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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7833575 | PMC |
| http://dx.doi.org/10.1016/j.chest.2020.05.548 | DOI Listing |
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Management of opioid use disorder: 2024 update to the national clinical practice guideline.
CMAJ
November 2024
Department of Psychology and Neuroscience (Yakovenko, Belliveau, Fraleigh, Stewart); Department of Psychiatry (Yakovenko, Stewart), Dalhousie University, Halifax, NS; Research Centre of Centre Hospitalier de l'Université de Montréal (Mukaneza, Germé), Montréal, Que.; Department of Medicine (Bach, Wood), University of British Columbia; British Columbia Centre on Substance Use (Bach, Wood), Vancouver, BC; Waypoint Centre for Mental Health Care (Poulin); Department of Psychiatry (Poulin), University of Manitoba, Winnipeg, Man.; Addictions Divisions (Selby), Centre for Addition and Mental Health; Dalla Lana School of Public Health (Selby, Rehm), University of Toronto, Toronto, Ont.; Department of Family Medicine and Emergency Medicine (Goyer, Bruneau), Université de Montréal; Centre de recherche et d'aide pour narcomanes (Goyer), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-del'Île-de Montréal, Montréal, Que.; Division of General Internal Medicine (Brothers), Department of Medicine, Dalhousie University, Halifax, NS; Addiction Medicine Consult Service, Mental Health & Addictions Program (Brothers), Nova Scotia Health; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (Rehm), Toronto, Ont.; Department of Psychology (Hodgins), University of Calgary; Department of Psychology (Hodgins), Alberta Gambling Research Institute, Calgary, Alta.; Drug addiction service (Bruneau), Centre Hospitalier de l'Université de Montréal, Montréal, Que.
Article Synopsis
- - The 2024 update of the 2018 National Guideline for Clinical Management of Opioid Use Disorder emphasizes the need for current scientific evidence to inform treatment practices for opioid use disorder in Canada.
- - A comprehensive review from 2017 to 2023 was conducted to revise the guidelines, involving a national committee including those with personal experience in opioid use disorder, and ensuring quality through established methods.
- - Key changes in the recommendations include recognizing methadone and buprenorphine as equally effective first-line treatments, introducing slow-release oral morphine as a second-line option, and highlighting that psychosocial interventions should be optional rather than mandatory.
"First, Do No Harm?": Metaphysical Harm and the Need for Iconic Perception.
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November 2024
"First, do no harm" has been cited so often as the fundamental principle of medical ethics that the entailed harm appears self-evident: intentional or unintentional physical harm. This article makes a case for a different kind of harm that physicians can commit against patients: metaphysically harming them by reducing them to mere objects to be fixed or manipulated, instead of persons to be known. Drawing on the history of medicine, theological reflection, and clinical practice, the author compares two ways of regarding the patient: (1) the medical dissective gaze, which knows the patient by mentally cutting her up and reducing her into parts; and (2) iconic perception, which encounters the patient as a living icon.
View Article and Find Full Text PDFReframing Dutch drug policies: a new era for harm reduction.
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, Amsterdam, The Netherlands.
In this article the authors offer their perspective on the changes in the Dutch harm reduction field. From the 1970s to the 1990s, the Netherlands emerged as a leader in harm reduction services, driven by grassroots movements like the Medisch-sociale Dienst Heroïne Gebruikers (MDHG) (Medisch-sociale Dienst Heroïne Gebruikers (MDHG) translates to Medical-Social Service Heroin Users in English) in Amsterdam and Junkiebond in Rotterdam. These organisations advocated for health-centred policies, initiated needle exchange programmes, and created safe consumption spaces.
View Article and Find Full Text PDFExercising medical judgement: resuscitation and "Decision-Making for End-of-Life Care," a new policy from the College of Physician and Surgeons of Ontario.
Can J Anaesth
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In March 2023, the College of Physicians and Surgeons of Ontario (CPSO) updated their policy entitled Decision-Making for End-of-Life Care. This policy will significantly change the landscape and clinical practice in Canada's most populous province with respect to decision-making for resuscitation. The update interrupts approximately eight years of CPSO policy that has mandated physicians to perform cardiopulmonary resuscitation (CPR) and other resuscitative measures unless they can explicitly obtain consent in the form of a do-not-resuscitate or no-CPR order.
View Article and Find Full Text PDFExploring the pathology of liver, kidney, muscle, and stomach of fledgling seabirds associated with plastic ingestion.
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Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, Tasmania, Australia.
There remain significant gaps in knowledge about 'sub-lethal' impacts of plastic ingestion, particularly chronic impacts on cells, tissues, or organs. Few studies have applied traditional animal health tools, such as histopathology, to assess physiological damage to wildlife, with fewer still providing information on the dosage or exposure to plastics needed to elicit negative effects. Our study seeks to investigate a common hypothesis in plastic pollution research; that an increasing plastics burden will have an impact on an animal's health, examining two wild species with high levels of environmental exposure to plastic through their diet.
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