Oxycodone users beware: Be afraid. Be very afraid. That's the message a new campaign from the Newfoundland and Labrador Department of Health and Community Services is sending to abusers of prescription drugs, particularly oxycodone (OxyContin). Pharmacists in the province have voiced concerns that the ads and posters, aimed primarily at young people, are scaring patients into not taking their prescriptions. The Newfoundland and Labrador Medical Association, however, has received no negative feedback from physicians, says President Dr. Susan King. She has discussed the campaign (see the print advertisement below) with her patients who take oxycodone, and the result is the opposite of fear. “They chuckle. They know they're not in the category of people the poster is aimed at. They are not overusing or abusing.” — Donalee Moulton, Halifax
Figure. Photo by: Government of Newfoundland and Labrador
Helsinki revisited: After 2 years of debate over an amendment to the Helsinki Declaration (CMAJ 2003;169[1]:997), a World Medical Association (WMA) working group advises leaving it as is. The declaration, an internationally recognized code of ethics for biomedical research, was amended in 2000. One of its new stipulations, set out in paragraph 30, is that after a study is completed subjects should be provided with “access to the best proven prophylactic, diagnostic and therapeutic methods identified by the study.” Critics, including some researchers and the US government, said the amendment was impossible to implement, but the WMA announced Jan. 30 that the amendment should stay. The working group did, however, suggest 2 other options: to add a preamble to the declaration explaining that it is a set of guidelines, not laws or regulations, or to add a note of clarification reaffirming the intention of paragraph 30. Dr. Delon Human, WMA secretary general, said “The aim of this paragraph is to guarantee that research participants are not worse off after a study than they are during the study.” The working group report and comments from national medical associations and other interested parties (submit to www.wma.net) will be debated at the WMA's May meeting.
Alcohol-impaired drivers get off: Intoxicated drivers in BC who require hospitalization following a motor vehicle crash are seldom convicted of impaired driving, finds a new study in the March issue of the Canadian Journal of Emergency Medicine (www.caep.ca). Researchers, led by Dr. Roy Purssell at Vancouver Hospital, reviewed the BC trauma registry record between January 1992 and March 2000 to identify 1697 patients who underwent an ethanol test. Of these, 619 were over the Canadian Criminal Code blood alcohol limit of >17.3 mmol/L. Police listed ethanol as a contributing factor to the collision in 70.6% of these cases, yet only 11% of these people were convicted of impaired driving. A review of 12 international studies shows the median rate of convictions for such drivers is 15.5%. The authors “feel strongly that emergency physicians and nurses should collaborate in ongoing and future efforts to increase the conviction rate of impaired drivers.”
Dangerous workplace: Workplace safety appears to be deteriorating within Britain's National Health Service (NHS). A new report states that the number of reported incidents involving staff grew by 24.3% between 2000/1 and 2001/2, rising from 108 743 to 135 172. Injuries now cost the NHS £170 million annually. The report, A safer place to work: improving management of health and safety risks to staff in NHS trusts, cited one case in which an occupational therapy assistant received £600 000 in compensation after her leg was so badly injured in a fall that it had to be amputated. — Mary Helen Spooner, West Sussex, UK
One-stop SARS info: A peer-reviewed Web site (www.SARSwatch.ca) maintained by the Infection Control division of Toronto's Mount Sinai Hospital offers the latest on SARS and related health issues. Information from the World Health Organization, Health Canada, leading journals and other reputable sources is posted in an easy-to-access format and covers everything from the latest statistics to how to wash your hands properly. The content of the site is reviewed by an advisory board consisting of health care professionals in infectious disease, family medicine and public health. — Compiled by Barbara Sibbald, CMAJ