sebastian he would give him 10 percent ownership of Solar D, a sunscreen brand Day created.</p> <p dir="ltr">Sebastian said he then became an informal ambassador for the brand, conducting interviews and participating in a rowing event and photoshoot among other duties.</p> <p dir="ltr">He said he didn’t expect any payment for the work because the emails made it clear he was part-owner of the company.</p> <p dir="ltr">Sebastian said “there were requests for intros”, and when asked about Day’s character in relation to the company, he gave “him a wrap”.</p> <p dir="ltr">“He’s a good bloke, and I’m involved as well. There’s nothing to worry about,” he recalled saying.</p> <p dir="ltr">The trial is expected to continue under Judge Gartelmann on Tuesday.</p> <p dir="ltr">The funeral for Judge Peter Zahra, who presided over the trial until his sudden passing and was a highly respected and senior judge in the NSW District Court, will be held on Friday.</p> <p dir="ltr">In a statement, Judge Zahra’s family said he would be remembered as a “special soul”.</p> <p dir="ltr">“We have received many lovely messages and memories that demonstrate the type of person he was, he had a big heart and wanted to see everyone achieve more than what they ever thought possible,” the statement said.</p> <p dir="ltr">“In honour of our Dad and his life, we encourage everyone to have a hot chocolate and share a dad joke in his honour!”</p> <p><span id="docs-internal-guid-0cdb885f-7fff-00d9-e8aa-0b79dacde790"></span></p> <p dir="ltr"><em>Image: Guy Sebastian (Facebook)</em></p>

Legal

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The new migraine drug that can target pain before it starts

<p>The latest in migraine treatments has been launched in Australia. It is part of a new class of medication specifically designed to target the condition.</p> <p>The new drug is called Vyepti, it is a part of a group of drugs which block a molecule in the brain known as calcitonin gene-related peptide, which becomes elevated during an attack.</p> <p>The anti-CGRPs, as the group of medications are known, are the first medicines developed to specifically target migraine attacks.</p> <p>Vyepti works slightly differently from any anti-CGRPs already available. It comes in the form of an infusion every three months, rather than a monthly self-administered injection. It also works to prevent attacks, rather than treating them once they arrive.</p> <p>"Being an intravenous therapy, we do achieve bioavailability very quickly at the end of the 30-minute infusion and benefits can be seen as early as day one," according to neurologist and migraine specialist Dr Nicole Limburg.</p> <p>"It's been game-changing for patients, the benefits they've been able to achieve."</p> <p>One of those patients is mum Emma Treadgold, who has regular migraine attacks which leave her bed ridden for days.</p> <p>"Having migraines adds a bit of a spanner in the works, I'm lucky I have a fantastic supportive husband," she told 9News.</p> <p>"It really does affect every area of your personal and professional life."</p> <p>Vyepti has helped her attacks, but at the moment the medication comes with a large price tag, about $1800 every three months.</p> <p>There is currently a submission to subside the treatment on the PBS to make it more accessible.</p> <p>"What works for one person may not work for another, so it's really important to give people of all demographics access to different medications they can try," Ms Treaddgold said.</p> <p>Carl Cincinnato from Migraine and Headache Australia said as more migraine-specific drugs become available patients should speak to their doctor about their options.</p> <p>"We want our community to have access, fair access to affordable treatments," he said.</p> <p>"It's actually different now, we have treatments designed specifically for migraines so it's a good opportunity to speak to your doctor about it."</p> <p>Migraines are the most common brain disease in the world. Around 71% of sufferers are women and the condition costs the economy more than $3.5 billion a year.</p> <p>Patients are frequently prescribed medications originally developed for other conditions, such as anti-depressants, anti-epileptic drugs, blood pressure medications and even Botox.</p> <p><em>Image: Nine News</em></p>

Caring

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“We still have a problem”: One in five people in aged care treated with antipsychotics

<p dir="ltr">One in five aged care residents are being given antipsychotic medication - used to treat the symptoms of psychosis - that has been linked to chemical restraint by the aged care royal commission, according to new data.</p> <p dir="ltr">The data was mandatorily collected for the Department of Health from over 2400 aged care homes, revealing the industry’s heavy reliance on using antipsychotics on patients.</p> <p dir="ltr">Residents are also more likely to be given the drugs if they live in rural areas.</p> <p dir="ltr">Over half of those receiving the drugs don’t have a psychosis diagnosis, which is of particular concern as the royal commission found that “many of these medications were being used as chemical restraint”.</p> <p dir="ltr">“I have to say it was higher than I was expecting,” pharmacy researcher Dr Juanita Breen, who appeared as an expert witness at the royal commission, told the <em><a href="https://www.abc.net.au/news/2022-03-31/chemical-restraint-antipsychotic-drugs-widespread-in-aged-care/100950924" target="_blank" rel="noopener">ABC</a></em>.</p> <p dir="ltr">Dr Breen said this data suggested that much of the use of these drugs was inappropriate.</p> <p dir="ltr">“It means that these medications are being used for other reasons,” she said.</p> <p dir="ltr">“It would suggest that a large proportion would be used as chemical restraint … that we still have a problem.”</p> <p dir="ltr">An earlier study from 2019 made similar findings after tracking 5825 people in residential aged care facilities over the age of 65 for three years, between 2014 and 2017.</p> <p dir="ltr">The study also found that residents were being given the medication for significantly longer periods of time than was recommended, per the <a href="https://www1.racgp.org.au/newsgp/professional/antipsychotics-overused-in-residential-aged-care-s" target="_blank" rel="noopener">RACGP</a>.</p> <p dir="ltr">Despite recommendations not to extend use of the medication beyond 84 days, the study found that the mean use for men and women sat at 212 days and 216 days (or around 30 weeks) respectively.</p> <p dir="ltr">Other experts who testified at the royal commission also indicated that a decrease in medically-trained staff at aged care facilities, combined with an increase in patients with complex needs, had contributed to the overreliance on antipsychotics.</p> <p dir="ltr">Former aged care nurse Amanda Gorton, who left the industry in 2020, told the <em>ABC </em>that staff shortages had regularly left her feeling overwhelmed.</p> <p dir="ltr">The same year, the home she worked at failed an audit from the aged care watchdog, the Quality and Safety Commission, over its use of antipsychotics.</p> <p dir="ltr">Ms Gorton said she saw workers use the drugs to restrain residents because they didn’t have the capacity to care for them.</p> <p dir="ltr">“I went home often in tears because I thought it can’t stay like this,” she said.</p> <p dir="ltr">“It has to get better, it has to improve, we can’t be treating elderly people like this.”</p> <p dir="ltr">According to an analysis of hundreds of aged care audits from the commission, Human Rights Watch said they found that the inappropriate use of antipsychotics was taking place all over the country. </p> <p dir="ltr">“We found homes where more than 75 percent of residents were given these drugs and there was not adequate documentation of why they needed them or relevant diagnosis,” researcher Sophie McNeil said.</p> <p dir="ltr">“We found homes where residents were so drugged up that they experienced a significant increase in falls, which resulted in injuries.”</p> <p dir="ltr">Ms McNeill also said there was a clear link between workforce issues and using chemical restraint, after finding that staff also used antipsychotics to deal with residents asking for help or who were in pain.</p> <p dir="ltr">“There’s not enough staff to look after people. So instead, vulnerable, older Australians are given these drugs when they don’t need them,” she said.</p> <p dir="ltr">The data and analyses come after the Senate passed an aged care bill on its last sitting day aimed at addressing several recommendations from the royal commission.</p> <p dir="ltr">It included an amendment to ensure every facility has a registered nurse rostered 24 hours a day.</p> <p dir="ltr">“Putting people on drugs, restraining people, is the easy option for an aged care facility that doesn’t have the necessary staff to deal with these sorts of matters,” Senator Rex Patrick, who put forward the new amendment, said.</p> <p dir="ltr">Having gone through the Senate without a formal division (where senators vote by sitting on the left or right of the chamber), the bill will be sent back to the House of Representatives for a vote.</p> <p dir="ltr">However, Senator Patrick believes the government won’t want the amendment to be successful and will “park the bill and it will never be seen again”.</p> <p dir="ltr">“The government didn’t want the optics of voting against nurses 24/7 in aged care, so they simply let it go through on the voices knowing that, tactically, they can avoid dealing with it in the house today,” he said.</p> <p><span id="docs-internal-guid-9484f429-7fff-c159-d545-a8c3ec1c52cf"></span></p> <p dir="ltr"><em>Image: Getty Images</em></p>

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