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ROC Weekly News Bites
Relationship Between Anti-Inflammatory Drugs and Pain, Drug Possession Decriminalization in BC, US Opioid Deaths Expected to Peak
Here is a recap of some of the top industry-related news stories of the week:
New Side Effects of Popular Medicines Discovered: Anti-Inflammatory Drugs Could Cause Chronic Pain
Whenever you have a headache, your back hurts, your arthritis flares up, or you have a fever, odds are you take some anti-inflammatory medicine. NSAIDs, or nonsteroidal anti-inflammatory drugs, are the most prevalent form of anti-inflammatory medication. According to the American Gastroenterological Association, nearly 30 million Americans take them every day to ease pain or discomfort.
According to McGill University and colleagues in Italy, using anti-inflammatory drugs and steroids to treat pain may increase the risk of developing chronic pain. Their findings question traditional pain-relief methods. Normal recovery from a severe injury involves inflammation, and medicines that prevent that inflammation may result in more difficult-to-treat pain.
“In analyzing the genes of people suffering from lower back pain, we observed active changes in genes over time in people whose pain went away. Changes in the blood cells and their activity seemed to be the most important factor, especially in cells called neutrophils,” says Luda Diatchenko a Professor in the Faculty of Medicine, Faculty of Dentistry, and Canada Excellence Research Chair in Human Pain Genetics.
“Neutrophils dominate the early stages of inflammation and set the stage for the repair of tissue damage. Inflammation occurs for a reason, and it looks like it’s dangerous to interfere with it,” says Professor Mogil, who is also a member of the Alan Edwards Centre for Research on Pain along with Professor Diatchenko.
Blocking neutrophils in mice increased pain duration by up to tenfold. Anti-inflammatory medicines and steroids such as dexamethasone and diclofenac had the same effect, despite being helpful against pain early on.
British Columbia Will Decriminalize Drug Possession
British Columbia has become the first jurisdiction in Canada to receive the federal green light to decriminalize drug possession. On May 31, the province announced that Health Canada has granted it an exemption allowing it to decriminalize the possession of up to 2.5 grams of drugs including opioids, methamphetamine, cocaine and MDMA. The exemption will come into effect on January 31, 2023, and will initially run until January 31, 2026.
Health Canada, together with the governments of BC and Vancouver—the province’s largest city—expressed enthusiasm about the move and its potential to stem overdose deaths. A group of people who use drugs in Vancouver also welcomed the development—although they raised some concerns about the threshold of permitted amounts and police involvement. Potential implications for exemption requests by other Canadian jurisdictions are currently unclear.
“The shocking number of lives lost to the overdose crisis requires bold actions and significant policy change. I have thoroughly reviewed and carefully considered both the public health and public safety impacts of this request,” Carolyn Bennett, federal minister of mental health and addictions and associate minister of health, said in a press release. “Eliminating criminal penalties for those carrying small amounts of illicit drugs for personal use will reduce stigma and harm and provide another tool for British Columbia to end the overdose crisis.”
BC has consistently reported the highest fatal overdose rates of any Canadian province. While decriminalization does not directly address the adulterated supply of unregulated drugs, proponents have long argued that removing the fear of arrest facilitates access to harm reduction resources, in addition to reducing criminalization.
Under this framework, the drugs remain illegal, but people aged 18 and over who have up to 2.5 grams of the indicated drugs in their possession will not be arrested or charged, nor will they have their drugs seized by police. “Instead, police will offer information on available health and social supports and will help with referrals when requested,” according to the Health Canada press release. Some models that offer treatment instead of arrest are far more coercive, so it’s significant that such referrals will—at least in theory—be optional.
Mega-Model Predicts US Opioid Deaths Will Soon Peak
The US opioid crisis might soon peak and then start to abate, a new model suggests — but it also projects that overdoses will kill more than half a million people from 2020 to 2032 due to the prevalence of the deadly synthetic opioid fentanyl.
To quantify how policy decisions have affected national patterns of opioid use and overdose, Mohammad Jalali, a systems scientist at Harvard University in Cambridge, Massachusetts, and his colleagues collected federal data on use and deaths across the United States between 1999 and 2020. They built a model that incorporated aspects of the opioid crisis that have changed over the past 20 years — factors such as the price of heroin, the number of opioid prescriptions, the prevalence of fentanyl and the distribution of naloxone.
The researchers also determined which policy interventions were likely to have the greatest impact. Restricting prescriptions, for instance, would have very little effect, as most deaths are now caused by illicit fentanyl. But distributing naloxone or increasing the availability of addiction treatment would push the projections towards the more optimistic scenario.
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