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New Canadian guideline for treating high-risk drinking, alcohol use disorder – UBC Faculty of Medicine

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The first-ever Canadian guideline for treating high-risk drinking and alcohol use disorder (AUD) has been published by the BC Centre on Substance Use (BCCSU), a UBC Faculty of Medicine research centre housed within Providence Health Care and Providence Research.

Developed in partnership with the Canadian Research Initiative on Substance Misuse (CRISM), the guideline provides 15 evidence-based recommendations to reduce harms associated with high-risk drinking and to support people’s treatment and recovery from AUD.

Along with the new clinical guidelines, a website has been developed, called helpwithdrinking.ca, to raise awareness of resources and treatments available to Canadians. These resources do not make recommendations for reducing health risks associated with alcohol, but provide Canadians with information about what treatments are available for high-risk drinking and how they can be accessed.

Over half of Canadians over 15 drink more than recommended amount

High-risk drinking, AUD and alcohol-related harms are common in Canada. Nearly 18 per cent of people aged 15 years or older in Canada will meet the clinical criteria for an AUD in their lifetime, and over 50 per cent of people in Canada aged 15 years or older currently drink more than the amount recommended in Canada’s Guidance on Alcohol and Health.

Despite the high prevalence of high-risk drinking and AUD, these conditions frequently go unrecognized and untreated in the health care system. Even if recognized, AUD does not receive evidence-based interventions. It’s estimated that less than two per cent of eligible patients receive evidence-based alcohol treatment in the form of evidence-based pharmacotherapies, likely owing to low awareness. Conversely, according to the guideline, many Canadian patients receive medications that may be ineffective and potentially harmful.

Fifteen recommendations

To address this health issue, Health Canada funded CRISM and the BCCSU to develop the “Canadian Guideline for the Clinical Management of High-Risk Drinking and Alcohol Use Disorder.” The guideline provides recommendations for the clinical management of high-risk drinking and AUD to support primary health care providers to implement evidence-based screening and treatment interventions.

The guidelines were written by a 36-member committee co-chaired by Dr. Evan Wood, a professor in UBC’s department of medicine and Canada Research Chair in addiction medicine, and Dr. Jürgen Rehm, senior scientist at the Centre for Addiction and Mental Health (CAMH) and a professor in the Dalla Lana School of Public Health at the University of Toronto.

The guideline is based on the latest evidence, expert consensus, and lived and living experience, as well as clinical experience from across Canada. It makes 15 recommendations for care providers about how to ask about alcohol, diagnose AUD, manage alcohol withdrawal, and create treatment plans based on the individual’s goals. These treatment plans can include medications, counselling, harm reduction or a combination.

Complexities of providing treatment

related practice article highlights the complexity of providing treatment to patients with AUD and the possible negative effects of selective serotonin reuptake inhibitor (SSRI) therapy, which can worsen the disease in some people.

The guideline recommends against SSRI antidepressants in patients with AUD, or AUD and concurrent anxiety or depression.

“Despite the burden of illness, there remains a tremendous gap between what we know is effective treatment and the care Canadians are actually receiving,” says Dr. Evan Wood, co-chair of the guideline writing committee and an addiction medicine specialist at UBC. “Unfortunately, in the absence of effective care, people are being routinely prescribed potentially harmful medications that can, unknown to most prescribers, actually increase alcohol use in some patients. These guidelines seek to close that gap and ensure Canadians are accessing the safest and most effective treatments that meet their needs.”

This story is based on a news release issued by the Canadian Medical Association Journal

 

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

The Canadian Press. All rights reserved.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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Bizarre Sunlight Loophole Melts Belly Fat Fast!

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