Opium and mortality

@HealthMed Opium is widely used internationally. A study from Iran just published in the British Medical Journal now reports almost doubling of mortality rates in regular users of opium.

Here are my comments to the Science Media Centre on this study:

"The key message in this prospective study on opiates is of interest to pharmacologists, health professionals and members of the public: use of recreational opium, whether raw or modified, smoked or swallowed, appears associated with increased risk of death from a wide range of diseases, including circulatory and respiratory disorders, and cancer.

"However the results need to be interpreted with caution. This work is from north-east Iran and may not be typical for other ethnically or genetically different individuals. The authors note that they cannot be sure whether the relationship is causative. And oddly, risks from opiates did not appear to be amplified in people with high blood pressure, smokers or diabetics, raising some questions about the accuracy of clinical data collection."

Although some commentators have linked findings of this study to use of medically prescribed or over the counter opiates, there are too many confounders for that to be a reasonable extrapolation from the BMJ study. Nonetheless the general principle remains that medicines should only be used when clinically indicated.

See more about the study and related comments on the New Zealand Science Media Centre site.

Favourite poems on a medical theme from entries in the 2012 Hippocrates initiative poll

@HealthMed To mark the launch of the 2012 International Hippocrates Prize for Poetry and Medicine, the organisers invited nominations of favourite poems with a medical theme. The top 5 favourites were:

Dylan Thomas – Do not go gentle into that good night
William Butler Yeats - When you are old
Dannie Abse - The Pathology of Colours
Jo Shapcott - Of mutability
Stevie Smith - Not waving but drowning

You can see examples of comments received and find links to many of the submitted favourite poems on the earlier blog on favourite poems on a medical theme.

'Medical' was to be interpreted in the broadest sense, with only one nomination to be made by any one person. Nominations were to be for poems written by a poet from anywhere in the world and in any language. The poem were to be contemporary or from any historical period.

The Hippocrates Prize of £5000 for the winning poem is one of the highest value awards in the world for an unpublished poem in English on a medical theme.

Entries for the 2012 Awards are now closed. 2012 Hippocrates Prize judges include New York poet and critic Marilyn Hacker and medical researcher Professor Rod Flower, Fellow of the Royal Society. Awards will be presented on Saturday 12th May 2012 at the 3rd International Symposium on Poetry and Medicine, to be held at the Wellcome Collection in London.

Favourite poems on a medical theme - 2012

To mark the launch of the 2012 International Hippocrates Prize for Poetry and Medicine, the organisers invited nominations of favourite poems with a medical theme.

'Medical' were to be interpreted in the broadest sense. Anyone in the world may nominate a poem. Nominations were to be for poems written by a poet from anywhere in the world and in any language. The poem could be contemporary or from any historical period.

When  a favourite poem on a medical theme was nominated, there was the option to add a comment about why you liked the poem and the poet.

Here are some examples of comments received:

On 'Patience Strong' by UA Fanthorpe: 'Here writes a poet about a poet, and about a lesson learnt from a gentleman living with epilepsy. Ursula Fanthorpe was a champion of the underdog, this poem is an epitome of both insight and humility and offers lessons to us all'.

On 'Hospital Waiting Room' by WH Davies: 'I love this poem. It was written in the early days of the NHS and is a fascinating look at class in British society from someone who put himself outside of it.'

On "The Pathology of Colours' by Dannie Abse: 'Abse is a master at combining the every day earthy detail with the mystical. He brings the world of medicine into the world of poetry in a way that speaks to all of us'.

On 'Seven Ages of Man' by William Shakespeare: 'A cameo of the whole of life from birth to frail, unknowing 'second childishness'.'

The online site for nominations of a favourite poem is now open.   

The top 10 entries will be included in an international Anthology on Poetry and Medicine to be published in 2012 by the Hippocrates Press.   

Submissions         

Dannie Abse - Song for Pythagoras and  The Pathology of Colours  
Joë Bousquet - La pupille (… the half-opening of the swallow’s nest …) La Connaissance du Soir, 1947, Gallimard
Simon Bridges - Tomorrows  

Constantine Petrou Cavafy - The death of the Emperor Tacitus

Blaise Cendrars - Le ventre de ma mère [My mother's womb]

WH Davies - Hospital Waiting Room

John Donne - No man is an island
   UA Fanthorpe - Patience Strong

Thom Gunn - In time of plague

Oliver Wendell Holmes - The morning visit
 

Jane Hirshfield - What binds us 

Ted Hughes - Examination at the Womb-Door

Victor Hugo -  Les feuilles d'Automne -  Ce siècle avait deux ans! [Autumn leaves - This century was 2 years old]

John Keats - Ode to a nightingale [... where palsy shakes a few, sad, last, gray hairs...]

Philip Larkin - Ambulances

Federico Garcia Lorca - El Lagarto Viejo (The Old Lizard) 

Stéphane Mallarmé: Le tombeau de Charles Baudelaire

Katherine Mansfield - A day in bed

Roger McGough - Wisdom Teeth Czeslaw Milosz - So little

John Milton – On his blindness
 and  Lycidas

Merrill Moore - The noise that time makes    

Thomas Nashe - A litany in time of plague      

Pablo Neruda - Oda ala tristeza (Ode to sadness)

 

Sylvia Plath - The companionable ills
 

Anna Piutti – Current
 

Peter Porter - A Chagall postcard


Peter Reading - C

Adrienne Rich – Power
 

William Shakespeare - Seven ages of man   [As you like it 2.3.139-167] 


Jo Shapcott - Hairless and  Of mutability

Stevie Smith - Not waving but drowning

Robert Louis Stevenson - The land of counterpane

Dylan Thomas – Do not go gentle into that good night  

Heather Wastie - Ping pong neonatal ICU    

William Carlos Williams - The last words of my English grandmother     

William Butler Yeats - When you are old  

The Hippocrates Prize is one of the highest value awards in the world for an unpublished poem in English on a medical theme. 

The 2012 Hippocrates Awards were judged by broadcaster Martha Kearney, US poet and critic Marilyn Hacker and medical researcher Professor Rod Flower, FRS. 

2012 Awards were presented by the judges at the close of the 3rd International Symposium on Poetry and Medicine on Saturday 12th May at the Wellcome Collection Rooms.

Anti-cholinergics, mortality and mental impairment

A report by a team of UK and US researchers in the Journal of the American Geriatric Society has suggested increased risk of mortality and mental impairment in older people from some medicines used in combination. The study relies on events from almost 20 years ago. How helpful is the study for current clinical practice? Hear Donald's interview by Annie Othen on BBC radio about the report.