On January 31, 2023, the government of British Columbia implemented a temporary, three-year drug decriminalization policy. Under the policy, adults (18 and older) could possess up to a combined 2.5 grams of specified illegal drugs—including opioids, cocaine, methamphetamine, and MDMA—for personal use without criminal charges, prosecution, or confiscation. The policy was intended to reduce the health and social harms of illicit substance use.A new study in CMAJ evaluated changes in drug-related hospitalizations and deaths alongside police interactions such as arrests during and after the period of decriminalization. Dr. Blair Bigham and Dr. Mojola Omole speak with coauthor Dr. Daniel Myran about the study, "<a href='https://www.cmaj.ca/content/198/31/E1212'>Impact of drug decriminalization and recriminalization on drug-related crime and health outcomes in British Columbia: a population-level time-series analysis</a>." He explains that the policy had no impact on hospitalizations and deaths but significantly reduced police interactions.The hosts then speak with Dr. Alexis Crabtree, coauthor of an accompanying commentary, "<a href='https://www.cmaj.ca/content/198/31/E1224'>What decriminalization in British Columbia could and could not achieve</a>." She explains that one goal was to reduce stigma and, in turn, increase interaction with substance use supports. Instead, she says, the policy may have increased stigma—though the reduction in police interactions alone may justify it.Together, the authors argue there is no silver bullet for reducing the harms of substance use. Any solution will need to be multipronged and long lasting.For more information from our sponsor, go to <a href='https://mdm.ca/what-we-offer?utm_source=MD&utm_medium=lifeplan+promo+redirect&utm_campaign=F26AO_TWP&utm_id=3335'>md.ca/lifeplan</a><a target="_blank" href="https://www.buzzsprout.com/1815691/fan_mail/new">Comments or questions? Text us.</a>Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. You can find Blair and Mojola on X  <a href='https://twitter.com/BlairBigham'>@BlairBigham</a> and <a href='https://twitter.com/Drmojolaomole'>@Drmojolaomole</a> X (in English):  <a href='https://twitter.com/cmaj'>@CMAJ </a> X (en français): <a href='https://twitter.com/JAMC_CMAJ'>@JAMC</a> <a href='https://www.facebook.com/CMAJ.JAMC'>Facebook</a> Instagram: <a href='https://www.instagram.com/cmaj.ca/'>@CMAJ.ca </a> The CMAJ Podcast is produced by <a href='http://www.podcraftproductions.com/'>PodCraft Productions</a>

On January 31, 2023, the government of British Columbia implemented a temporary, three-year drug decriminalization policy. Under the policy, adults (18 and older) could possess up to a combined 2.5 grams of specified illegal drugs—including opioids, cocaine, methamphetamine, and MDMA—for personal use without criminal charges, prosecution, or confiscation. The policy was intended to reduce the health and social harms of illicit substance use. A new study in CMAJ evaluated changes in drug-related hospitalizations and deaths alongside police interactions such as arrests during and after the period of decriminalization. Dr. Blair Bigham and Dr. Mojola Omole speak with coauthor Dr. Daniel Myran about the study, "Impact of drug decriminalization and recriminalization on drug-related crime and health outcomes in British Columbia: a population-level time-series analysis." He explains that the policy had no impact on hospitalizations and deaths but significantly reduced police interactions. The hosts then speak with Dr. Alexis Crabtree, coauthor of an accompanying commentary, "What decriminalization in British Columbia could and could not achieve." She explains that one goal was to reduce stigma and, in turn, increase interaction with substance use supports. Instead, she says, the policy may have increased stigma—though the reduction in police interactions alone may justify it. Together, the authors argue there is no silver bullet for reducing the harms of substance use. Any solution will need to be multipronged and long lasting. For more information from our sponsor, go to md.ca/lifeplan Comments or questions? Text us. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. You can find Blair and Mojola on X @BlairBigham and @Drmojolaomole X (in English): @CMAJ X (en français): @JAMC Facebook Instagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

On January 31, 2023, the government of British Columbia implemented a temporary, three-year drug decriminalization policy. Under the policy, adults (18 and older) could possess up to a combined 2.5 grams of specified illegal drugs—including opioids, cocaine, methamphetamine, and MDMA—for personal use without criminal charges, prosecution, or confiscation. The policy was intended to reduce the health and social harms of illicit substance use.A new study in CMAJ evaluated changes in drug-related hospitalizations and deaths alongside police interactions such as arrests during and after the period of decriminalization. Dr. Blair Bigham and Dr. Mojola Omole speak with coauthor Dr. Daniel Myran about the study, "<a href="https://www.cmaj.ca/content/198/31/E1212" rel="noopener noreferrer">Impact of drug decriminalization and recriminalization on drug-related crime and health outcomes in British Columbia: a population-level time-series analysis</a>." He explains that the policy had no impact on hospitalizations and deaths but significantly reduced police interactions.The hosts then speak with Dr. Alexis Crabtree, coauthor of an accompanying commentary, "<a href="https://www.cmaj.ca/content/198/31/E1224" rel="noopener noreferrer">What decriminalization in British Columbia could and could not achieve</a>." She explains that one goal was to reduce stigma and, in turn, increase interaction with substance use supports. Instead, she says, the policy may have increased stigma—though the reduction in police interactions alone may justify it.Together, the authors argue there is no silver bullet for reducing the harms of substance use. Any solution will need to be multipronged and long lasting.For more information from our sponsor, go to <a href="https://mdm.ca/what-we-offer?utm_source=MD&amp;utm_medium=lifeplan+promo+redirect&amp;utm_campaign=F26AO_TWP&amp;utm_id=3335" rel="noopener noreferrer">md.ca/lifeplan</a><a href="https://www.buzzsprout.com/1815691/fan_mail/new" rel="noopener noreferrer">Comments or questions? Text us.</a>Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. You can find Blair and Mojola on X&nbsp; <a href="https://twitter.com/BlairBigham" rel="noopener noreferrer">@BlairBigham</a> and <a href="https://twitter.com/Drmojolaomole" rel="noopener noreferrer">@Drmojolaomole</a> X (in English):&nbsp; <a href="https://twitter.com/cmaj" rel="noopener noreferrer">@CMAJ </a> X (en français): <a href="https://twitter.com/JAMC_CMAJ" rel="noopener noreferrer">@JAMC</a> <a href="https://www.facebook.com/CMAJ.JAMC" rel="noopener noreferrer">Facebook</a> Instagram: <a href="https://www.instagram.com/cmaj.ca/" rel="noopener noreferrer">@CMAJ.ca </a> The CMAJ Podcast is produced by <a href="http://www.podcraftproductions.com/" rel="noopener noreferrer">PodCraft Productions</a>

What drug decriminalization in British Columbia could and could not achieve

A contrast allergy note on the chart can trigger delays, unnecessary steroids and avoided scans, yet often these labels are not clinically justified. A new practice article in CMAJ, “<a href='https://www.cmaj.ca/content/198/23/E899'>Hypersensitivity reactions to iodinated contrast media</a>,” examines how the labels arise and why the standard premedication rests on contrast agents that are no longer used.Dr. Samira Jeimy, an associate professor and program director of the division of clinical immunology and allergy at Western University and an author of the article, separates adverse reactions into Type A, the dose-dependent flushing, nausea and vasovagal symptoms anyone can get, and Type B, the bizarre ones from anaphylaxis to delayed reactions such as Stevens-Johnson syndrome. She notes the weak literature behind corticosteroid premedication is based on older high-osmolality agents that modern imaging has left behind.Dr. Amit Katyan, a radiologist at the Ottawa Hospital and its lead for CT, has built a protocol that works back through the history for signs the reaction affected airway, breathing or circulation, or required epinephrine, an emergency visit or admission. For mild and moderate reactions his team skips steroids and switches to a contrast agent the patient has not had before, an approach he says the guidelines favour.For physicians, the first move is to reverse-engineer the label rather than act on it, since many notes describe an expected physiological reaction rather than a true allergy. A necessary contrast study should not be delayed for steroid premedication when the history points to a mild reaction and another  agent can be substituted.For more information from our sponsor, go to <a href='https://mdm.ca/what-we-offer?utm_source=MD&utm_medium=lifeplan+promo+redirect&utm_campaign=F26AO_TWP&utm_id=3335'>md.ca/lifeplan</a><a target="_blank" href="https://www.buzzsprout.com/1815691/fan_mail/new">Comments or questions? Text us.</a>Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. You can find Blair and Mojola on X  <a href='https://twitter.com/BlairBigham'>@BlairBigham</a> and <a href='https://twitter.com/Drmojolaomole'>@Drmojolaomole</a> X (in English):  <a href='https://twitter.com/cmaj'>@CMAJ </a> X (en français): <a href='https://twitter.com/JAMC_CMAJ'>@JAMC</a> <a href='https://www.facebook.com/CMAJ.JAMC'>Facebook</a> Instagram: <a href='https://www.instagram.com/cmaj.ca/'>@CMAJ.ca </a> The CMAJ Podcast is produced by <a href='http://www.podcraftproductions.com/'>PodCraft Productions</a>

A contrast allergy note on the chart can trigger delays, unnecessary steroids and avoided scans, yet often these labels are not clinically justified. A new practice article in CMAJ, “Hypersensitivity reactions to iodinated contrast media,” examines how the labels arise and why the standard premedication rests on contrast agents that are no longer used. Dr. Samira Jeimy, an associate professor and program director of the division of clinical immunology and allergy at Western University and an author of the article, separates adverse reactions into Type A, the dose-dependent flushing, nausea and vasovagal symptoms anyone can get, and Type B, the bizarre ones from anaphylaxis to delayed reactions such as Stevens-Johnson syndrome. She notes the weak literature behind corticosteroid premedication is based on older high-osmolality agents that modern imaging has left behind. Dr. Amit Katyan, a radiologist at the Ottawa Hospital and its lead for CT, has built a protocol that works back through the history for signs the reaction affected airway, breathing or circulation, or required epinephrine, an emergency visit or admission. For mild and moderate reactions his team skips steroids and switches to a contrast agent the patient has not had before, an approach he says the guidelines favour. For physicians, the first move is to reverse-engineer the label rather than act on it, since many notes describe an expected physiological reaction rather than a true allergy. A necessary contrast study should not be delayed for steroid premedication when the history points to a mild reaction and another agent can be substituted. For more information from our sponsor, go to md.ca/lifeplan Comments or questions? Text us. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. You can find Blair and Mojola on X @BlairBigham and @Drmojolaomole X (in English): @CMAJ X (en français): @JAMC Facebook Instagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

A contrast allergy note on the chart can trigger delays, unnecessary steroids and avoided scans, yet often these labels are not clinically justified. A new practice article in CMAJ, “<a href="https://www.cmaj.ca/content/198/23/E899" rel="noopener noreferrer">Hypersensitivity reactions to iodinated contrast media</a>,” examines how the labels arise and why the standard premedication rests on contrast agents that are no longer used.Dr. Samira Jeimy, an associate professor and program director of the division of clinical immunology and allergy at Western University and an author of the article, separates adverse reactions into Type A, the dose-dependent flushing, nausea and vasovagal symptoms anyone can get, and Type B, the bizarre ones from anaphylaxis to delayed reactions such as Stevens-Johnson syndrome. She notes the weak literature behind corticosteroid premedication is based on older high-osmolality agents that modern imaging has left behind.Dr. Amit Katyan, a radiologist at the Ottawa Hospital and its lead for CT, has built a protocol that works back through the history for signs the reaction affected airway, breathing or circulation, or required epinephrine, an emergency visit or admission. For mild and moderate reactions his team skips steroids and switches to a contrast agent the patient has not had before, an approach he says the guidelines favour.For physicians, the first move is to reverse-engineer the label rather than act on it, since many notes describe an expected physiological reaction rather than a true allergy. A necessary contrast study should not be delayed for steroid premedication when the history points to a mild reaction and another&nbsp; agent can be substituted.For more information from our sponsor, go to <a href="https://mdm.ca/what-we-offer?utm_source=MD&amp;utm_medium=lifeplan+promo+redirect&amp;utm_campaign=F26AO_TWP&amp;utm_id=3335" rel="noopener noreferrer">md.ca/lifeplan</a><a href="https://www.buzzsprout.com/1815691/fan_mail/new" rel="noopener noreferrer">Comments or questions? Text us.</a>Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. You can find Blair and Mojola on X&nbsp; <a href="https://twitter.com/BlairBigham" rel="noopener noreferrer">@BlairBigham</a> and <a href="https://twitter.com/Drmojolaomole" rel="noopener noreferrer">@Drmojolaomole</a> X (in English):&nbsp; <a href="https://twitter.com/cmaj" rel="noopener noreferrer">@CMAJ </a> X (en français): <a href="https://twitter.com/JAMC_CMAJ" rel="noopener noreferrer">@JAMC</a> <a href="https://www.facebook.com/CMAJ.JAMC" rel="noopener noreferrer">Facebook</a> Instagram: <a href="https://www.instagram.com/cmaj.ca/" rel="noopener noreferrer">@CMAJ.ca </a> The CMAJ Podcast is produced by <a href="http://www.podcraftproductions.com/" rel="noopener noreferrer">PodCraft Productions</a>

Rethinking the contrast allergy label

Highlights from the November 18th issue, presented by Dr. John Fletcher, editor-in-chief, and Dr. Kirsten Patrick, deputy editor for CMAJ. In this issue: vitamin D levels in non-dairy milk alternatives, research on Mediterranean diet and metabolic syndrome in the PREDIMED trial, C-CHANGE cardiovascular guidelines, nutrition in dementia, hallucinations case, physician-assisted dying viewpoints, and more. Full issue table of contents: http://www.cmaj.ca/content/186/17.toc

Mediterranean diet, taxing unhealthy food, non-cow's milks & vit D, physician-assisted dying & more

Highlights from the November 4th issue, presented by Dr. John Fletcher, editor-in-chief, and Dr. Ken Flegel, senior editor for CMAJ. In this issue: families of children who have complex chronic medical conditions, prostate guidelines, longevity of guidelines, patients in clinical trials, periodic health exam, end-of-life care, and more. Full issue table of contents: http://www.cmaj.ca/content/186/16.tocTo request a transcript of this podcast, contact cmajgroup@cmaj.ca<a target="_blank" href="https://www.buzzsprout.com/1815691/fan_mail/new">Comments or questions? Text us.</a>Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. You can find Blair and Mojola on X  <a href='https://twitter.com/BlairBigham'>@BlairBigham</a> and <a href='https://twitter.com/Drmojolaomole'>@Drmojolaomole</a> X (in English):  <a href='https://twitter.com/cmaj'>@CMAJ </a> X (en français): <a href='https://twitter.com/JAMC_CMAJ'>@JAMC</a> <a href='https://www.facebook.com/CMAJ.JAMC'>Facebook</a> Instagram: <a href='https://www.instagram.com/cmaj.ca/'>@CMAJ.ca </a> The CMAJ Podcast is produced by <a href='http://www.podcraftproductions.com/'>PodCraft Productions</a>

Highlights from the November 4th issue, presented by Dr. John Fletcher, editor-in-chief, and Dr. Ken Flegel, senior editor for CMAJ. In this issue: families of children who have complex chronic medical conditions, prostate guidelines, longevity of guidelines, patients in clinical trials, periodic health exam, end-of-life care, and more. Full issue table of contents: http://www.cmaj.ca/content/186/16.tocTo request a transcript of this podcast, contact cmajgroup@cmaj.caComments or questions? Text us. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. You can find Blair and Mojola on X @BlairBigham and @Drmojolaomole X (in English): @CMAJ X (en français): @JAMC Facebook Instagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Highlights from the November 4th issue, presented by Dr. John Fletcher, editor-in-chief, and Dr. Ken Flegel, senior editor for CMAJ. In this issue: families of children who have complex chronic medical conditions, prostate guidelines, longevity of guidelines, patients in clinical trials, periodic health exam, end-of-life care, and more. Full issue table of contents: http://www.cmaj.ca/content/186/16.tocTo request a transcript of this podcast, contact cmajgroup@cmaj.ca<a href="https://www.buzzsprout.com/1815691/fan_mail/new" rel="noopener noreferrer">Comments or questions? Text us.</a>Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. You can find Blair and Mojola on X&nbsp; <a href="https://twitter.com/BlairBigham" rel="noopener noreferrer">@BlairBigham</a> and <a href="https://twitter.com/Drmojolaomole" rel="noopener noreferrer">@Drmojolaomole</a> X (in English):&nbsp; <a href="https://twitter.com/cmaj" rel="noopener noreferrer">@CMAJ </a> X (en français): <a href="https://twitter.com/JAMC_CMAJ" rel="noopener noreferrer">@JAMC</a> <a href="https://www.facebook.com/CMAJ.JAMC" rel="noopener noreferrer">Facebook</a> Instagram: <a href="https://www.instagram.com/cmaj.ca/" rel="noopener noreferrer">@CMAJ.ca </a> The CMAJ Podcast is produced by <a href="http://www.podcraftproductions.com/" rel="noopener noreferrer">PodCraft Productions</a>

Fragile families, prostate guidelines, periodic health exam and more

Highlights from the November 4th issue, presented by Dr. John Fletcher, editor-in-chief, and Dr. Ken Flegel, senior editor for CMAJ. In this issue: families of children who have complex chronic medical conditions, prostate guidelines, longevity of guidelines, patients in clinical trials, periodic health exam, end-of-life care, and more. Full issue table of contents: http://www.cmaj.ca/content/186/16.toc

CMAJ Podcasts: Exploring the latest in Canadian medicine from coast to coast to coast with your hosts, Drs. Mojola Omole and Blair Bigham. CMAJ Podcasts delves into the scientific and social health advances on the cutting edge of Canadian health care. Episodes include real stories of patients, clinicians, and others who are impacted by our health care system.

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CMAJ Podcasts: Exploring the latest in Canadian medicine from coast to coast to coast with your hosts, Drs. Mojola Omole and Blair Bigham. CMAJ Podcasts delves into the scientific and social health advances on the cutting edge of Canadian health care. Episodes include real stories of patients, clinicians, and others who are impacted by our health care system.

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