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Opioid addicts are overdosing on common diarrhoea drug

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A popular anti-diarrhoeal drug is fast becoming another dangerous byproduct of the opioid crisis, as more addicts take huge quantities of it to ease withdrawal symptoms or get dangerously high.

Investigators found that the number of patients who were reported to the US National Poison Data System after taking toxic doses of loperamide (one over-the-counter brand is Imodium) skyrocketed by more than 90% between 2010 and 2016.

Why the jump? The primary appeal of loperamide is that while it has an opioid-like effect on bowel movements and doesn’t produce a high in recommended doses, it can make someone high in huge quantities.

On top of that, it’s both cheap and accessible for addicts looking for ways to self-medicate the withdrawal symptoms that typically kick in when they try to stop taking powerful opioids.

“Loperamide is a safe, targeted and effective treatment for diarrhoea and has been used since the 1970s, and is on the ‘World Health Organization List of Essential Medicines’ for [diarrhoea],” explained study author Dr Diane Calello. She is the executive and medical director of Rutgers University’s New Jersey Poison Control Center (NJPCC).

At recommended dosages, which the US Food and Drug Administration pegs at 8 milligrams (mg) per day, loperamide does not produce euphoria or sedation, she said.

But “a ‘high’ can result when the drug crosses the blood-brain barrier at high doses, as seen in this study,” noted Calello. She and her colleagues found that majority of loperamide abuse cases involve extremely high doses, in the range of between 50 and 100 2mg pills.

Easily available

Emily Einstein is deputy chief of the science policy branch at the US National Institute on Drug Abuse. She stressed that “the appeal of loperamide is likely due to its easy availability, not due to the quality of the high. It appears that many of those who misuse loperamide are not seeking a high at all, but are rather doing so to self-treat opioid withdrawal.

“It is not surprising that people with opioid addiction seek out and share methods of staving off opioid withdrawal, especially in the context of the current opioid crisis,” Einstein explained.

“While effective medications exist for the treatment of opioid addiction – namely buprenorphine, methadone and extended-release naltrexone and the opioid withdrawal drug [lofexidine], they are seriously underused,” she said.

Instead, the Rutgers study showed that since 2010 there has been a steady annual rise in the number of loperamide abuse cases being reported to a national overdose registry. The average age was 27, most were white, and more than half were male.

At the national level, there were 916 overdoses in 2015, resulting in two deaths. And that, said Einstein, suggests the loperamide threat needs to be seen in context, since “its relative toxicity is nowhere near that of other opioids, especially illicit synthetics such as fentanyl, a drug category that killed more than 28,000 people in 2017.”

Failing to solve the problem

Still, the question remains: what can be done 

One option, making loperamide prescription-only, is less than ideal, cautioned Calello, “because there are many people who use the medication appropriately, for whom needing a prescription would limit access.

“Education about the risks of excessive loperamide dosing is key,” she said. “Opioid users who take it in high doses may assume that its toxicity is typical of opioids – take a little too much, get sleepy, take a lot too much, stop breathing.

“While this “typical” toxicity is reversed by naloxone, loperamide causes cardiac arrhythmias and cardiac arrest — for which naloxone does nothing,” Calello warned.

On that front, the FDA issued a high-dose cardiac risk safety warning in 2016. “So, getting the word out that this is a uniquely dangerous opioid medication in high doses is important,” Calello said.

Linda Richter, director of policy research and analysis with the Center on Addiction in New York City, thinks that loperamide abuse is just the latest sign that our health care system fails at solving the addiction problem.

“Unless we make it easier for people with opioid addiction to get the treatment they need, they will do whatever it takes to try to manage their addiction symptoms on their own,” she said, “whether it is by using potentially deadly drugs like fentanyl or by turning to high doses of legal drugs like loperamide to stave off their excruciating withdrawal symptoms and cravings.”

The findings are published in the February 4 issue of the journal Clinical Toxicology.







 

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Riot police squads intervene as pro-Israel and pro-Palestinian protesters clash in Montreal

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People wave flags atop cars in traffic during a demonstration to voice support for the people of Palestine, at Toronto City Hall in Toronto, Ontario, Canada, on 15 May 2021.


People wave flags atop cars in traffic during a demonstration to voice support for the people of Palestine, at Toronto City Hall in Toronto, Ontario, Canada, on 15 May 2021.

  • Violence
    between pro-Israel and pro-Palestine protesters in Montreal was condemned by
    Canadian Prime Minister Justin Trudeau.
  • Montreal’s
    city police force intervened and declared the protests illegal after tensions
    heightened and clashes broke out.
  • Israeli
    strikes killed 42 Palestinians in the Gaza Strip on Sunday, the worst daily
    toll in almost a week of clashes.

Montreal
– Canadian Prime Minister Justin Trudeau on Sunday condemned the violence and
“despicable rhetoric” that marked several weekend protests throughout
the country, after clashes between pro-Israel and pro-Palestinian protesters in
Montreal.

The
worst violence in years, sparked by unrest in Jerusalem, is raging between the
Jewish state and Islamist militants.

Israeli
strikes killed 42 Palestinians in the Gaza Strip on Sunday, the worst daily
toll in almost a week of deadly clashes.

Speaking
after protests in Montreal, Trudeau condemned what he said was “despicable
rhetoric and violence we saw on display in some protests this weekend”.

While
insisting on the “right to assemble peacefully and express themselves
freely in Canada”, Trudeau stressed in a tweet that there was no tolerance
for “antisemitism, Islamophobia, or hate of any kind”.

Earlier
on Sunday, Montreal police used tear gas following clashes between pro-Israel
and pro-Palestinian protesters.

Several
hundred demonstrators, draped in Israeli flags, had gathered in a central
Montreal square to express solidarity with the Jewish state.

‘Protesting is a right’

Although
the protest started peacefully, tensions ratcheted up with the arrival of
pro-Palestinian demonstrators and clashes soon broke out.

The
SPVM, Montreal’s city police force, declared the protests illegal, and squads
of riot police intervened, using tear gas to separate and disperse the two
groups, according to an AFP journalist at the scene.

The
police spent much of the afternoon in pursuit of the pro-Palestinian
protesters, who spread out and regrouped in commercial streets in the city centre.

Following
the clashes, Montreal Mayor Valerie Plante said on Twitter that
“protesting is a right”, but that “intolerance, violence and
anti-Semitism have no place here”.

She said:

Montreal is a city of peace.

Several
thousand pro-Palestinian demonstrators had gathered on Saturday in central
Montreal to denounce what they said were Israeli repression and “war
crimes” in Gaza.

“Terrorist
Israel”, some protesters chanted, while others held up a banner that read,
“Stop the genocide of Palestinian children”.

Pro-Palestinian
protests happened the same day in multiple Canadian cities, including Toronto,
Ottawa and Vancouver.


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Peter Thiel Helps Fund an App That Tells You What to Do

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“How would you feel about being able to pay to control multiple aspects of another person’s life?” asks the BBC.

“A new app is offering you the chance to do just that.”

When writer Brandon Wong recently couldn’t decide what takeaway to order one evening, he asked his followers on social media app NewNew to choose for him. Those that wanted to get involved in the 24-year-old’s dinner dilemma paid $5 (£3.50) to vote in a poll, and the majority verdict was that he should go for Korean food, so that was what he bought…

NewNew is the brainchild of Los Angeles-based entrepreneur Courtne Smith. The app, which is still in its “beta” or pre-full release stage, describes itself as “a human stock market where you buy shares in the lives of real people, in order to control their decisions and watch the outcome”. For many of us that sounds a bit ominous, but the reality is actually far less alarming. It is aimed at what it calls “creators” — writers, painters, musicians, fashion designers, bloggers etc. It is designed as a way for them to connect far more closely with their fans or followers than on other social media services and, importantly, monetise that connection…

Whenever a vote is cast the creator gets the money minus NewNew’s undisclosed commission… In addition to voting, followers can also pay extra — from $20 — to ask a NewNew creator to do something of their choosing, such as naming a character in a book after them. But the creator can reject all of these “bids”, and if they do so then the follower doesn’t have to part with the money…

Co-founder and chief executive Ms Smith, a 33-year-old Canadian, has big plans for NewNew, and has some heavyweight backers. Investors include Peter Thiel, the billionaire co-founder of PayPal, and the first outside person to put money into Facebook. Others with a stake in the business include leading US tech investment fund Andreessen Horowitz, and Hollywood actor Will Smith (no relation to Courtne). Snapchat has also given technical support.

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Sandpapergate will haunt Australia cricket forever: ex-bowling coach

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Cameron Bancroft. (Photo by Brenton Geach - Gallo Images/Getty Images)


Cameron Bancroft. (Photo by Brenton Geach – Gallo Images/Getty Images)

The 2018 ball-tampering scandal will haunt Australian cricket forever, much like the infamous underarm delivery of 40 years ago, the team’s former bowling coach David Saker said on Monday.

Saker was responding to opening batsman Cameron Bancroft suggesting that Australia’s bowlers knew about the plan in Cape Town to alter the ball which earned him a nine-month ban and rocked the game.

Saker was Australia’s bowling coach when Bancroft was caught trying to rough up the ball with sandpaper during the third Test against South Africa.

While refusing to be drawn on who knew what, Saker said “the finger-pointing is going to go on and on and on”.

“It’s like the underarm, it’s never going to go away,” he told Fairfax Media, referring to a 1981 incident when Trevor Chappell bowled underarm to ensure New Zealand lost a one-day match at the Melbourne Cricket Ground.

The notorious delivery is still cited in New Zealand and in cricketing circles as a prime example of unsporting conduct.

However, the ball-tampering scandal – dubbed “sandpapergate” – had a greater impact on Australian cricket, with the then-captain Steve Smith and his deputy David Warner suspended for a year from all cricket and stripped of their leadership roles.

Darren Lehmann also quit as coach and all the top brass from Cricket Australia left after a scathing review blasted their “arrogant and controlling” win-at-all-costs culture.

No one else among the team or coaching staff was held to account but Bancroft’s remarks in an interview with The Guardian newspaper hinted that the team’s bowlers at least knew about the plan.

“Obviously what I did benefits bowlers and the awareness around that, probably, is self-explanatory,” he said.

Saker added: “There was a lot of people to blame. It could have been me to blame, it could have been someone else. It could have been stopped and it wasn’t, which is unfortunate.

“Cameron’s a very nice guy. He’s just doing it to get something off his chest … He’s not going to be the last.”

In response, Cricket Australia said that if anyone had new information, they would look into it.

Saker said he was not opposed to a fresh investigation but added “I just don’t know what they’re going to find out.”

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Mexico’s Andrea Meza crowned Miss Universe

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Miss Universe Andrea Meza


Miss Universe Andrea Meza

UPDATE:

MISS UNIVERSE 2020/2021 IS ANDREA MEZA FROM MEXICO:


UPDATE:

THE MISS UNIVERSE 2020/2021 TOP 5:

1. Mexico

2. India

3. Brazil

4. Dominican Republic

5. Peru


UPDATE:

HERE ARE THE MISS UNIVERSE 2020/2021 TOP 10 CONTESTANTS:

1. Jamaica 

2. Dominican Republic 

3. India

4. Peru 

5. Australia 

6. Puerto Rico

7. Thailand

8. Costa Rica

9. Mexico

10. Brazil


UPDATE:

MISS UNIVERSE TOP 21 IN SWIMWEAR:


UPDATE:

MISS UNIVERSE TOP 21: 

1. Columbia

2. Peru 

3. Australia 

4. France

5. Myanmar

6. Jamaica 

7. Mexico 

8. Dominican Republic 

9. USA

10. Indonesia 

11. Argentina 

12. India

13. Curaçao

14. Puerto Rico

15. Phillipines 

16. Brazil

17. Great Britain

18. Nicaragua

19. Thailand 

20. Costa Rica

21. Vietnam


 UPDATE:

MISS UNIVERSE SOUTH AFRICA NATASHA JOUBERT WALKS THE STAGE AT MISS UNIVERSE 2020/2021:


74 contestants will compete for the title of Miss Universe on 16 May in Hollywood, Florida. 

The Miss Universe pageant takes place on 16 May in the US (02:00 to 05:00 on 17 May SA time). The show will be broadcast live on 1 Magic (DStv Channel 103) with a repeat at 21:30. 

Reigning Miss Universe Zozibini Tunzi of South Africa will crown her successor at the end of the event.

Representing South Africa is Natasha Joubert, and South Africans are hoping for the “magic double” – back-to-back consecutive wins, which has only happened once before in the pageant’s history.

Natasha wowed crowds at the national costume competition last week and on Friday impressed during the preliminary round

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Miss Mexico crowned Miss Universe 2021

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By AFP Time of article published 16m ago

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Washington – Miss Mexico was crowned Miss Universe on Sunday in Florida, after fellow contestant Miss Myanmar used her stage time to draw attention to the bloody military coup in her country.

Sunday night marked the Miss Universe competition’s return to television, after the pageant was cancelled in 2020 for the first time due to the coronavirus pandemic.

Andrea Meza, 26, finished first ahead of the Brazilian and Peruvian finalists in a flashy televised event, hosted by American actor Mario Lopez and television personality Olivia Culpo.

Former Miss Universe contestants Cheslie Kryst, Paulina Vega and Demi-Leigh Tebow (who won the title in 2017) served as competition analysts and commentators, and a panel of eight women determined the winner.

Dressed in a sparkling red evening gown, Meza tearfully walked the catwalk as Miss Universe for the first time, before rushing back for a group hug with the other competitors.

Meza beat more than 70 contestants from around the globe in the 69th installment of Miss Universe, which was held at the Hard Rock Hotel & Casino in Hollywood, Florida.

In the days leading up to the final competition, Miss Myanmar Thuzar Wint Lwin, who made the top 21, made waves when she used her time in the spotlight to bring attention to the coup in her country.

“Our people are dying and being shot by the military every day,” she said during her biographical video, which showed photos of her taking part in the anti-coup protests. “Therefore I would like to urge everyone to speak out about Myanmar.”

Natasha Joubert, Miss Universe South Africa 2020 competes on stage in Ema Savahl swimwear during the MISS UNIVERSE® Preliminary Competition.

She also won the award for best national costume: during that competition segment on Thursday, she wore an outfit beaded in traditional Burmese patterns and held up a sign that said, “Pray for Myanmar.”

Myanmar has been in uproar since February 1, when the army ousted civilian leader Aung San Suu Kyi.

At least 796 people have been killed by security forces since then, according to a local monitoring group, while nearly 4 000 people are behind bars.

Miss Singapore Bernadette Belle Ong – who did not make the top 21 – also used the national costume portion to make a political statement.

Dressed in a glittering red bodysuit and matching thigh-high boots, she turned around to reveal her cape – in the colours of the Singaporean flag – was painted with the words “Stop Asian Hate.”

“What is this platform for if I can’t use it to send a strong message of resistance against prejudice and violence?” she wrote on Instagram alongside pictures of her outfit.

The United States in particular has seen a surge in anti-Asian violence in the past year, which activists have blamed on former president Donald Trump’s rhetoric, especially his repeated description of Covid-19 as the “China virus.”

The pageant has also drawn criticism in the past for objectifying the contestants.

In recent years, the competition has shifted image, focusing more on female empowerment and activism.

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