Tag Archives: medical

Seeking medical abortions online is safe and effective, study finds

A study into women who seek abortion pills online in the face of strict laws against terminations has found that almost 95% safely ended their pregnancy without surgical intervention.

Experts say the study underscores the safety of medical abortion, and highlights that women who go on to experience symptoms of possible complications do follow advice to seek medical help at clinics or hospitals.

“This is abortion entirely outside the formal healthcare setting: it is an online telemedicine model, but this research shows that it can be both safe and highly effective,” said Abigail Aiken, assistant professor of public affairs at the University of Texas at Austin.

Worldwide about 43,000 women die each year as a result of not having access to safe and legal abortions.

Abortion in Ireland is currently legal only if a termination saves a woman’s life. In Northern Ireland abortion is also allowed if there is a permanent or serious risk to the woman’s mental or physical health.

However, the 1861 Offences Against the Person Act means that women can face life imprisonment for administering a drug to induce miscarriage, as the 1967 Abortion Act was not adopted in Northern Ireland.

Writing in the British Medical Journal, Aiken and an international team of researchers reveal how they probed the outcomes for women in Ireland and Northern Ireland who had sought the abortion drugs mifepristone and misoprostol through Women on Web – a digital community that provides medical consultations, abortion drugs and online support.

Of the 1,636 women who were sent the drugs between the start of 2010 and the end of 2012, the team were able to analyse self-reported data from 1,000 individuals who confirmed taking the pills. All were less than 10 weeks pregnant.

The results reveal that almost 95% of the women successfully ended their pregnancy without the need for surgical intervention. None of the women died, although seven women required a blood transfusion and 26 needed antibiotics.

Of the 93 women who experienced symptoms for which the advice was to seek medical attention, 95% did so, going to a hospital or clinic.

“When we talk about self-sought, self-induced abortion, people think about coat hangers or they think about tables in back alleys,” said Aiken. “But I think this research really shows that in 2017 self-sourced abortion is a network of people helping and supporting each other through what’s really a safe and effective process in the comfort of their own homes, and I think is a huge step forward in public health.”

But while Aiken said that previous research found that women in Ireland and Northern Ireland have welcomed being able to buy abortion pills online, she pointed out that the approach was far from the ideal solution for women wishing to end their pregnancy.

“I think that even though it is a positive thing for public health, it is not a positive thing for women’s lives because they still have to feel like criminals,” she said.

Aiken added that the study had limitations, not least that it relied – albeit through necessity – on self-reported information, and did not have data for more than 450 women who were sent the abortion medication but made no further contact with Women on Web.

Richy Thompson, director of public affairs and policy at the British Humanist Association, welcomed the study, but said covert online access to abortion pills wasn’t enough.

“That still doesn’t help women who have to access an abortion later on and so cannot use pills, and those women currently have to go to Britain in order to have an abortion and are charged up to £900 by the NHS,” he added. “Also, it does not remove from those women the risk of prosecution for having obtained abortion pills.”

Indeed, one ongoing case is that of a woman from Northern Ireland who was prosecuted for obtaining abortion pills for her daughter after a GP reported her to the police.

“Hopefully this research will only reinforce the need to end the legal injustice that women, while perhaps being able to access safe abortion pills in practice, nonetheless can face prosecution for doing so,” said Thompson.

Mara Clarke, founder of the Abortion Support Network, which helps women from Ireland, Northern Ireland and the Isle of Man travel to the UK for terminations, agreed. “More and more people contacting us are expressing fear of criminal prosecution,” she said, adding that women should beware of online scammers when searching for abortion pills.

While Clarke welcomed further evidence of the safety of the two drugs, she stressed that organisations such Women on Web and the Abortion Support Network are only a plaster on the problem facing women.

“Anything that helps women have terminations safely and encourages them to have terminations safely is ace in my book, but my end goal is for the abortion support network to be put out of business by law reform,” she said.

Should over-the-counter medical abortion be available? | Daniel Grossman

The coat hanger – often with a red line through it – is a powerful feminist symbol. Conjuring images of women suffering unspeakable consequences of unsafe abortion, the coat hanger sends a foreboding message about a past we must not return to. The implications are clear: abortions women give themselves when they cannot access legal services are dangerous.

While the coat hanger rhetoric has been useful for the abortion rights movement, it has become problematic in the 21st century. Coat hangers are no longer the method of choice for women who want to end a pregnancy on their own. In my research in Texas, women much more commonly report using medications or herbs when they try to self-induce an abortion. Some of these medications are very safe and effective, while the problem with herbs is that they are often ineffective.

This representation of self-abortion as always dangerous is also problematic, because women may in fact be able to safely have an abortion on their own without medical supervision. Focusing solely on the coat hanger imagery also overshadows any conversation about women’s agency and self-determination when it comes to their healthcare.

Not all women who attempt to end a pregnancy on their own do so because they have no other option. Some prefer self-care and turn to herbs and supplements to manage most of their health needs, and some women see self-induction as less invasive and more natural than a clinic-based abortion. Others are just looking for a simple solution to a problem that our society has stigmatized and made difficult to solve.

Medication abortion could change the way our society perceives self-induced abortion. This option for pregnancy termination is available in many US clinics at up to 10 weeks gestation and allows women to take medications at home, where their experience is very similar to a natural miscarriage.

The most effective regimen involves the use of mifepristone, also known as RU-486, followed by misoprostol. Taken together, these drugs are more than 95% effective at causing a complete abortion. Misoprostol can also be used alone, but the efficacy of this method is closer to 85%.

A new article I co-authored in the British Journal of Obstetrics and Gynaecology turns the notion of self-abortion even further on its head by asking a simple question: do the drugs used in medication abortion meet the criteria of the US Food and Drug Administration (FDA) for over-the-counter sale? The answer is a qualified yes, although more research is needed.

Of course, at the moment, the idea of over-the-counter access to medication abortion in the United States sounds crazy. Currently American women in most states – unlike women in many other countries – are unable to buy even birth control pills without a prescription.

But in the same way that women around the globe are getting contraceptives on their own, many are obtaining medication abortion over the counter at pharmacies. The limited data so far suggests women are doing this safely – and there is no question that use of these medications has contributed to a reduction in abortion-related mortality worldwide.

The FDA has standardized criteria to decide if a medication is appropriate for over-the-counter sale. For medication abortion, the most critical remaining step is determining whether women can assess on their own if the method is appropriate for them – in particular, whether they are less than 10 weeks pregnant. Studies have shown that women are quite accurate at dating their pregnancies if they know when their last menstrual period was. Of course, women could also get an ultrasound, which might be easier to obtain – and more likely to be covered by insurance if they have it – than a clinic-based abortion.

Beyond dating the pregnancy, women must only answer a few health-related questions to determine their eligibility. One or two blood tests may also be required, although their utility is debatable. The rest of the medication abortion process already takes place at home, and women are told to seek care if they have unusual symptoms, such as fever or heavy bleeding. Women can also assess on their own whether the abortion was complete.

While all of these preliminary data are encouraging, more research is needed to clearly document whether the FDA’s criteria are met. We also need to know how much demand there is for over-the-counter medication abortion. It may be that most US women would prefer to meet with a doctor or nurse practitioner before beginning the abortion process, and clearly clinic-based support must remain an option for women.

From a purely medical perspective, it no longer makes sense to demonize women’s safe use of abortion medications at home – just as the abortion rights movement should no longer rely on rhetoric around returning to the days of coat-hanger abortions.

It may be a long time before these drugs are on the shelf of your neighborhood pharmacy, but in the meantime, there are other ways to improve access to this technology and help women obtain abortion care earlier in pregnancy.

Research has already demonstrated the safety of nurse practitioners providing medication abortion, as well as the use of telemedicine to expand access to this option. While we wait for more data on over-the-counter medication abortion, the time has come to start loosening restrictions on this abortion method and to help give women the type of care they want.

NHS and medical watchdog tried to suppress scandal over vaginal mesh implants

NHS bosses and the watchdog that oversees medical devices tried to limit public exposure of the scandal over vaginal mesh implants that have harmed hundreds of women.

Minutes of a meeting held in October 2016 show that NHS England and the Medicines and Healthcare Products Regulatory Agency agreed to “avoid media attention” over the implants, despite the fact they were seeking to encourage patients to report any complications.

The document, obtained by the Press Association, records an agreement to “take the press element out” of the “yellow card” campaign to record adverse reactions experienced by vaginal mesh patients, suggesting that it could be folded into a wider effort, “of which mesh is one element, to avoid media attention on mesh”.

The apparent cooperation between NHS England and the MHRA to minimise media focus on the debilitating problems increasingly associated with the implants appears to breach the NHS’s duty – reiterated regularly by health secretary Jeremy Hunt – to be open and transparent over patient safety failings.

NHS England and the Department of Health both refused to comment on the minutes of the meeting.

One possible reason for the NHS to want to limit exposure of the issuecould be to reduce the number of potential lawsuits faced by the health service.

More than 800 women are suing the NHS and the manufacturers of vaginal mesh implants after suffering serious complications, it emerged this week. Some women reported that implants had cut into their vaginas, with one woman saying she was left in so much pain that she considered suicide. Others have been left unable to walk or have sex, according to the BBC.

Vaginal mesh implants are used to treat incontinence after childbirth or pelvic organ prolapse, where the womb or bladder bulge against the walls of the vagina. Between 2006 and 2016, more than 11,000 women in England were given the implants to treat prolapse or incontinence, NHS data shows.

Around 11%-12% of users have reported problems, while lawsuits in the US have already seen around $ 2bn (£1.5bn) paid to affected women.

Campaigners say that hundreds more women have come forward after learning of the group planning to sue.

Kath Sansom, who runs the campaigning website and Facebook group Sling the Mesh, says the number of women contacting her has risen from a few people a day to more than 200 in the past 24 hours.

“It’s always the same story,” she said. “There are so many women who were told it was just them, that they were a one-off. They can’t believe there are others out there. So many people are told it’s back pain, endometriosis, gall bladder pain, scar tissue. And so many of them accept it, you trust medical professionals.”

Data from the MHRA, which has been looking at the issue since 2011 following complaints from women, shows more than 1,000 adverse incidents have been reported in the past five years.

Despite the problems that have emerged the MHRA insists that the best current evidence supports the continued use of the implants to resolve health conditions that could themselves cause serious distress to patients.

A report into the issue from a working party led by NHS England admits there is a huge lack of data on complications from the devices. Published studies on mesh implants do “not tell the whole story” and there are gaps in NHS knowledge about their safety, it added.

Could shared medical appointments help the NHS and patients?

In medicine, the private one-to-one consultation is sacrosanct.

Yet shared medical appointments have been used successfully for years at the Cleveland Clinic in the US. Patients appreciate them. They compare experiences with other patients, learn from their questions, gain more advice than they might otherwise, and improve their understanding of their symptoms.

For the hospital, the gains are seen in improved outcomes, higher patient satisfaction, dramatically reduced waiting times and lower costs.

Here, then, is an innovation that could help the NHS, caught between rising demand and squeezed budgets, which is leading to longer waiting lists and growing discontent. By sharing appointments, more patients could be treated more quickly, reducing waiting times, saving costs, yet raising standards of care.

They have been tried by GPs in Edinburgh, Sheffield and Newcastle, following the lead of doctors in the US and Australia. As a surgeon, I can see the potential benefits in bringing together patients undergoing the same procedure for pre- and post-surgical care.

Shared appointments are not appropriate for all patients or all conditions. They should always be offered, never imposed, and patients would always retain the option of a one-to-one consultation, if that was what they preferred. There might, however, be trade offs. Patients might be offered a one-to-one consultation in four weeks or a shared appointment in 48 hours.

They can yield real benefits in the routine care of chronic illnesses such as asthma, diabetes and heart disease, where patients can learn from and motivate each other. We already know the secret of Weight Watchers’ success lies in creating peer pressure among group members who compete to see who can shed most pounds. Alcoholics Anonymous similarly allows people to share a problem and begin to tackle it together. There are websites such as PatientsLikeMe which connect people to others with similar conditions.

However, shared medical appointments work differently from self-help groups. Each patient is examined by the doctor, diagnosed and prescribed treatment in exactly the same way as they would be in a one-to-one consultation. The benefit for the patients comes from observing how the other patients are managed, or manage themselves. In one example, a patient with heart disease was persuaded to get on an exercise bike by hearing about a teenager with a heart condition who had a passion for basketball.

The doctors are spared having to repeat the same information a dozen times a day, saving time and costs. Whereas a heart patient might require a half-hour appointment for a routine follow-up visit, with a shared appointment six or seven patients could be seen in 90 minutes.

In certain cases, only part of the appointment might be shared. For example, in a typical shared appointment for female patients at the Cleveland Clinic, the doctor performs breast and pelvic examinations and discusses test results in private, while the remainder of the appointment includes the other patients.

Given these benefits, it is surprising that shared appointments have not been taken up more widely. In an article in the New England Journal of Medicine, Professor Kamalini Ramdas of London Business School and I suggest there are four principal reasons: the lack of rigorous scientific evidence of their value, the absence of easy ways to pilot them, missing incentives and lack of awareness among both patients and clinicians.

There is another reason. Innovations in healthcare typically take 17 years to spread, from proof of principle to widespread uptake. And this is an average – some take decades.

We need smart ideas – and disruptive innovators to implement them – if we are to improve the outlook for patients and for the NHS. Shared appointments is an idea worth pursuing.

Lord Darzi is a surgeon and director of the Institute of Global Health Innovation at Imperial College London. He was a Labour health minister from 2007–09.

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Medical couriers launch case challenging self-employed status

Couriers carrying emergency blood supplies to hospitals and samples to laboratories are to challenge their self-employed status in the first gig-economy test case to hit the healthcare sector.

The five cyclists, motorcyclists and van drivers, who all work for The Doctors Laboratory, a company which provides pathology services to the NHS, argue that they are employees and not independent contractors.

“I risked my life every day to get emergency blood to people, but the company won’t even recognise my basic employee rights without a fight,” one claimant, Ronnie De Andrade, said.

“I have been working for them for over five years and I don’t see my life progressing like this. I can’t get a mortgage, I have no pay when I go on holiday and I can’t get sick because I won’t get paid.”

TDL said it had not received formal notification of any employment tribunal claims brought by any of its couriers.

“We keep the working arrangements of our couriers under constant review to ensure that we comply with the latest standards and legal requirements,” a spokesperson said.

The couriers’ claim for employee status, which was filed on Tuesday at the London central employment tribunal, goes a step further than previous gig-economy cases – against taxi hailing app Uber and courier firm City Sprint – which both successfully argued drivers were officially “workers”.

Workers, who are employed under a contract in which they must always turn up for work even if they don’t want to, are entitled to employment rights including the national living wage, holiday pay and protection against discrimination, and may also miss out on other benefits including sick pay and maternity leave.

Employees have those additional rights guaranteed as well as protection against unfair dismissal, statutory redundancy pay and the right to request flexible working.

A self-employed person receives no entitlement to employment rights, beyond basic health and safety and anti-discrimination framework.

Jason Moyer-Lee, general secretary of the Independent Workers’ Union of Great Britain, said the TDL case was a “black and white example of bogus employment status”, as the couriers were required to work regular shifts dictated by the company, had to request time off and were not allowed to reject deliveries they were told to do. They are also not allowed to take outside employment while working for TDL.

The case has emerged as employment experts call on the government to tackle exploitation of the lower paid by abolishing different categories of worker after a string of scandals concerning the treatment of lower paid workers in the UK. The chancellor Philip Hammond is also expected to announce a consultation on the taxation of the self employed in Wednesday’s budget.

Speaking on Tuesday at the first hearing into the future world of work by the Commons business, energy and industrial strategy committee,

Hannah Reed, a senior policy officer at the Trades Union Congress, said: “There should be a floor of rights for all working people – a single worker definition.” Sue Tumblety, founder and managing director of the employment human resources consultancy HR Dept Ltd, added: “I would like the ‘worker’ category to go.”

Moyer-Lee said there was clarity between the different classes of worker but there needed to be better enforcement of the rules. He said: “I’m not in favour of eliminating worker status. I think there are are people who are in between an independent contractor and an employee.”

He added that getting rid of worker status might also make it harder for those currently classed as self-employed to win more rights from their employers – because the hurdle of proof was higher.

Britons ‘bumped off’ EU medical research grant applications, MPs told

British medical researchers are being removed from applications for EU research grants by European colleagues because of Brexit, MPs have been told.

Prof David Lomas, representing UK university hospitals, told MPs that Britain’s position at the forefront of medial advancement was threatened were it no longer able to access the European Research Council, one of the world’s leading funders of scientific research.

“One big issue for most of hospital academics is applying for grant applications, and we’ve seen people bumped off grant applications to the EU,” he told the health select committee.

Applications to the ERC are usually made by consortiums of researchers from a variety of EU countries. Britain has a strong track record of taking the lead in these groupings.

“Previously having a British member would help you in your application to get funding … Now you are less than an asset, so we have had academics removed from grant applications,” Lomas said.

He said it was vital for patients that Britain continued to be part of leading edge research and was pressing the government to argue the case for continuing to contribute to the ERC on a pay-as-you-go system.

“If we don’t get the very best people we don’t drive the research and innovation where we punch above our weight. If we can’t attract the very best, we can’t lead in the innovations that will lead to patient benefits.”

Lomas said his own university, University College London, where he is vice-provost of health, and the University of Cambridge were huge beneficiaries of the ERC, as was the UK.

“We raised €760m [£642m] between 2007 and 2013 from the ERC. My own university and Cambridge are neck and neck for bringing more in to any university [than any other] in the EU,” he told the committee.

Brexit was also affecting recruitment of high-calibre staff in medical schools, with teaching hospitals in Leeds and Glasgow reporting people pulling out of job offers, he continued. “So we have lost stellar people who would have come otherwise.”

Concern over the right to live and work in the UK after Brexit was already affecting recruitment across the board, said Danny Mortimer, chief executive of NHS Employers.

Giving evidence before the select committee, he said the controversial application process for permanent residency cards involving an 85-page application form had proved counterproductive, and was deterring valuable healthworkers from planning to stay in the UK after Brexit.

Both men were speaking just weeks after the Nursing and Midwifery Council reported a sharp decline in registrations from Europe.

Just 101 nurses and midwives from the EU27 registered to work in the UK in December, down from 1,300 in July, the committee heard. About 5% of nurses and 10% of doctors in the NHS are EU nationals.

Mortimer said EU staff were critical to the smooth running of the the health service. “We cannot believe that the NHS can do without our EU national colleagues,” he said.

One area that could be more heavily impacted than hospitals is social care, with EU nationals plugging the gaps, particularly in rural areas where it was difficult to recruit British staff, MPs heard.

“Some areas it has been very difficult to recruit, rural areas are very difficult to recruit people in social care, so EU [nationals] have come into this area,” said Martin Green, chief executive of Care England.

NHS at breaking point, according to British Medical Association

The NHS is at “breaking point” with a decline in the number of hospital beds leading to delays and cancelled operations, the British Medical Association (BMA) has warned.

Analysis by the BMA found the number of overnight beds in English hospitals fell by a fifth between 2006-07 and 2015-16. The report found that in the first week of January this year, almost three-quarters of trusts had a bed occupancy rate of 95% on at least one day.

According to the analysis, in 2000 there were an average of 3.8 beds per 1,000 people, but this had dropped to 2.4 beds by 2015. The report said that in November 2016 14.8% of patients spent more than four hours waiting for a hospital bed, having been seen in an A&E department.

“The data demonstrates the increasing pressures on the system. It provides evidence of the underlying cracks within the NHS, such as funding constraints, changes and increases in demand, disjointed care and workforce pressures,” the BMA report said.

It noted that pressures on mental health services were particularly acute, with a 44% decrease in the number of mental health beds since 2000-01.

The document was seized on by opposition politicians, with Labour saying it was a “wake-up call [that] Theresa May must not ignore” and the Liberal Democrats warning the situation was becoming “intolerable”.

The BMA’s chairman, Mark Porter, said: “The UK already has the second lowest number of hospital beds per head in Europe and these figures paint an even bleaker picture of an NHS that is at breaking point.

“High bed occupancy is a symptom of wider pressure and demand on an overstretched and underfunded system. It causes delays in admissions, operations being cancelled and patients being unfairly and sometimes repeatedly let down.

“The delays that vulnerable patients are facing, particularly those with mental health issues, have almost become the norm and this is unacceptable. Failures within the social care system are also having a considerable knock-on effect on an already stretched and underfunded NHS.

“When social care isn’t available, patients experience delays in moving from hospital to appropriate social care settings, which damages patient care and places a significant strain on the NHS.

“In the short term we need to see bed plans that are workable and focused on the quality of care and patient experiences, rather than financial targets. But in the long term we need politicians to take their heads out of the sand and provide a sustainable solution to the funding and capacity challenges that are overwhelming the health service.”

Jonathan Ashworth, shadow health secretary, said: “Thanks to Tory mishandling of our NHS, patient numbers in hospitals are now routinely above the levels recommended for safety. The shameful reality is this overcrowding puts patients at risk and blows apart ministers’ claims to be prioritising safety.

“The number of overnight hospital beds has decreased by over a fifth and combined with Tory neglect and underfunding this has left nine out of 10 hospitals dangerously overcrowded this winter.

“Almost all hospitals have been running over the safe 85% mark for bed occupancy while 60 hospital trusts are over 95% this winter. The response from ministers is to blame others and bury their heads in the sand.

“This government’s mismanagement is failing our NHS and failing patients. The prime minister must wake up to this crisis and ensure that the NHS and social care have the funding and support needed in the budget next month.”

Norman Lamb, the Lib Dem spokesman and former health minister, said: “Chronic bed shortages should be the exception not the rule. The situation is getting intolerable, with more cancelled operations, longer delays and those with mental health issues being systematically let down.

“Ultimately we could reduce the need for hospital beds by improving preventive care. But cutting both preventive services and beds leads to disaster. That is what we are now witnessing.”

An NHS Improvement spokeswoman said: “The NHS has been under real pressure this winter, as it copes with a surge in demand for emergency services the knock-on effects are felt throughout our hospitals.

“Our hospitals are extremely busy but we are working tirelessly alongside providers to help them manage and to support more efficient use of the number of beds available.”

The BMA’s report is published before the NHS Improvement’s figures for the third quarter of 2016-17, which are expected to show the parlous state of trusts’ finances.

NHS Improvement’s chief, Jim Mackey, has acknowledged trusts will miss the £580m deficit “control target” and forecasters have predicted the combined black hole in their finances could reach nearly £1bn by the end of the year.

The Department of Health disputed the BMA’s analysis, insisting figures from before 2010-11 could not be compared with those afterwards; the earlier figures included NHS-provided residential care beds and were compiled on an annual basis, while the more recent figures were published quarterly and only included beds under the care of consultants.

A spokesman said: “This analysis is inaccurate, the figures come from two different time periods when the way of counting beds was different, and so they aren’t comparable.

“Our hospitals are busier than ever but thanks to the hard work of staff, our performances are still amongst the best in the world. We have backed the NHS’s own plan for the future with an extra £10bn by 2020.”

Ireland to legalise cannabis for specific medical conditions

Ireland is set to legalise the use of cannabis for treating specific medical conditions, after a report commissioned by the government said the drug could be given to some patients with certain illnesses.

The Irish health minister, Simon Harris, said he would support the use of medical cannabis “where patients have not responded to other treatments and there is some evidence that cannabis may be effective”.

The report said cannabis could be given to patients with a range of illnesses including multiple sclerosis and severe epilepsy, and to offset the effects of chemotherapy.

“I believe this report marks a significant milestone in developing policy in this area,” Harris said. “This is something I am eager to progress but I am also obligated to proceed on the basis of the best clinical advice.”

Last November, Harris asked Ireland’s Health Products Regulatory Authority (HPRA) to examine the latest evidence on cannabis for medical use and how schemes to facilitate this operate in other countries.

The study found “an absence of scientific data demonstrating the effectiveness of cannabis products” and warned of “insufficient information on [the drug’s] safety during long-term use for the treatment of chronic medical conditions”.

“The scientific evidence supporting the effectiveness of cannabis across a large range of medical conditions is in general poor, and often conflicting,” it added.

However, it added that any decision on legalising use of cannabis was ultimately for society and the government to make.

Harris said he wanted to set up a “a compassionate access programme for cannabis-based treatments” and was now considering any changes in the law needed for its operation.

The new medical cannabis scheme will run for five years and will be constantly monitored by Irish health service experts.

The big policy shift came in the same week that the Fine Gael-led coalition in Dublin backed the idea of a “safe injection” room for heroin addicts in Ireland’s capital.

The Temple Bar Company, which represents bars, clubs, restaurants and other businesses in the cultural-entertainment quarter on the south bank of the Liffey in Dublin, expressed opposition to locating any of the injection centres in or close to the tourist district.

The Temple Bar chief executive, Martin Harte, said businesses in the tourist centre collected 1,500 syringes from the streets around the area every year.

“We are bracing ourselves for an increase in the level of syringe disposals and related antisocial behaviour,” he said.

“Addiction centres make no provision for what happens outside of opening hours … The Temple Bar Company is not opposed to tackling issues with drugs in Ireland, but we are opposed to proposals that exacerbate and fuel an injecting epidemic in Dublin city.”

Last year, Aodhán Ó Ríordáin, the former Irish Labour party junior health minister, became the first politician to call publically for a safe injection centre for the more than 20,000 registered heroin addicts in Dublin alone.

Ó Ríordáin also said he favoured making the possession of heroin, cocaine or other opiates for personal use no longer an arrestable offence.

Although he is no longer in government, after last year’s election, Ó Ríordáin’s suggestion of partial decriminalisation of drugs among users won the backing of rank-and-file police officers in Ireland, who said it would free up resources.

What Is Medical Identity Theft?

A recent study showed that the number of cases involved with medical identity theft have gone up more than 21% in the year prior to the release of the report. While identity theft in general has been on the rise for some time, these specific figures and their relation to the medical industry could be seen as shocking. What is medical identity fraud, and how does it differ from traditional identity theft? We’re going to take a look, along with how you can protect yourself.

What is medical identity theft?

The specifics of medical identity theft vary from case to case, but they obviously pertain in some way to your medical care, insurance or provisions. Examples of this specific type of fraud can include someone using your insurance for specialist care or to see a doctor, using your identity to obtain subscriptions for drugs they are not entitled, attempting to buy expensive medical equipment in your name or even make a false claim for compensation.

Medical identity theft is not just a financial problem, either. While someone using your identity for expensive goods could end up costly, it could also confuse your medical history. If someone visits a doctor pretending to be you, new information could be added to your medical history that obviously has nothing to do with you – this could be a problem when you really do visit the doctor as your files won’t be accurate and could lead to a misdiagnosis or mistake in care.

Medical identity theft is also unique because unlike some other types of similar fraud, you don’t need someone’s social security number to commit it. Because of the nature of some medical care, hospitals who are in a rush to provide treatment might not spot the fraud until much later.

How can you protect against it?

Everyone is entitled to a copy of their own medical billing records under HIPAA rules. It’s important to keep a copy and make sure you’re aware of how much you’re spending on average. Many people simply ignore such bulling data and are therefore unaware if there are any changes. This can be the first way to spot if you’re being overcharged or even defrauded.

Check your EOB (Explanation of Benefits) statement regularly to see if there have been any changes or if any provisions of care you haven’t received are listed. Be aware of your medical records and make sure you know if something is listed that has nothing to do with you.

Some medical providers might resist giving you your files, but you have a right to access them. More tips for preventing medical fraud can be found here.

As with all types of identity theft, there are some other simple measures you can take. Things like protecting passwords might not be as relevant here – but it’s still something you should be aware of. Some consumers choose to rely on identity theft protection services for an extra level of protection. Make sure you check all your mail regularly so you can spot any irregularities. You should also consider shredding your mail and other important documents as some fraudsters still rely on rummaging through trash.

While medical fraud is on the rise, if you know what you’re looking for – you should be more protected than most.



About the author

Peter Ellington has years of experience in the web security and fraud industry. He knows how important protecting your identity can be – that’s why he recommends identity theft protection.

What happens to your body when you use medical marijuana

Smoking marijuana, i.e. even the first puff, has an almost immediate effect on your brain, heart rate and sense of perception. Marijuana may have long-term effects on health as well, even though claimed otherwise by habitual users.

Marijuana, or cannabis, has an extensive history of traditional uses as a botanical medicine and an industrial material all throughout Europe, Asia, Africa, and America, and it has been used for at least 5,000 years.

What Is Medical Marijuana

Unlike “pot” (the recreationally used illegal drug), the term medical marijuana refers to the use of the whole, unprocessed marijuana plant along with its pure extracts, for the purpose of improving a symptom or treating a disease. For it to be effective, “it must be sourced from a medicinal-grade cannabis plant that has been meticulously grown without the use of toxic pesticides and fertilizers”.

Marijuana’s incredible healing properties can be attributed to its critical levels of medical terpenes and flavonoids as well as a very high cannabidiol (CBD) content. Even though marijuana has not yet been approved by the Food and Drug Administration (FDA) except in Colorado and Washington State, more and more physicians are prescribing it, swearing by its effectiveness and health benefits.

What are the Effects of Marijuana on the Body?

When marijuana smoke is inhaled into the lungs, the effect is immediate; marijuana is quickly released into the bloodstream, slowly reaching your brain and other organs. Smoking it is the most effective way for it to have a quick result; when drank or absorbed through food, it takes a little longer to take effect.

Here’s what happens to the body when marijuana is ingested:

Respiratory System

Marijuana smoke is made up of an assortment of toxic chemicals (including ammonia and hydrogen cyanide) which, much like tobacco smoke, may severely irritate your bronchial passages and lungs. Apart from wheezing, coughing and producing phlegm on a regular basis, you are looking at increased risk of bronchitis and lung infections. On top of that, marijuana has the potential to elevate your risk of developing lung cancer, as its smoke contains carcinogens. According to some studies, “marijuana may aggravate existing respiratory illnesses like asthma and cystic fibrosis”.

Circulatory System

Marijuana has a very serious effect on the circulatory system, as THC is carried throughout your body and it moves from your lungs straight into your bloodstream. Your heart rate may increase by 20 to 50 beats per minute within minutes, and this may continue for up to three hours. Still, marijuana can potentially stop the growth of blood vessels that feed cancerous tumors.

Bloodshot eyes are one of the telltale signs of recent marijuana use.

Central Nervous System

Once THC enters your circulatory system, it quickly enters your bloodstream and gets transported to your brain and the rest of your organs. The brain (under THC) releases large amounts of dopamine, which may not only make you feel good, but heighten your sensory perception, as well as your perception of time. THC changes the way information is processed in the hippocampus, leading to your judgment being impaired. New memories are rarely created when you’re high.

Your balance may also be upset due to the changes that take place in the cerebellum and basal ganglia, as can your coordination and reflex response. It is not uncommon for large doses of marijuana to cause hallucinations or delusions. In some people, marijuana can cause anxiety, while the symptoms of withdrawal are known to include insomnia, irritability and loss of appetite.

It is estimated that about nine percent of marijuana users develop an addiction, with young people whose brains are not fully developed facing a lasting impact on their thinking and memory skills.

Pregnant marijuana users will face additional issues, i.e. marijuana intake affects the brain development of your unborn baby. The child may be more prone to trouble with concentration, memory and problem-solving skills.

The pharmacologic effects of marijuana are thought to ease pain and inflammation. It may also be of use in controlling seizures and spasms.

Digestive System

Smoking marijuana often causes a burning in your mouth and throat. Taking THC orally is processed in your liver.

Using medical marijuana is recommended for people living with cancer or AIDS as it can help increase appetite. Also, marijuana can ease nausea and vomiting.

Immune System

Some research indicates that THC might damage the immune system, making you vulnerable to infections and illness. However, further research is needed.

What Diseases Can it Help Treat?

There’s still an ongoing research and debate on the effectiveness of medical marijuana. Those who swear by its effect claim that medical marijuana has an important role in many body processes, including immune functions, metabolic regulation, pain, cravings, anxiety and bone growth.

Common ailments being treated with medical marijuana include:

Degenerative neurological disorders such as dystonia

Mood disorders

Parkinson’s disease

Post-traumatic stress disorder (PTSD)

Multiple sclerosis


Sunburn (with cannabis oil)

Potential side effects of medical cannabis are also numerous, and should be taken very seriously.

To everyone who is looking to use medical marijuana for curing an illness, it is advised they first consult with their appointed MD; while marijuana may potentially help ease or cure symptoms of one illness, it may potentially be the cause of another. If you are ill, don’t take it without having someone around, in case of a side-effect occurring.