Closer Look
When it comes to addiction, 'treatment' doesn't merit a mention from GOP candidates
There's no argument about whether there's a fentanyl crisis. But while Americans are dying of fentanyl overdoses in record numbers, there's disagreement over what to do about it. The Republican presidential candidates are talking tough:
- Florida Gov. Ron DeSantis has pledged to "use lethal force" by sending troops to attack cartel operations in Mexico.
- Former President Donald Trump has called for convicted drug dealers to be sentenced to death.
- Sen. Tim Scott of South Carolina pledged to finish constructing Trump's wall along the U.S.-Mexico border.
- Biotech entrepreneur Vivek Ramaswamy suggested a different tack: Decriminalizing nearly all drugs, including ayahuasca and ketamine.
But few of them mention addiction treatment. The GOP candidates are emphasizing drug interdiction as opposed to drug treatment, even though both Trump and DeSantis have previously backed evidence-based addiction treatment. STAT's Lev Facher explores.
reproductive health
Who chooses telehealth over in-clinic medication abortion services?
Two historic events with seismic impact on health care are intersecting: the pandemic-fueled growth of telehealth and post-Dobbs abortion limits. A research letter in JAMA Network Open asks how telehealth affected choices of medication abortion services from April 2020 through January 2021. Looking at more than 1,200 patients' records from a clinic in Washington state, the researchers found that just over two-thirds of patients received in-clinic appointments for medication abortion services, which the remaining patients got via telehealth.
Those who lived farther away and who'd had abortions before were more likely to choose telehealth. Other differences: Patients who were multiracial or of other race were more likely than white patients to choose telehealth. Black patients, younger people, and non-English speakers were more likely to be seen in the clinic. "As access to abortion care continues to be restricted in the U.S., innovative models of care delivery are needed," the authors write.
medicine
Opinion: Question lists have a place in health care
Did you know that patients who brought lists of questions to their doctor's visits were once considered hypochondriacs, perhaps more so if they were female? And a 1985 NEJM study had to marshal evidence to dispel the reputation that list-makers were more likely to have neuropsychiatric problems? Writing in a STAT First Opinion, Akila Muthukumar, Leigh Simmons, and Karen Sepucha of Massachusetts General Hospital tell us that not only are lists good in the short visits now the norm in health care, but health systems should also promote the practice.
Because some patients could use some help beforehand, a program at their hospital enlists medical student volunteers to come up with prompts to help brainstorm and then organize what's on a patient's mind. "The program offers a three-in-one benefit: improving patient preparedness, maximizing physician understanding, and encouraging student education." Read more.
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