Tag Archives: drugs

Is This the Best Treatment for me Doctor? Statistics on a Postage Stamp by Dr Kathleen Thompson

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When we read about impressive new drugs, do we really understand what the percentages quoted mean?

You may need to make medicines-related choices—particularly for cancer, but other illnesses too. To make rational decisions you MUST understand the numbers your doctor quotes. He won’t deliberately mislead, but it is easy to misunderstand  statistical data.

So let me give you an inkling—not a maths lesson, just a few tips to help you ask the right questions.

Last week the BBC headlined: ‘Breast cancer: Taking hormone drugs for up to 15 years can reduce risk … cancer recurrence was cut by 34%’

Wow. Impressive. But let’s look closer: In that particular study, 95% of those who took the treatment for 15 years were cancer-free, compared to 91% who stopped at 10 years.

Hang on – 95% isn’t that different from 91%. How is that cutting risk by 34%?

Well (and this is important) improvement percentages quoted in newspapers, and by doctors and scientists, are often described in relation to the original risk.

In these patients, the original risk of cancer recurring was only 9%, so any improvement would appear large relative to 9%. If the original risk had been higher, the same benefit would have appeared less.

OK that’s the bottom line. But for the curious, another example:

Relative Risk Reduction (RRR) is a statistic often used to describe drug benefit. It is what it says—the reduction in risk (eg risk of death, or disease recurrence) relative to the original risk, ie the actual risk improvement divided by the original risk.

cancerriskreduction2

The Table shows an example. Patient A has a low risk of cancer returning (9%); Patient B’s cancer is more likely to recur (50%).

You can see from the Table that Patient A’s risk will only decrease by 4% with Treatment X, whereas Patient B’s will decrease by 15%.

Knowing this, Patient B should be more inclined to take treatment X than Patient A.

However, if Patient A’s doctor describes the benefit as RRR (see Table), then Patient A’s risk appears to decrease by a massive 44%. Consequently Patient A may have wildly inaccurate expectations for the treatment. The doctor isn’t tricking him, RRR is scientifically valid, but you need to know what it means.

This example highlights another point. Sometimes we only know that a treatment works in most people. However sometimes there is more information about how much it works in different patients eg Patient B would respond to Treatment X more than Patient A.

If available, you need specific information on the benefit for YOU. This could influence your decision, particularly for a treatment which has significant side-effects.

So, in summary: 

If your doctor uses percentages to explain a treatment benefit, ask:

1. Exactly what do the numbers mean?

2. By how many percentage points should you improve on treatment?

3. Is there more specific information for your particular situation? 

Don’t be frightened to ask your doctor for more information—he wants you to understand and may not realise when you don’t.

By Dr K Thompson, author of From Both Ends of the Stethoscope: Getting through breast cancer – by a doctor who knows

http://www.amazon.co.uk/dp/B01A7DM42Q http://www.amazon.com/dp/B01A7DM42Q

http://faitobooks.co,uk

Note: These articles express personal views. No warranty is made as to the accuracy or completeness of information given and you should always consult a doctor if you need medical advice

Further information:

http://www.bbc.co.uk/news/uk-36455719

http://www.nejm.org/doi/pdf/10.1056/NEJMoa1604700

http://scienceblog.cancerresearchuk.org/2013/03/15/absolute-versus-relative-risk-making-sense-of-media-stories/

http://www.breastcancer.org/risk/understand/abs_v_rel

http://www.nps.org.au/glossary/absolute-risk-reduction-arr

 

 

 

Do Medicines Cost Too Much? By Dr Kathleen Thompson

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The UK Cancer Drug Fund, which funds non-NHS cancer treatments, has removed twenty-five drugs off its list recently, to combat a £100 million (and rising) overspend. This highlights a recurring dilemma of modern healthcare.

Medical science is advancing with cosmic speed. Patients with desperate diseases have new hope. Genetic advances allow personalised medicine for enhanced individual benefit.

However, drug costs are becoming frighteningly high, and, as people live longer, health budgets rise further. To be cynical, it was cheaper when people simply didn’t survive.

In response, many governments have attempted to force medicine prices down. Politically a quick win. But what are the consequences?

Let’s examine the drug development process. 

picture2drugarticle180915

First a drug target is chosen – often a protein molecule (receptor) on the surface of some of our cells.

Thousands of chemicals are then screened. If they bind to this receptor, they could influence how that cell works, and hence affect disease activity.

Chemicals which do bind are further narrowed down to those with additional potential drug properties—those likely to be well-absorbed, lack toxicity, and remain in the body long enough to work.

A lead candidate is chosen, and then modified further, optimising its chances of success.

Next, as required by government regulations, it is tested in animals and in the test-tube, for potential safety, effectiveness, and suitable dose.

Finally, clinical trials can begin. Often in healthy volunteers first, then small numbers of patients and finally in many patients. Thousands of people are usually tested before a drug can be marketed, and the size and duration of clinical trials has increased, as regulatory requirements have increased1.

Consequently, the typical cost of a new drug development is US$350 million according to a recent study by Forbes2.

But it’s worse than that—the development path is littered with booby-traps and precipices. Fledgling drugs frequently fail, and the Tufts Centre study found that, even those medicines which make it as far as clinical trials, have only  approximately a 12% chance of eventually reaching the market3.

Thus, including the costs of failed developments, the actual cost for each successful drug is nearer US$2.6 billion3, and for many smaller companies, if the roulette wheel isn’t kind, the cost is failure and liquidation.

Pharmaceutical companies are not angels, nor are they demons. To survive, they must make enough profit from their marketed drugs to fund their development pipeline, in addition to returning some profit to shareholders. Long drug-development times, mean they may only have a few years of patent-protection left to achieve this. If governments force prices down, companies sometimes react by reducing development risk – choosing drugs more likely to succeed in preference to innovative but riskier developments for difficult diseases.

A typical drug development takes around ten years – so we won’t see this effect immediately, and when we do, it will be too late – it could take another ten years to correct.

So there’s the problem – health bills cannot continue rising exponentially, but forcing drug prices down has serious consequences too. What to do?

Further Information and References:

1. http://www.phrma.org/sites/default/files/pdf/rd_brochure_022307.pdf

2. http://www.forbes.com/sites/matthewherper/2013/08/11/how-the-staggering-cost-of-inventing-new-drugs-is-shaping-the-future-of-medicine/

3. http://csdd.tufts.edu/files/uploads/Tufts_CSDD_briefing_on_RD_cost_study_-_Nov_18,_2014..pdf

Note: These articles express personal views. No warranty is made as to the accuracy or completeness of information given and you should always consult a doctor if you need medical advice

 

 

H&M Dump Cara Delevingne

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H&M have announced that Cara, who worked with them on their 2011 Authentic Collection, will no longer be modeling for them. This follows pictures where a bag of what looked like white powder were dropped by the 20-year-old model outside her London flat in Belgravia. She laughed as she covered the bag with her foot.

H&M also denied that Cara was ever the face of H&M.

‘She is not a model with us and I think there was a misunderstanding that she was the face of H&M. We just used her for the show.’’ a spokeswoman told The Sun on Sunday

She also said that H&M had  ‘no particular reason’ to work with  Delevingne in the foreseeable future.

Club DKNY In Celebration of #DKNYARTWORKS

What do you think?

 

Debbie Harry Talks To Fabulous About Sex, Drugs, Dating & Cosmetic Surgery

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One of Frost’s Favourite music icons, Debbie Harry, has given a candid interview revealing her thoughts on sex, drugs and cosmetic surgery. 

In an interview and photoshoot for Fabulous magazine’s Age issue, published on Sunday June 2, Blondie front woman and living legend Debbie Harry opens up about sex over 60, the dating scene and cosmetic surgery.

Debbie, who sold 40 million records worldwide as part of the ’70s rock band and paved the way for the likes of Gwen Stefani and Lady Gaga, says she still has strong sexual desires and feels just as sexy at 67 as she did in her 20s: “Whether it’s just pure sex or having that physical contact, sex is very important. Most people need it.”

Debbie Harry

Miami-born Debbie also opens up about her past experiences with cosmetic surgery, calling it, “a part of showbiz, really. A few needles in the face? It’s not a major thing. What offends me and horrifies me more is bad surgery. When I see somebody that’s permanently changed everything about their face, it’s like: ‘Oh my God, were you so miserable about yourself before?’”

The blonde bombshell – who once battled drug addiction – reveals that she doesn’t regret her wilder days and admits she’s glad she had that time: “I certainly would encourage any young people who want to freak out to go right ahead.” Drug addiction can be battled and overcome with the help of rehabs so looking for drug rehabs near you is a good idea in such cases.

Debbie, who along with her band mates is set to go back on the road, also admits to having a bit of a soft spot for the 1D boys who recently covered her classic hit One Way or Another: “I thought it was fun! It was also fitting for the charity and achieving things ‘one way or another’, so it was all very positive.”

Fabulous magazine is available free in The Sun every Sunday.

Tweaking The Dream By Clea Myers | Book Review

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cleamyersMany people have landed in the city of dreams with high hopes of making it big, and in return Los Angeles has chewed them up and spit them out. There are over 100,000 actors in LA and not everyone gets to live their dream. This book by Clea Myers is a cautionary tale. One that should be read by every wannabe. Clea is from a good background, went to Brown University and landed a job with a top producer. Then everything went wrong and she became addicted to crystal meth.

First of all I will point out that Clea is a friend. She is a very lovely person and incredibly talented. She now lives in London and is a writer and casting associate. She even gave an amazing performance in my film Prose & Cons. As I read the book I found it hard not to only to picture this drug addicted young woman with the Clea I know, but I also found it hard to read about her suffering. It is quite a story, and a testament to how strong Clea is, and how far she has come. Clea is heartbreakingly honest and holds nothing back. Her nightmare descent is told in vivid glory. It is a story that was brave to tell and she should be commended for it.

The book is well written. Clea is obviously a writer of note. The tale of her descent into crystal meth addiction should be read by everyone from drug addicts to school children. It is the most anti-drug book I have ever read. In fact, the most anti-drug thing I have every come across. For this reason it should be widely read. If it stops just one person from becoming addicted to drugs then it will have served it’s purpose.

Tweaking The Dream is an excellent read. Even if, like me, you don’t know anything about drugs. The story is partly an epic struggle of survival and another side of Hollywood. An excellent book.

Tweaking the Dream: A Crystal Meth True Story

Whitney Houston Dies Aged 48.

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Whitney Houston has died at the tragically young age of 48. Her death has left the entertainment industry in shock.

 

Houston was found dead in her room in the Beverly Hilton yesterday. The Los Angeles police said paramedics had tried to resuscitate Houston but they were unable and she was pronounced dead at 3.55pm local time.

 

Houston, who was one of the biggest selling artists of the 80s and 90s, had battled drug addiction. Police also said that there was no “obvious signs” of any criminal intent.

 

Houston had been due to make an appearance at the Grammy Awards tonight, and had been at rehearsals, as she was to perform for her mentor Clive Davis.

 

Aretha Franklin said: “I just can’t talk about it now, It’s so stunning and unbelievable. I couldn’t believe what I was reading coming across the TV screen. My heart goes out to Cissy, her daughter Bobby Kris, her family and Bobby.”

 

Tributes have been flooding in for the singer. Mariah Cary said she was “heartbroken”

 

“Heartbroken and in tears over the shocking death of my friend, the incomparable Ms. Whitney Houston,” Carey wrote on Twitter.

 

“My heartfelt condolences to Whitney’s family and to all her millions of fans throughout the world.

 

“She will never be forgotten as one of the greatest voices to ever grace the earth.”

 

In a statement, Dolly Parton said: “Mine is only one of millions of hearts broken over the death of Whitney Houston.

 

“I will always be grateful and in awe of the wonderful performance she did on my song and I can truly say from the bottom of my heart, “Whitney, I will always love you. You will be missed.”

 

Houston also starred in hit movies including The Bodyguard. She won multiple Grammys and sold millions of records.

As well as her drug addiction her 15-year marriage to Bobby Brown came to an end in 2007.

 

Brown told a sell-out crowd in Mississippi: “First of all, I want to tell you that I love you all. Second, I would like to say, I love you Whitney. The hardest thing for me to do is to come on this stage.”

 

Staying Safe this Christmas and New Year – Top Tips!

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Staying Safe this Christmas and New Year – Top Tips

As a key Youth Leader when it comes to gangs and breaking the cycle of criminal behaviour one of the key things I get asked by people of all ages is ‘How do I avoid becoming a victim?’

It is really tough question isn’t it? I mean, if the headlines are to be believed you are almost twice as likely to become a victim as you were this time last year. Although we are living in tough times Christmas means that people are out and about doing Christmassy things; enjoying themselves, getting merry and having a host of parties and clubs to go to. In the midst of this hustle and bustle some are ever more desperate to steal, rob or take advantage.

I for one know someone who had their card cloned only a few weeks ago and the upheaval it can cause is immense. So these words of advice I am about to offer come not a moment too soon.

  1. Taxi Cabs – this is number one on my list as I am still in awe of how many people don’t know this despite the horror stories and despite the ad campaigns.  If you are going to be drinking pre-arrange how you will be getting back home. Black cabs can be hailed off the street but under NO CIRCUMSTANCES should anyone get into an unlicensed taxi/and or minicab off the street. It is illegal for minicabs to tout for business. Minicabs must be pre-booked. Listen if you get into an unlicensed cab then essentially it is just a stranger’s car and there is no telling what will happen so please – don’t do it!
  1. Drinking – do your best to drink less alcohol and drink more water during your night out. A top tip is to have one drink of water for every two glasses of alcohol. Do your best to stick to the same drink, try and not mix your drinks and always make sure you have your drink with you. Yes girls – take it with you if you are going for a pee. If you leave your drinks unattended then DO NOT drink it. This is one of the ways drug rape can happen. A long time ago I was a First Aider in clubs – spiking as it is called (when someone puts drugs in your drink) was a big issue for us back then – my friends who are still in that field have said on good authority that it is still a big issue now.
  1. Drugs – Lets get it straight – taking drugs is illegal. However if you do then do not buy drugs from someone you have just met. Most of the time drug dealers at clubs / bars are selling to the masses and are not selling you what you think you may be buying. They can easily combine it with chemicals that will be very harmful to you and your body, and you could have a very bad reaction to it. I suppose the final point I want to make is that if you do decide to take do the stupidest thing and take drugs then you should never be left on your own until everyone has recovered. There are reactions and delayed reactions and both could potentially be fatal.
  1. Being sensible – This is one of those tips that sound easy on the ear but can be difficult to put into practice. Firstly be sensible in your approach. If you are talking to a stranger for the first time then do not give him personal details about yourself like where you live. Do not make yourself vulnerable. Secondly never leave your valuables such as your purse or phone with them while you run to the loo or leave your bag or valuables on the table or at some distance from you. Your phone should be locked with a pin that only you know and you also should be sensible with your social network – that is, it and your personal details should be set to private. A new trend is for guys to butter up women with soft words etc but there are lots of instances where once the woman has gone they are gone except they have gone with cash, plastic and I-phone tablets.
  1. Confidence is crucial – Being confident and assertive can assist you from staying out of danger. This is reflected in your body language and demeanor. Keep your head up and use eye contact. Becoming drunk and very loud can sometimes draw the wrong people towards you. Essentially most predators know that the less aware and less able a person is, the more easy they are to take advantage of and the more likely they are not to defend themselves properly.
  1. Fight or flight – If a fight breaks out / and or other trouble then remove yourself very quickly from the venue and call the police for help. This is crucially a tip mainly for the guys out there but as it seems to be a paradox akin to finding the ‘god atom’ it is there for everyone. Here’s the problem – good friends, both male and female want to protect the ‘ones they love’ from ‘bad’ people. The problem is that ‘bad’ people can be everyone especially once a fair bit of alcohol has been drunk. You’ll be surprised at the amount of arguments and fisticuffs that can flare up over mere ‘looks’ ‘knocks’ on the dance floor and people being rude. Ask either party to just walk away and you’d have more luck trying to explain the euro crisis. Yet you have your mobile phone in your pocket so rather than choosing to join in on the rugby tackle why not just use it and get help. Trust me; you’ll thank me in the morning.
  1. Cold and hard can only be cash – Try not to carry large sums of money, credit cards and other valuables with you. I am going to say it again but DO NOT leave your bag unattended. Just bring what you need for the night. A top tip is to put some money safely on you away from the money you will be spending on your night out. So if unfortunately if you are a victim of crime and your money / cards are stolen you have some money to get home with.
  1. Keep your eye on the prize – When paying for anything by credit / debit card make sure the machine is brought to you and you see what is being done. If anyone ever takes your card away / and or behind a bar they may be cloning your card. A big tip is to keep all of the receipts from the night, perhaps in your purse and then the following day check back with the money that has been deducted. If you need to you can query with the bank if any amounts seem unjustified.
  1. Mobile phones – Do not talk on your mobile phone when you get off London Transport and think this is going to save you from being attacked, it just makes you more vulnerable as you cannot see and / or hear what’s going on around you. What’s more people can see what mobile phone you have and that could make you a target too.
  1. Keep in touch – Number ten is my greatest gem. Be with at least one person you trust and make contact with them when you get home, so they know you are in safe. If you out and meet members of the opposite sex and are having a good time, why not stay together until you are in a cab (a licensed one obviously) where you can cab share until you part company.
  1. Be aware – please be aware of the people around you. Not being aware has consequences. This is especially true at cash-points but even places like at the bar or till can be crucial for someone looking to glance at your pin or hear the code word for your tab. I have seen many offenders hear ‘Table 12’ shouted across a noisy bar and then casually saunter over and order drinks for themselves and their mates moments later claiming to be from the same table. Equally a friend of mine had her phone stolen when someone came round with a collection box for a ‘charity’ and took her phone from the table whilst she took out some money from her purse. Be aware
  1. Never blame yourself – my final tip is the same as last year. Just remember even Justin Bieber has been a victim of a crime at one point – probably. Some people just do bad things – it’s as simple as that. The main thing is that they are counting on your silence so they can do it again. So talk to someone you can trust and report it. Most importantly though never blame yourself.

So ends my tips on staying safe over Christmas and New Year – I am not aiming to make anyone nervous or afraid as there are bundles of fun to be had lets just keep it safe and sensible. If you have any questions, comments or even tips of your own please post them. Here’s to an exciting and prosperous New Year!

 

 

Drugs, Drink & Driving Set To Trigger Lethal Festival Cocktail

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Drug and drink driving, coupled with a lack of insurance were expected to cause a surge in the number of people arrested while attending the August Bank Holiday festivals last weekend.

With thousands of revellers hitting the roads for the hugely popular Creamfields, Reading and Leeds festivals, leading motoring solicitors were bracing themselves for a busy few days.

Matt Reynolds, a solicitor with Just Motor Law, said: “Festivals inevitably see a sharp rise in the use of illegal drugs and alcohol and we would expect to see a number of motoring arrests in relation to these.

“However, another growing area of concern is the amount of people being tempted to drive without insurance because they cannot afford the ever-increasing premiums.

“We would urge all people attending festivals being held this Bank Holiday Weekend to think through the consequences of being stopped for drink or drug driving or lack of insurance.”

Young men aged between 17 and 29 are believed to be the most likely to drive while on illegal drugs. Cannabis is known to distort a driver’s perception of time and distance, cocaine causes aggressive and risky driving, amphetamines such as speed impair coordination, while Ecstasy causes blurred vision and poor judgement. Looking for a drug rehab near me can help with overcoming the issue.

Police currently have no equivalent to an alcohol breathalyser to test for drugs and instead use a Field Impairment Test (FIT). Tests can include standing on one leg, touching your nose with the tip of your finger and closing your eyes and estimating when 30 seconds have elapsed.

Reynolds added: “People who are arrested on suspicion of any motoring offences while attending music festivals need to ensure they get the right support immediately. They have a right to be represented at a police station and, should it be required, to be defended in a court of law.”

Just Motor Law – www.justmotorlaw.co.uk – provides specialist legal advice on all motoring offences with a 24-hour hotline and online live chat facility. The company also specialises in providing clients with technical defences, challenging equipment used by police officers and highlighting any failure to conform with rules of evidence.