The latest Covid situation in England and a look at where NHS services are as we head into winter

The government has been locked in a dispute with pharmaceutical companies for a number of months over how much the NHS pays for new branded medicines. Sally Gainsbury and Huseyin Naci set out the issu...

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Symbicort Turbohaler 100/6, Inhalation powder - Summary of Product Characteristics (SmPC) by AstraZeneca UK Limited

Sophie, a patient with cystic fibrosis, tells us about her experience of trying to get hold of Creon and the challenges she has faced

Background Drug-related deaths have substantially increased over the past decade in the UK, particularly in Scotland. Co-use of opioids and benzodiazepines (prescribed and/or illicit) is contributing to rising mortality. This study identified motivations in people’s co-use with the aim of informing prescribing and harm reduction interventions to address drug-related deaths. Methods We interviewed 48 people who co-use opioids and benzodiazepines and/or z-drugs (zopiclone and zolpidem) in Glasgow (n = 28), Teesside (n = 10) and Bristol (n = 10). Most participants self-identified as male (n = 37, 77%), white (n = 45, 94%) and had a mean age of 43 years (range: 25–61 years). The majority reported at least one overdose experience, and poor mental health including trauma. Interviews were semi-structured, conducted by an academic and/or peer researcher, and analysed using reflexive thematic analysis. Results Participants’ motivations for co-using mapped onto two interlinked meta-themes: (1) Functional motivations included co-using to augment drug effects, self-medicate or help to generate income. (2) Experiential motivations described participants’ desires to achieve a ‘buzz’ (feeling energised), ‘glow’ (feeling comforted), ‘oblivion’ (escaping trauma and adversity), and ‘gouching’ (physical and mental sensations of ebbing in and out of glow and oblivion). Functional and experiential motivations were dynamic, interrelated and often co-occurred. Conclusions The importance of assessing motivations to co-use should be routinely recognised as part of harm reduction and medication assisted treatments to reduce mortality risk.

Women from Black African backgrounds almost six times less likely to receive hormone replacement therapy than white women, new department-led research finds

Ma et al. demonstrate that air pollution is associated with an increased risk of thoracic aortic aneurysm and dissection (TAAD), and that genetic susceptibility to TAAD amplifies this risk through multiplicative and additive interactions.

AbstractBackground and Aims. Anticholinergic burden has been linked to cardiovascular events and mortality, but its association with out-of-hospital cardia