Health
Stepping up: A B.C. doctor spreads the word about treating alcohol dependence with medication
|
|
Dr. Jeff Harries, seen here at his Penticton, B.C. home on Oct. 11, 2020, has found success treating alcohol-use disorder with medication.
Lucas Oleniuk/The Globe and Mail
Jeff Harries knew what most patients went through when they tried to quit drinking: the agony of physical and emotional withdrawal symptoms, including elevated heart rate, nausea, agitation and anxiety, and the revolving door of detox, rehab and relapse.
So when he read in The Lancet about a pill that could curb cravings and reduce drinking, he decided to offer it to one of his patients, who had struggled with severe alcohol-use disorder for nearly 30 years. The results stunned him.
“It was like this miracle,” says Dr. Harries, a family physician in Penticton, B.C. “He didn’t go to detox or counselling. He just slowly stopped drinking. And he didn’t drink for the rest of his life.”
Story continues below advertisement
The patient’s stark recovery prompted Dr. Harries to re-evaluate what he understood about the disorder.
For too long, he says, doctors, including himself, have tried to get their patients to quit or reduce their drinking by shaming, encouraging or berating them. Like many physicians, Dr. Harries was taught in medical school that controlling one’s drinking was a matter of willpower and required strength of character. But he recognized this approach was failing patients. And so the humble, plain-spoken doctor made it his mission to change how physicians view and treat alcohol-use disorder, a diagnosis that includes alcohol abuse and alcohol dependence.
Although there are several inexpensive, effective medications available to help manage patients’ drinking, including naltrexone, acamprosate and topiramate, many doctors across the country aren’t aware of them. So over the past three years, Dr. Harries has delivered more than 140 talks to his fellow physicians throughout B.C. and Alberta to raise awareness of them and encourage more compassionate care.
Dr. Harries is in a race against time to share his knowledge with his peers. In April, 2018, he was diagnosed with amyotrophic lateral sclerosis (also known as ALS or Lou Gehrig’s disease), which has a typical survival time of about two to five years after diagnosis. He is starting to lose his ability to speak and will not be able to continue offering his talks much longer, says his wife and mother of nine children, Leona Harries, who is also a general practitioner in Penticton.
Nevertheless, he marvels at the thousands of doctors, health workers and even judges whose minds he has changed through his talks so far. And he muses about his leading role in advocating for patients whom he believes deserve better.
“I still wonder why it’s me, why some schmuck from Penticton is doing this,” he says.
Alcohol is one of the most harmful and costly drugs in Canada, associated with an estimated 18,320 deaths in the country and $5.4-billion in health care costs in 2017, according to a report earlier this year from the Canadian Centre for Substance Use and Addiction. The most recent data from Statistics Canada in 2012 estimated as many as 18 per cent of Canadians, ages 15 and older, met the clinical criteria for alcohol-use disorder during their lifetime. Yet while the disorder is widespread and its adverse health consequences are well-known, the potential to treat it with medication is much less so.
“It’s actually a staggering failure,” says Evan Wood, an addiction-medicine clinician and clinical-research scientist at the British Columbia Centre on Substance Use (BCCSU).
While medications for other illnesses are often readily adopted into widespread use, such as statins for preventing heart attacks, this has not been the case for pharmacotherapy for alcohol-use disorder, Dr. Wood says. In Ontario, for example, a 2017 study in the Canadian Family Physician journal found less than 1 per cent of public drug-plan beneficiaries with alcohol-use disorder in the province were given first-line medications.
Part of the reason doctors don’t know to prescribe these medications may be because they’re generic, which means pharmaceutical companies have no incentive to push them, Dr. Harries says.
But more importantly, he says, changing the way doctors treat people with alcohol-use disorder requires a paradigm shift, untangling long-standing prejudices and stereotypes.
Even now, roughly 15 years since Health Canada approved naltrexone and acamprosate for the disorder, Dr. Harries says medical residents have told him they’ve been taught the “tried and true” way to manage patients’ drinking is to send them to detox and rehab – an approach bolstered by a large industry of private, for-profit rehab facilities, yet which does not work for many.
Medications don’t replace the need for counselling, and none of them work for everyone. But with about seven different drugs doctors can prescribe, patients can be offered a broader range of treatment options. If one drug doesn’t work, patients may find some success with another, Dr. Harries says. (He says patients can stop taking the drugs within a few months and may only need to use them briefly again if they relapse.)
By treating that early patient with topiramate back in 2003, Dr. Harries recognized what research supports – that alcohol-use disorder has nothing to do with one’s moral fibre but is caused by biological dysfunction of the brain. Beyond medications, some researchers are experimenting with neuromodulation treatments, such as deep brain stimulation, to try to quell cravings and reduce patients’ alcohol consumption by targeting dysfunctional circuitry of the brain.
When her husband began using medications to treat a patient with alcohol-use disorder, “it just wasn’t mainstream by any means,” says Leona Harries, with whom he shared a joint practice until the couple closed it after his ALS diagnosis. “This stuff just wasn’t being talked about, so he was kind of a lone soldier.”
The first year he decided to share his knowledge and experience beyond his own community, he gave 20 talks to about 200 family doctors, emergency physicians and other front-line health professionals as part of their continuing medical-education programs. Last year, he gave 80 talks to around 2,500 doctors. Though he received stipends for some speaking engagements, much of this was voluntary.
Recently, he also joined forces with the BCCSU, which has expanded his reach. Dr. Harries served on the committee behind BCCSU’s provincial guideline, published late last year, for the clinical management of high-risk drinking and alcohol-use disorder. It recommends the drugs naltrexone and acamprosate as first-line pharmacotherapy treatments for alcohol-use disorder and offers guidance to doctors on the evidence and risks of using them, as well as topiramate, gabapentin, disulfiram, baclofen and ondansetron.
This document is by no means the first, nor only, such guideline in the country. But B.C. is leading the way in implementing a new standard of care for patients, in large part because of Dr. Harries’s efforts.
“I don’t know why, but I seem to be able explain it in a manner that people can change their minds,” he says. “And then, once they start … looking at people suffering with this disorder in this new way, it just takes off.”
Source: – The Globe and Mail
|
|
NEWS RELEASE
SOUTHLAKE REGIONAL HEALTH CENTRE
**************************
This Cancer Awareness Month, Southlake is adding advanced technologies to detect and treat breast cancer and other women’s cancers thanks to generous community donor support, most recently through the HERE is Where Cancer Meets its Match campaign. New cancer care technology, including new mammography machines, the MyoSure System and the MOLLI 2® System will make a measurable impact in diagnosing and treating women’s cancers in the communities Southlake serves.
Southlake is installing three new mammography machines to expand its breast cancer screening program to 1,500 more women each year. Two of these machines have new biopsy capabilities that will reduce the number of cancelled exams due to equipment failure, ensuring timely care for women. Women ages 40 to 49 years old will be able to self-refer for publicly funded mammograms through the Ontario Breast Screening Program starting this fall.
“Early detection is critical when treating breast cancer and other women’s cancers,” said Lorrie Reynolds, Director, Regional Cancer Program at Southlake. “We treat more than 1,700 breast cancer patients at Southlake every year. By adding advanced technology, like the new mammography machines, we’re ensuring women have the best experience at Southlake.”
Southlake is also introducing the MyoSure System, an innovative technology that can help detect female reproductive cancers. Damaged tissue in a woman’s uterus such as fibroids and polyps can now be removed in a precise, minimally invasive procedure that leaves the rest of the uterus intact. This will improve the overall patient experience by supporting faster recovery, reducing the risk of infection and giving more women the option to have children. An estimated 200 women per year will benefit from the MyoSure System.
The new mammography machines and the MyoSure System build on Southlake’s recent investment in the MOLLI 2® System, a made-in-Canada wire-free breast localization technology. This technology is considerably less invasive and more accurate when compared to wire-guided localization, resulting in a better patient experience and improved cosmetic outcomes. More than 200 women each year will benefit from this innovative medical device as they are treated for breast cancer at Southlake.
“As a clinician caring for women with cancer in our community, I’m incredibly proud of the work Southlake is doing to advance women’s health and improve patient experiences,” said Sara Temple, MD, Surgical Oncologist and Chief of Surgery at Southlake. “Women who visit Southlake can be confident that they are receiving leading edge care, close to home when they need it most.”
The World Health Organization anticipates a 77 per cent increase in cancer diagnoses by 2050. Southlake serves some of the fastest growing communities in Canada and anticipates that the number of patients requiring cancer care will grow. By investing in new technology, Southlake is ensuring that women in the communities it serves have access to leading edge cancer care. All of these investments were funded with support from community donors who generously gave to Southlake to support investments into women’s health at the hospital.
“The generosity of our donor community and the impact they have made for women receiving cancer diagnosis and treatment at Southlake is something we can all take great pride in,” said Jennifer Ritter, President and CEO of Southlake Foundation. “From our Women’s Health Initiative donors supporting new mammography machines, to the Ladies in Philanthropy for Southlake funding the MOLLI 2 System, to our long-standing partners The Edge Benefits and Pheasant Run Golf Club enabling the introduction of MyoSure System through their joint annual charity golf tournament, we are incredibly lucky to share a vision of access to exceptional care for everyone who depends on Southlake when they need us most. Thank you, to every donor who contributed to these important upgrades to care for women.”
Southlake Foundation’s HERE is Where Cancer Meets its Match campaign supports the Stronach Regional Cancer Centre at Southlake. For more information or to make a donation, visit: southlake.ca/HERE.
|
|
The U.S. Food and Drug Administration says that samples of pasteurized milk have tested positive for remnants of the bird flu virus that has infected dairy cows.
The agency stressed that the material is inactivated and that the findings “do not represent actual virus that may be a risk to consumers.” Officials added that they’re continuing to study the issue.
“To date, we have seen nothing that would change our assessment that the commercial milk supply is safe,” the FDA said in a statement on Tuesday.
The announcement comes nearly a month after an avian influenza virus that has sickened millions of wild and commercial birds in recent years was detected in dairy cows in at least eight states. The Agriculture Department (USDA) says 33 herds have been affected to date.
FDA officials didn’t indicate how many samples they tested or where they were obtained. The agency has been evaluating milk during processing and from grocery stores, officials said. Results of additional tests are expected in “the next few days to weeks.”
WATCH | Bird flu spread in U.S. cows:
For the first time ever, avian influenza, or H5N1 bird flu, was detected in roughly a dozen dairy cow herds across the U.S. About That producer Lauren Bird explores why scientists and public health officials are concerned about the cross-species transmission and whether humans are now at higher risk.
The polymerase chain reaction (PCR) lab test the FDA used would have detected viral genetic material even after live virus was killed by pasteurization, or heat treatment, said Lee-Ann Jaykus, an emeritus food microbiologist and virologist at North Carolina State University
“There is no evidence to date that this is infectious virus, and the FDA is following up on that,” Jaykus said.
Officials with the FDA and the USDA had previously said milk from affected cattle did not enter the commercial supply. Milk from sick animals is supposed to be diverted and destroyed. Federal regulations require milk that enters interstate commerce to be pasteurized.
Tests for viable virus underway, agency says
Because the detection of the bird flu virus known as Type A H5N1 in dairy cattle is new and the situation is evolving, no studies on the effects of pasteurization on the virus have been completed, FDA officials said. But past research shows that pasteurization is “very likely” to inactivate heat-sensitive viruses like H5N1, the agency added.
The agency said it has been evaluating milk from affected animals, in the processing system and on the shelves. It said it is completing a large, representative national sample to understand the extent of the findings.
Matt Herrick, a spokesperson for the International Dairy Foods Association, said that time and temperature regulations for pasteurization ensure that the commercial U.S. milk supply is safe. Remnants of the virus “have zero impact on human health,” he wrote in an email.
Scientists confirmed the H5N1 virus in dairy cows in March after weeks of reports that cows in Texas were suffering from a mysterious malady. The cows were lethargic and saw a dramatic reduction in milk production. Although the H5N1 virus is lethal to commercial poultry, most infected cattle seem to recover within two weeks, experts said.
To date, two people in the U.S. have been infected with bird flu. A Texas dairy worker who was in close contact with an infected cow recently developed a mild eye infection and has recovered. In 2022, a prison inmate in a work program caught it while killing infected birds at a Colorado poultry farm. His only symptom was fatigue, and he recovered.
|
|
The U.S. Food and Drug Administration said Tuesday that samples of pasteurized milk had tested positive for remnants of the bird flu virus that has infected dairy cows.
The agency stressed that the material is inactivated and that the findings “do not represent actual virus that may be a risk to consumers.” Officials added that they’re continuing to study the issue.
Giant prehistoric salmon had tusk-like spikes used for defence, building nests: study
Just bought a used car? There’s a chance it’s stolen, as thieves exploit weakness in vehicle registrations
B.C. online harms bill on hold after deal with social media firms
Silver investment demand jumped 12% in 2019
12 Bizarre Things People Did Just To Make Social Media Content
Global Media Markets, 2015-2020, 2020-2025F, 2030F – TV and Radio Broadcasting, Film and Music, Information Services, Web Content, Search Portals And Social Media, Print Media, & Cable – GlobeNewswire
-
Health19 hours agoRemnants of bird flu virus found in pasteurized milk, FDA says
-
Health23 hours ago
Bird flu virus found in grocery milk as officials say supply still safe
-
News16 hours ago
Amid concerns over ‘collateral damage’ Trudeau, Freeland defend capital gains tax change
-
Art20 hours ago
Random: We’re In Awe of Metaphor: ReFantazio’s Box Art
-
Investment24 hours ago
Taxes should not wag the tail of the investment dog, but that’s what Trudeau wants
-
Art13 hours ago
The unmissable events taking place during London’s Digital Art Week
-
Media19 hours ago
Vaughn Palmer: B.C. premier gives social media giants another chance
-
Art24 hours ago
Penetang couple 'saddened' after complaint forces folk art removal – MidlandToday
