Drugs you need, and drugs you don’t need
Following the passing of its Access to Medicinal Cannabis Bill on 12 April, the Victorian Government has announced that “hundreds of kids with severe epilepsy will have access to medicinal cannabis as early as next year”.
It has released a $28.5 million package as part of its 2016-17 Budget to support the establishment of the Office of Medicinal Cannabis and an Independent Medical Advisory Committee, with priorities including ensuring “seriously ill kids can access this life-changing treatment as soon as possible.”
The Tasmanian Government has now also announced it will permit specialist doctors to prescribe medicinal cannabis for people with serious or chronic illnesses from 2017, according to ABC News.
But advocates said the plans do not go far enough, saying a tiered approach to growing and supplying the drug was needed to provide different levels of access to the drug.
Increasing government acceptance of the evidence for cannabis’ medical potential sits in in stark contrast to UN Drug Control Conventions, which Greg Chipp, CEO of Drug Policy Australia, described in an opinion piece in The Sydney Morning Herald as “out of step with the modern world.”
“The UN conventions classify cannabis as a narcotic of extremely limited therapeutic value, listing it on the most restricted Schedule IV alongside heroin,” he wrote.
As the UN met to convene a special session on the global drugs problem, he argued that a “drug-free world” — a target set in 1998, by a special session of the United Nations General Assembly — is an impossible dream.
Concerns remain, however, that cannabis can increase the risk of psychosis in vulnerable people. The Guardian published an article outlining why scientists in the UK, US, Europe and Australia believe a global public health campaign is necessary to warn people of the dangers of using the drug.
This comes as newly released data from the Australian Institute of Health and Welfare’s Alcohol and Other Drug Treatment Services National Minimum Data Set showed that more than 115,000 Australians received treatment from publicly-funded alcohol & drug treatment agencies in 2014–15, with cannabis being the second most commonly treated-for drug (24%), after alcohol (38%) and followed by amphetamines (20%).
Also this past fortnight, research coming from the latest issue of Public Health Research & Practice has highlighted the risks of e-cigarette vapour. A systematic review concluded that those passively exposed to the vapours of e-cigarette users are exposed to numerous pollutants “at levels above background and at concentrations that are associated with potential adverse health effects”.
But tensions over the use of e-cigarettes were highlighted when Medical news reported on a paper in the International Journal of Drug Policy in which University of Ottawa researchers reviewed major US health websites — and declared that many are misleading consumers by “omitting” information on the differential risks of products such as e-cigarettes versus traditional cigarettes.
“The public is dramatically misinformed about the relative risks of substitutable tobacco and nicotine products. The risk differentials are huge, but this is simply not known by a vast majority of those whose lives are at risk,” the authors wrote.
This longread published by Huffington Post explores questionable pharmaceutical marketing practices in the US, and is well worth your time: “Drugs you don’t need for disorders you don’t have.”
Indigenous innovation, damning data and tragedy
Included was a New Zealand study that aims to look at how and why cancer patients miss out on curative treatment because they also suffer other chronic conditions, such as diabetes; innovation that is occurring in Indigenous anti-smoking programs; and published video interviews with key speakers, presenters and participants.
Marie McInerney provided a final wrap up summarising key conference highlights, a selection of tweets, and some ideas for what might come next.
Also this fortnight, The Guardian reported on a landmark study that showed being Indigenous in a wealthy country like Australia, the US or Canada does not necessarily lead to better health outcomes compared to Indigenous people living in disadvantaged countries.
Many of the reasons why are highlighted in this powerful story by Dr Megan Williams about her friend Sandy, an Aboriginal man who has been in and out of prison many times. Published at Croakey as part of its #JusticeJustice series, it explores how punitive, disconnected systems contribute to recidivism.
International coverage has continued too of the devastating crisis in the remote Canadian region of Attawapiskat — as mentioned in last fortnight’s Health Wrap — with the news that more young people have attempted to take their lives.
Canadian Prime Minister Justin Trudeau spoke about how mental health issues in Indigenous communities might be addressed, saying:
“In indigenous communities where there has been the support and an ability to do language and cultural teaching to an extremely high level, suicide rates have plummeted… So much of it is about a sense of identity, of who they are, how they fit in.”
Closer to home, ABC News reported on worrying news from the Northern Territory, where rates of children in protective care is four times the national average — and rising.
A story in The Guardian also focused on the Northern Territory, saying its Government is yet to implement a single recommendation from a report into the effects of foetal alcohol spectrum disorder, 14 months after it was handed down.
There are also important questions about accountability of the National Disability Insurance Scheme (NDIS) for Aboriginal and Torres Strait Islander people, according to Dr John Gilroy, from the Centre for Disability Research and Policy at The University of Sydney, in this post at Croakey.
Environmental factors, behaviours and health
Changes to the way we collect information about people’s exposure to asbestos are needed if Australia is going to minimise the impact of the predicted “third wave” of asbestos exposure, according to this perspectives paper in Public Health Research & Practice.
Professors Bruce Armstrong and Tim Driscoll from the University of Sydney argue that while there is currently limited scientific evidence for how asbestos exposure will affect people who work or have worked in repairing, renovating or demolishing asbestos-containing buildings, it is likely that it will contribute to future asbestos-related disease.
The Guardian reported that a significant fall in the proportion of older people diagnosed with dementia in the UK over the past two decades is most likely due to men smoking less and living healthier lives. A team from three British universities concluded the number of new cases of dementia had fallen by a fifth over the past 20 years and was lower than had been predicted in the 1990s.
A new Australian study has shown that more than half of Australian infants have multiple risk factors for developing a mental illness by the time they are adults, The Guardian reported, with risk factors including bullying, neglect and divorce or separation.
Meanwhile, a major systematic review found loneliness raises the risk of stroke and heart disease, this article said.
Depression and social isolation have also been implicated in the complex aetiology of back pain; but despite growing evidence linking the condition to lifestyle factors, research reported on by SMH found a disproportionately high number of spinal fusions are being performed in private hospitals in response to the unrealistic expectations of patients.
Research, policy plans and success
Following Health Minister Sussan Ley’s announcement of the members making up the board of the Medical Research Future Fund, Warwick Anderson, previous CEO of the National Health and Medical Research Centre (NHMRC), wrote an important article for The Conversation arguing that rather than basing funding decisions on ‘priority’ individual conditions such as dementia or breast cancer, we need to need to consider the quality of research and its capacity to impact health outcomes.
In health policy news, Croakey published an update on the Government’s Health Care Homes initiative, with responses from health policy experts, and a piece from Ben Harris emphasising the need for consumer-centred outcomes for determining their success.
According to The Australian (paywalled), experts are saying the Government could knock 15% off the health budget by targeting waste in the health system, particularly by reforming the prostheses list and the Medicare Benefits Schedule to ensure prices for medical devices were fair and consistent across the public and private sectors.
This post at Croakey by Brett Holmes, General Secretary of the NSW Nurses and Midwives’ Association, says a comprehensive policy on tax avoidance would also go a long way in boosting the revenues needed to fund public health services. He argues that tax avoidance is not a “victimless crime” and that its impact on budgets makes it a health hazard.
An interesting post on Croakey from the University of Melbourne’s Professor Peter Brooks criticised what he describes as a ‘lack of transparency’ around medical fees, particularly those pertaining to specialist care.
Health bureaucrats are sure to be taking a close look at a new report from the National Health Performance Authority which shows the cost of public hospital treatment varies wildly across the country, with some public hospitals spending nearly twice as much as others to deliver the same procedure to similar patients, as reported by The Sydney Morning Herald.
The Age reported that the new data showed Victoria’s hospitals were the most efficient in Australia, and revealed the state was set to receive about $800 million out of the $2.9 billion recently promised by the Commonwealth for state hospitals between 2017-18 and 2019-20 — about $1.34 billion less than it had expected to receive under a health funding agreement with the former Labor government.
The Federal Government has announced a new national Child and Adult Public Dental Scheme, but Labor argued that it represented a $1 billion cut to healthcare, according to ABC News. Croakey published a summary of responses to the plan from key health groups, all of whom had several criticisms of the scheme.
A new policy requiring NSW childcare centres to collect proof of children’s vaccination status have been successful in prompting forgetful parents to fully vaccinate their children, new research suggests, according to this article by Australian Doctor (registration required).
Meanwhile, Victoria’s state budget handed down this week contains a funding boost to mental health – $356 million in new funding – with $27 million earmarked for new community-based suicide prevention, The Age reported.
Spread of disease
Details about Zika virus continued to emerge, with detailed maps published in the journal eLife and reported by BBC.com showing that two billion people live in parts of the world where the Zika virus can spread.
Also in the news was the less notorious norovirus, which despite accounting for approximately one fifth of all acute gastroenteritis illnesses has received comparatively less attention than other infectious pathogens, according to a study in PLOS One which revealed the virus may contribute to tens of billions of dollars of economic loss worldwide.
In Britain, The Guardian reported on a highly drug-resistant type of “super-gonorrhoea” which it says is spreading across the country, with senior medics warning it may become untreatable.
In Australia, a parliamentary inquiry into tick-borne Lyme disease has heard from patients, doctors, pathologists and advocates, with news emerging that five West Australians suffering from conditions similar to that of Lyme disease have taken their own lives in the past three years, ABC News reported.
And finally, an article from the Medical Journal of Australia warned about “the world’s most lethal infectious disease” — multi-drug resistant tuberculosis. The authors argue in a post for Croakey that Australia should be taking a lead role on tackling this emerging global issue.
“Australia has the expertise and capacity to work with countries in our region to lead the implementation of these initiatives and support global efforts towards halting the spread of drug-resistant TB. We must rise to the challenge.
Other Croakey reading you may have missed this fortnight:
- Would you like to support the IHMayDay Twitter festival? Here’s how…
- On Labor’s Climate Action Plan: expert analysis and reaction
- How Australia is failing our children – reports from Caring for Country Kids conference
- Death in offshore detention: predictable and preventable
- Turf wars and conflict across dentistry professions are a barrier to health reform: academic leader
- Lowitja Institute releases world-first study on Indigenous and tribal peoples worldwide
- The Cancer Lifestyle Check – a missed opportunity?
- Health groups lead call to end investment in coal, oil and gas
- Find out why Summer May Finlay made this short clip – and watch it!
- The anniversary of the Port Arthur massacre is also a reminder of wider traumas
Frances Gilham is Digital Communications Manager at the Sax Institute. Follow @SaxInstitute or Frances via @francesgilham on Twitter.