Publisher Health

7 hours agoNia PriceBBC News

Jim Jones, the director of the Food and Drug Administration’s food division, resigned on Monday, citing what he called “indiscriminate” layoffs that would make it “fruitless for him to continue.”In his resignation letter, Mr. Jones estimated that 89 people of the 2,000 in his division were fired over the weekend, many of them freshly hired to do more in-depth work on chemical safety to protect the nation’s food supply.“I was looking forward to working to pursue the department’s agenda of improving the health of Americans by reducing diet-related chronic disease and risks from chemicals in food,” Mr. Jones wrote in the letter submitted to Sara Brenner, the acting commissioner of the F.D.A.But the Trump administration’s “disdain for the very people” who would do that work gave him no choice but to depart, he said.Mr. Jones also singled out Robert F. Kennedy Jr., the newly appointed secretary of the Department of Health and Human Services, for criticizing the F.D.A. as being too beholden to the industries it oversees and for vowing to to dismiss the agency’s nutrition staff.“The secretary’s comments impugning the integrity of the food staff, asserting they are corrupt based on falsities, is a disservice to everyone,” Mr. Jones wrote in the letter.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

A core group of so-called disease detectives, who track outbreaks, was apparently spared. But other young researchers are out of jobs.The notices came all weekend, landing in the inboxes of federal scientists, doctors and public health professionals: Your work is no longer needed.At the National Institutes of Health, the nation’s premier biomedical research agency, an estimated 1,200 employees — including promising young investigators slated for larger roles — have been dismissed.At the Centers for Disease Control and Prevention, two prestigious training programs were gutted: one that embeds recent public health graduates in local health departments and another to cultivate the next generation of Ph.D. laboratory scientists. But the agency’s Epidemic Intelligence Service — the “disease detectives” who track outbreaks around the world — has apparently been spared, perhaps because of an uproar among alumni after a majority of its members were told on Friday that they would be let go.President Trump’s plan to shrink the size of the federal work force dealt blows to thousands of civil servants in the past few days. But the cuts to the Department of Health and Human Services — coming on the heels of the coronavirus pandemic, the worst public health crisis in a century — have been especially jarring. Experts say the firings threaten to leave the country exposed to further shortages of health workers, putting Americans at risk if another crisis erupts.Public health officials, for instance, have been tracking a lethal strain of bird flu that they say remains a low risk to Americans. In recent weeks, however, it claimed its first victim in the United States — a patient in Louisiana who had been exposed to a backyard flock.“It’s not canceled,” Elon Musk, the billionaire in charge of the downsizing, wrote on social media in response to the blowback about the purported dismantling of the Epidemic Intelligence Service.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Oxygen is vital to many medical procedures. But a safe, affordable supply is severely lacking around the world, according to a new report.At the height of the Covid-19 pandemic, millions of people in poor nations died literally gasping for breath, even in hospitals. What they lacked was medical oxygen, which is in short supply in much of the world.On Monday, a panel of experts published a comprehensive report on the shortage. Each year, the report noted, more than 370 million people worldwide need oxygen as part of their medical care, but fewer than 1 in 3 receive it, jeopardizing the health and lives of those who do not. Access to safe and affordable medical oxygen is especially limited in low- and middle-income nations.“The need is very urgent,” said Dr. Hamish Graham, a pediatrician and a lead author of the report. “We know that there’s more epidemics coming, and there’ll be another pandemic, probably like Covid, within the next 15 to 20 years.”The report, published in The Lancet Global Health, comes just weeks after the Trump administration froze foreign aid programs, including some that could improve access to oxygen.Boosting the availability of medical oxygen would require an investment of about $6.8 billion, the report noted. “Within the current climate, that’s obviously going to become a bit more of a challenge,” said Carina King, an infectious disease epidemiologist at the Karolinska Institute and a lead author of the report.Still, she said, governments and funding organizations should prioritize medical oxygen because of its importance across health care. People of all ages may need oxygen for pneumonia and other respiratory conditions, for severe infections including malaria and sepsis, for surgeries and for chronic lung conditions.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

4 hours agoLola MayorBBC Wales News

When President Trump announced plans to impose tariffs on Mexico and Canada, one of his stated rationales was to force those countries to curb the flow of fentanyl into the United States. In fiscal year 2024, United States Customs and Border Protection seized nearly 22,000 pounds of pills, powders and other products containing fentanyl, down from 27,000 pounds in the previous fiscal year. More than 105,000 people died from overdoses, three-quarters of them from fentanyl and other opioids, in 2023. It doesn’t take much illicit fentanyl — said to be about 50 times as powerful as heroin and 100 times as powerful as morphine — to cause a fatal overdose.In my article for the magazine, I note that one of the many tragedies of the opioid epidemic is that a proven treatment for opioid addiction, a drug called buprenorphine, has been available in the United States for more than two decades yet has been drastically underprescribed. Tens of thousands of lives might have been saved if it had been more widely used earlier. In his actions and rhetoric, Trump seems to emphasize the reduction of supply as the answer to the fentanyl crisis. But Mexico’s president, Claudia Sheinbaum, has pointed to American demand as a driver of the problem. Indeed, if enough opioid users in the United States ended up receiving buprenorphine and other effective medication-based treatments, perhaps that demand for illicit opioids like fentanyl could be reduced.Comparing buprenorphine and abstinence-based treatments for opioid-use disorder.A wealth of evidence suggests that a medication-based approach using buprenorphine — itself a type of opioid — is much more effective at preventing overdose deaths than abstinence-based approaches. (Methadone, a slightly more powerful opioid, is also effective as treatment.) That greater success stems in part from the fact that by engaging the same receptors stimulated by fentanyl and other illicit opioids, buprenorphine (and methadone) can greatly blunt cravings and withdrawal symptoms. Several studies indicate that people exiting abstinence-based programs actually face a greater danger of overdosing than they did when chronically using illicit opioids. After abstaining for a long period, former users lose their tolerance to opioids; doses that were previously fine can become deadly. This is one reason many addiction experts think that a medication like buprenorphine is more effective as a treatment for opioid-use disorder than stopping cold turkey. It greatly reduces the cravings and misery that could provoke a relapse.Where buprenorphine has reduced deaths.Although the United States government partly funded buprenorphine’s development as a treatment for opioid addiction, France was one of the first countries to most fully exploit its potential. In the 1990s, French health authorities began allowing all doctors to prescribe buprenorphine. By the early 2000s, overdose deaths there from heroin and other opioids had declined by nearly 80 percent. Other European countries, like Switzerland, that have made medication to treat opioid-use disorder easily accessible also have much lower overdose death rates than those seen in the United States.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

10 hours agoPeter SaullPolitical editor, BBC East Midlands

10 hours agoHugh PymHealth editor

The middle-aged patient seemed to embody all the twists and contradictions of the opioid crisis. A white-collar professional with a history of addiction, he had become hooked on prescription painkillers again after a knee operation. When doctors would no longer prescribe the opioids, he returned to heroin. But recently he had developed an abscess at an injection site on his leg. Now he was in Highland Hospital, in Oakland, Calif., claiming to have been bitten by a spider.Listen to this article, read by Robert PetkoffAndrew Herring, a specialist in emergency medicine at the hospital, vividly remembers this man, the first person he would ever treat with the drug buprenorphine. The patient was hoping to receive a few opioid pills to help with his “spider bite.” But he had also caught wind of a trial program Herring was just then starting in the emergency department. He and his colleagues were interested in buprenorphine — itself an opioid — as a way to treat addiction to more powerful opioids like heroin. The patient wanted to try that instead of attempting to finagle pills. Struck by his forthrightness and honesty, and by his evident desire to escape the downward spiral of addiction, Herring sent him home with a prescription.This was in 2016. The previous year, doctors at the Yale School of Medicine published what would come to be seen as a seminal study in the field of addiction medicine. Their study subjects, primarily people who were using heroin or prescription opioids, had been divided into three groups. One received a referral to addiction-treatment services outside the hospital. Another group received a similar referral, along with a brief counseling session at the hospital. And a third group received both the referral and the counseling while also starting on buprenorphine, taken daily as a tablet. After a month, this last cohort was about twice as likely as the other two groups to remain in treatment. This one medicine doubled these patients’ likelihood of staying the course and greatly improved their odds of avoiding a fatal overdose.An unusual aspect of the study was its setting: the emergency room. Addiction treatment usually didn’t happen in the emergency department, a place generally seen as reserved for acute medical issues, not disorders like drug addiction that require long-term treatment. Yet Herring couldn’t stop thinking about the implications of the Yale research — about how many lives might be saved if E.R. doctors embraced this approach.And there was already evidence of buprenorphine’s effectiveness, at the population level, in combating overdose deaths. Although the United States government had partly funded buprenorphine’s development as a treatment for opioid addiction, France was one of the first countries to most fully exploit the drug’s potential. In the 1990s, French health authorities began allowing any doctor to prescribe buprenorphine. By the early 2000s, overdose deaths there from heroin and other opioids had declined by nearly 80 percent.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Soon, Irene Mekel will need to pick the day she dies.She’s not in any hurry: She quite likes her life, in a trim, airy house in Castricum, a Dutch village by the sea. She has flowers growing in her back garden, and there is a street market nearby where vendors greet villagers by name. But if her life is going to end the way she wants, she will have to pick a date, sooner than she might like.Listen to this article with reporter commentary“It’s a tragedy,” she said.Ms. Mekel, 82, has Alzheimer’s disease. It was diagnosed a year ago. She knows her cognitive function is slowly declining, and she knows what is coming. She spent years working as a nurse, and she cared for her sister, who had vascular dementia. For now, she is managing, with help from her three children and a big screen in the corner of the living room that they update remotely to remind her of the date and any appointments.In the not-so-distant future, it will no longer be safe for her to stay at home alone. She had a bad fall and broke her elbow in August. She does not feel she can live with her children, who are busy with careers and children of their own. She is determined that she will never move to a nursing home, which she considers an intolerable loss of dignity. As a Dutch citizen, she is entitled by law to request that a doctor help her end her life when she reaches a point of unbearable suffering. And so she has applied for a medically assisted death.In 2023, shortly before her diagnosis, Ms. Mekel joined a workshop organized by the Dutch Association for Voluntary End of Life. There, she learned how to draft an advance request document that would lay out her wishes, including the conditions under which she would request what is called euthanasia in the Netherlands. She decided it would be when she could not recognize her children and grandchildren, hold a conversation or live in her own home.But when Ms. Mekel’s family doctor read the advance directive, she said that while she supported euthanasia, she could not provide it. She will not do it for someone who has by definition lost the capacity to consent.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.