Posts in category: Health

A disability rights organization is challenging a suburban New York ban on wearing masks in public except for health and religious reasons, arguing it is unconstitutional and discriminates against people with disabilities.

The federal class action lawsuit, filed by Disability Rights of New York on behalf of individuals with disabilities, seeks a temporary restraining order and preliminary injunction to immediately stop enforcement of Nassau County’s Mask Transparency Act.

“This mask ban poses a direct threat to public health and discriminates against people with disabilities.” Timothy A. Clune, executive director of the rights organization, said in a statement. The lawsuit includes two plaintiffs with various health conditions and who wear medical-grade face masks to protect themselves, noting they are now fearful of being harassed and possibly arrested because of the new mandate.

“While in public and private places, strangers have come up to G.B. since Aug. 5, 2024, to ask them if they are sick, if they are healthy or not, and to ask why they are wearing a facemask,” according to the lawsuit, referring to one of the plaintiffs by their initials and to the date when the Nassau County Legislature passed the local bill.

The lawsuit, filed Thursday, said G.B., a resident of Nassau County for 24 years, has been diagnosed with cerebral palsy and asthma and uses a wheelchair for mobility.

“G.B. fears that they will be arrested just for wearing a facemask for their health because there is no standard for the police to follow to decide if they meet the health exception or not,” according to the lawsuit. “G.B. is also concerned that they will be harassed, discriminated against, or even assaulted by people, including business owners and employees, in Nassau County for just going about their day with a mask on.”

Messages were left seeking comment with media contacts for Nassau County Executive Bruce Blakeman, a Republican who signed the bill into law on August 14.

When the county’s Republican-controlled Legislature approved the ban on face coverings, legislator Howard Kopel said lawmakers were responding to “antisemitic incidents, often perpetrated by those in masks” since the October 7 start of the Israel-Hamas war.

The law makes it a misdemeanor punishable by up to a year in jail and a $1,000 fine for anyone in Nassau to wear a face covering to hide their identity in public. It exempts people who wear masks “for health, safety, religious, or cultural purposes, or for the peaceful celebration of a holiday or similar religious or cultural event for which masks or facial coverings are customarily worn.”

Blakeman has said that while mask-wearing campus protesters were the impetus for the ban, he sees the new law as a tool to fight everyday crime as well.

“This is a broad public safety measure,” Blakeman said at a news conference. “What we’ve seen is people using masks to shoplift, to carjack, to rob banks, and this is activity we want to stop.”

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George Resch, who goes by TankSinatra on social media, recently mentioned that he had an addiction to the over-the-counter nasal spray Afrin. “I have been congested for a year,” he said on the podcast Meme Daddies.

How does that happen? Plenty of over-the-counter medications — those that are sold on pharmacy and grocery store shelves without a prescription — have the potential to be habit-forming if used incorrectly.

OTC medications are available for dozens of conditions, including allergies, cough, diarrhea, constipation, skin issues, and pain. As long as you use them for short periods of time and as directed, you should be fine. Go outside those label instructions, though, and you could be inviting trouble.

You could end up with something called a rebound effect, which is when the original symptoms you were trying to treat come back, sometimes with a vengeance, after you stop taking the drug. 

What is the difference between misuse, dependency, and addiction?

A rebound effect, which generally comes from medication misuse, is not the same as a true addiction, although there are nonprescription drugs that can be abused or contribute to an addiction relapse.

A person who is misusing an OTC drug can develop a physical dependency on the drug, which means their body comes to rely on it for a particular function. That isn’t the same as an addiction to a drug, which results in compulsive behavior to get the drug despite the sometimes devastating and even life-threatening repercussions. 

Addiction can happen with fentanyl, oxycodone, or illicit drugs like cocaine or heroin. Typically the person who has the addiction needs more and more of the substance to get the same high or other effects. That person keeps misusing a substance despite experiencing negative social, physical, and psychological consequences associated with the abuse, Dr. Kelly Johnson-Arbor, a medical toxicologist and interim executive director of the National Capital Poison Center, explained.

Rather than using substances for a high or to feel better, misuse means that people take a drug to treat a condition or symptoms but do so incorrectly.

“Misuse occurs when a person takes more of the medication than prescribed on the label, for a longer period of time, more often than what is recommended, or is using it for a purpose other than what was intended,” explained Pat Aussem, associate vice president of consumer clinical content development at the Partnership to End Addiction.

That said, the physical consequences of misusing an OTC drug can be unpleasant and can include withdrawal or rebound symptoms. And misuse can lead to addiction when it comes to certain classes of medications, Johnson-Arbor explained.

Here’s what to know before you start taking any OTC medication. 

Nasal sprays with oxymetazoline 

The nasal decongestant Afrin contains oxymetazoline, which reduces congestion by narrowing blood vessels in the nose. But using it too often can backfire, leading to “Afrin addiction,” as many people have posted about on TikTok. (The hashtag #AfrinAddiction has nearly 800,000 views on the platform.)

“When Afrin is used for longer than three days, it can cause a chemical imbalance in the body that actually results in worsening nasal stuffiness when Afrin is discontinued,” Johnson-Arbor said. This leads to a vicious cycle of using Afrin to relieve decongestion, then using it again when the congestion returns. The medical name for the condition is rhinitis medicamentosa.

In addition to nasal stuffiness, congestion, and pain, overuse of Afrin can lower blood pressure and heart rate, leading to dizziness or fainting. Doctors sometimes prescribe steroids to lessen the discomfort of quitting Afrin, Johnson-Arbor said.

You should not use Afrin and other nasal sprays that contain oxymetazoline for longer than three days. 

Headache medications

Just about any medication you can take for head pain — aspirin, ibuprofen, naproxen, acetaminophen, or anything else — can cause rebound headaches if you take them for prolonged periods of time.

A rebound headache, also known as a medication overuse headache, may be a possibility for anyone who is taking pain relievers for at least three months and then starts having headaches 15 or more days per month.

So how often is too often when it comes to pain relievers? Well, it depends on the drug, but if you are taking an nonsteroidal anti-inflammatory drug at least 10 times a month, you could be at risk for medication overuse headaches. 

The headaches generally start first thing in the morning and will temporarily get better after you take the drug, but then the pain comes back. Other symptoms can include nausea, irritability, and neck pain. 

The best approach is to limit how often you take pain relievers. “If someone has to take one of these more than two to three times per week (or more than 10 to 15 times in a month), they are putting themselves at significant risk of developing the medication overuse headache,” said Kayode Giwa, a pharmacist and clinical specialist in psychiatry and internal medicine at Houston Methodist.

The antidote is typically taking a vacation from the medications for one or two weeks so our bodies can reset, he added. If you’ve been using these medications for long periods of time, taper off instead of going “cold turkey,” Johnson-Arbor said. 

Eye drops that contain tetrahydrozoline

Some eye drops are marketed as a way to reduce eye redness along with itching and dryness. The most well known is Visine, which is similar to Afrin in the way it works. The eye drops contain the decongestant tetrahydrozoline, which works by constricting blood vessels in your eye. 

While this may be an effective temporary solution, over the long term it can exacerbate the problem, ending up in a vicious cycle. When the redness wears off, your eyes may appear even more red (“rebound redness”), leading to more eye drops, more red eyes, more eye drops, etc.

Ophthalmologists typically recommend using artificial tears rather than products that claim they’ll take the red out. If you do use products containing decongestants, limit them to occasional use and not for longer than 72 hours, the American Academy of Ophthalmology warns. 

Just know that some artificial tears products were recently recalled due to bacterial contamination. While those particular brands are no longer being sold, check the label for any products you might have at home. (The brand names are EzriCare or Delsam Pharma’s Artificial Tears.) Three people who have used the drops have died from serious infections; in some cases, people have had permanent vision loss or the need for eye removal.

In addition to using drugs for the correct amount of time, you should also not use them on any part of the body other than those recommended by the manufacturer.

Unfortunately, a “prank” portrayed in the 2005 film Wedding Crashers suggested that putting eye drops in a drink can cause violent diarrhea or other side effects. In fact, consuming tetrahydrozoline can be fatal and was even implicated in one homicide case. The perpetrator allegedly added the drops to her husband’s drinking water for three days. 

“This is a super dangerous thing to do,” Giwa said.

Skin creams that contain hydrocortisone

OTC cortisone cream contains the active ingredient hydrocortisone, which is a corticosteroid that blocks inflammation-causing immune reactions. It’s commonly used to treat rashes, sunburns, eczema, and other skin conditions.

It’s remarkably effective at reducing symptoms like itching. However, the medication, especially the stronger formulations, can lead to “red skin syndrome,” a sort of withdrawal process marked by bright red skin along with burning, stinging, itching, and pain. These typically occur within days of ceasing use of the product, Johnson-Arbor said.

Many cases of red skin syndrome occur after long-term use of hydrocortisone (a year or so). The National Eczema Association cautions against using topical corticosteroids for more than two to four weeks. After that, frequency of use should be tapered off.

Using corticosteroids on the skin for too long can lead to skin thinning and permanent stretch marks. When used on the eyelids frequently and for a prolonged period of time, it can also increase the risk of glaucoma and cataracts.

Lip balm

There are no ingredients in ChapStick and other lip balms that could cause physical dependence, but overuse may lead to what’s known as a “behavioral addiction.” People have admitted to putting tube to lip as often as 300 times a day and needing to have multiple tubes with them at all times. There’s even a Facebook group, Lip Balm Addicts Anonymous, “For everybody addicted to flavoured wax.”

As far as habits go, though, this is one of the least harmful. The main consequence is likely to be drier lips. That’s because many people like to lick the balm off, allowing digestive enzymes to dry out the membranes.

Ingredients like phenol, menthol, and salicylic acid may also dry out your lips, causing you to use yet more of the product. If you use lip balm, stay away from these ingredients and avoid flavors that invite licking. 

Laxatives with bisacodyl, senna, or castor oil

Although there are several different classes of laxatives, problems related to misuse are more likely with stimulant laxatives containing bisacodyl (brand name Dulcolax), senna, or castor oil. 

“They basically make your large intestine act more. They push more stool out of your body,” Giwa said.

Misuse is not uncommon among people with eating disorders because of the misperception that they cause weight loss. In fact, they don’t, they generally just lead to temporary water loss, he said.

To be safe, don’t use these products for more than three to five days. “The body becomes physiologically addicted so you can only have a bowel movement when you use them. After many months or years, your colon stops working,” Giwa said. “If you need it more than that, you need to see a physician,” he said.

Fiber-containing or bulk-forming laxatives are considered safer ways to get things going if you have a problem with constipation.

Nasal inhalers that contain propylhexedrine

Benzedrex is a nasal decongestant that comes in an inhaler (rather than a spray) that has the potential for misuse and abuse. 

“OTC inhalers like Benzedrex can be used to simulate stimulants,” Aussem said. 

The key ingredient is propylhexedrine, which sometimes people take specifically for the stimulant effect. Abusing the drug can cause high blood pressure, abnormal heart rhythm, paranoia, and even death. 

Because of the stimulant effect, people who already have substance use disorders can be particularly vulnerable. “I was working with a family where a loved one had a stimulant use disorder as a result of using meth,” Aussem said. “After attending residential treatment, he was trying to avoid using meth and instead bought Benzedrex.”

The Food and Drug Administration warns against more than two inhalations in each nostril every two hours. You also shouldn’t use it for longer than three days.

Cough drugs with dextromethorphan (DXM)

The active ingredient in many extra-strength cough suppressants, including some formulations of Robitussin and NyQuil, dextromethorphan may be one of the more potent compounds out there in terms of abuse or misuse.

According to the Drug Enforcement Administration, more than 100 medicines contain DXM. “It’s the number one decongestant we have,” Giwa said.

“Referred to as Robo-tripping, DXM used in cough syrup can be used to get high,” Aussem said. Some people also refer to it as “skittling.” At extremely high doses, it can cause hallucinations. “There have been cases where people have had to be psychiatrically hospitalized,” Giwa said. “It also doesn’t show up on drug screens.”

Antidiarrheal drugs that contain loperamide

Misuse of antidiarrheals containing loperamide (for example, Imodium) is becoming more widespread. “In the last few decades, there have been increased reports of loperamide abuse and misuse reported to Poison Control Centers nationwide,” Johnson-Arbor said.

Loperamide is taken to achieve euphoria but also to self-treat opioid withdrawal, Aussem said.

Unfortunately, it can also cause nausea, constipation, sleepiness, and stomach pain.

The FDA has warned of potentially fatal heart problems with higher-than-recommended doses of the drug, especially when combined with certain other drugs such as Tagamet (cimetidine) and Zantac (ranitidine).

“Since loperamide acts like an opioid in overdose situations, naloxone (Narcan) may be effective in reversing breathing abnormalities that occur after loperamide overdose,” Johnson-Arbor said. 

The FDA approved the first over-the-counter naloxone spray on March 29. 

Antihistamines that contain diphenhydramine

When taken in doses higher than recommended, the active ingredient in Benadryl, diphenhydramine, an antihistamine, can have intoxicating effects, sometimes making people experience euphoria, delusions, or hallucinations.

Although not as habit-forming as pseudoephedrine in decongestants (see below), diphenhydramine is also prone to misuse or abuse. One example was the “Sleepy Time Chicken” trend on TikTok in 2022. This involved some people reportedly basting chicken in antihistamines and then eating it. “It produced a downer, stoner feeling,” Giwa said.

The FDA posted a warning about the practice, noting that boiling medications can make them more concentrated and release vapors that may damage your lungs. Long-term use can cause severe constipation, blurry vision, and dry mouth.

In 2021, the FDA issued a warning about the “Benadryl Challenge,” which included some people taking diphenhydramine in an effort to hallucinate.

In general, using any antihistamine over the long term has the potential to cause withdrawal symptoms when stopping, Giwa said. The most common offenders, though, are cetirizine (Zyrtec) and levocetirizine (Xyzal), he noted. Both can involve unbearable itching, Johnson-Arbor said.

Decongestants with pseudoephedrine

In many states, some decongestants, including certain formulations of Sudafed or DayQuil, are only sold “behind the counter” and you have to be 18 to buy them. The key ingredient is pseudoephedrine, which has the opposite effect of antihistamines. “People will abuse it for weight loss because they are so stimulating,” Giwa said. “They’re very comparable to your classic stimulants like Ritalin, cocaine, Adderall, and meth. You can become dependent.”

Many OTC products actually contain both decongestants and antihistamines, which is a lot like mixing vodka and Red Bull, Giwa said. 

“It’s a similar feeling to where your heart is racing really fast but you’re drowsy from the alcohol [or antihistamine],” he explained. “It’s an upper and a downer. Physiologically you’re down but you’re not going to fall asleep.” People will sometimes use these OTC products in combination with an illegal drug to calm themselves down, he added.

What to do

If you experience itchy skin from antihistamine withdrawal, or any other unexpected symptoms when you stop taking an OTC medication, contact your doctor. Also get in touch with a healthcare professional if you’re unsure how to take a medication, especially how long to use it.

If unwanted signs or symptoms develop after use or misuse of over-the-counter medications, contact Poison Control for immediate guidance. There are two ways to contact Poison Control in the United States: online at www.poison.org or by phone at 1-800-222-1222. Both options are free, confidential, and available 24 hours a day.

Authentik Fudge of Sainte-Julie, Quebec, Canada, is recalling some of its Chocolate Fudge with Nuts branded Montreal Fudge because of potential mold growth contamination.

“We initiated this recall after a consumer complained about some mold pieces inside the purchased box, and we also found some remaining unpacked sealed products at the manufactured place that had beginning signs of mold,” the company said in its recall notice posted by the Food and Drug Administration.

The recalled Fudge with nuts branded Montreal Fudge was distributed on 2024-06-19 and 2024-06-20 through the Marshalls chain and sold in the following stores:

There are TJ Maxx stores in Arizona, California, Colorado, New Mexico, Nevada, Utah, Washington, and Wyoming.

Marshall’s stores in California, Colorado, Connecticut, Delaware, Florida, Georgia, Iowa, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maryland, Michigan, Minnesota, Montana, Mississippi, North Carolina, Nebraska, New Hampshire, New Jersey, Nevada, New York, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin, West Virginia and Wyoming.

The product is packaged in a Montreal Fudge gable box, Chocolate Fudge with nuts 5.6 oz, marked on the back of the box with the lot 0241500805, with an expiration date of 2025/MR/01, lot 0241690105, with an expiration date of 2025/MR/17, and lot 0241690205, with an expiration date of 2025/MR/17. This recall impacts no other products.

No illnesses have been reported to date in connection with this problem.

Consumers who have purchased those affected products are urged to destroy them or to return them to the place of purchase for a full refund. Consumers with questions may contact the company Authentik Fudge/Montreal Fudge at info@authentikfudge.com or by at 450-649-1331 or 877-313-1331 post 210 or 205.

(To sign up for a free subscription to Food Safety News,click here)

It has become a rhetorical theme for Democrats working to hold on to the White House: Allies of former president Donald Trump, they say, want to infuse conservative ideals into how the federal government does business.

That vision is outlined in the Project 2025 “Mandate for Leadership,” a 900-page blueprint produced by the conservative Heritage Foundation and other conservative organizations as a guide for the next administration.

Although Trump has repeatedly said Project 2025 has no place in his campaign, Democrats keep bringing it up. On each night of the Democratic National Convention so far, speakers have invoked Project 2025, with Sen. Bernie Sanders (I-Vt.) calling it “radical”; Colorado Gov. Jared Polis (D) holding up a bound copy of the “Mandate for Leadership” and calling it Trump’s “road map to ban abortion in all 50 states”; and comedian Kenan Thompson highlighting its call to use the 19th-century Comstock Act to block the mailing of abortion pills.

Among Project 2025’s proposals are plans for federal health policy.

For instance, the Department of Health and Human Services would adopt a staunch antiabortion stance, and federal approval for one commonly used abortion drug could be revisited and potentially withdrawn.

“Abortion,” “reproductive health” and any other term “used to deprive Americans of their First Amendment rights” would be removed from every federal rule, regulation, grant or piece of legislation.

The Centers for Disease Control and Prevention would research abortion risks and complications. And HHS would be recast as the Department of Life, underscoring a new Christian nationalist focus.

Although Trump has repeatedly denied that the document will inform his White House if he wins in November, Democrats’ focus on Project 2025 will probably continue beyond the convention, in part because some of its proposals, including abortion restrictions, poll poorly for him and other Republican candidates.

Support for abortion access is growing. Sixty-one percent of adults want their state to allow legal abortion for any reason, according to a poll conducted in June by the Associated Press and the University of Chicago’s NORC, which provides social research.

Vice President Kamala Harris’s campaign says Project 2025 shows “they’ll implement a 50-state ‘backdoor ban’ on abortion — without Congress — and jail health care providers.”

Abortion rights groups are also using Project 2025 to say Trump would endanger access to abortion. The former president has said abortion issues should be decided by states.

“We’re so focused on educating voters about 2025. It’s an extreme ban,” said Julie Lewis, director of public policy at Planned Parenthood Federation of America.

The Heritage report, a version of which has been produced roughly every four years since the 1980s, has had considerable sway on GOP presidents. Former president Ronald Reagan adopted about 60 percent of the recommendations in a Heritage guide. Trump did the same in his presidency.

As Election Day approaches, Trump continues to try to distance himself from the document, and its authors say he wasn’t involved. A number of high-ranking officials from his administration, though, were. His running mate, Sen. JD Vance of Ohio, wrote the foreword to a yet-to-be-released book by Kevin Roberts, who is president of Heritage.

Roger Severino, vice president of domestic policy at Heritage, who wrote the HHS chapter in the Project 2025 blueprint, ran the agency’s Office for Civil Rights during Trump’s presidency.

Severino pushed back on Democratic claims that the document would ban medication abortion: “It’s a lie, plain and simple,” he said.

This article is not available for syndication due to republishing restrictions. If you have questions about the availability of this or other content for republication, please contact NewsWeb@kff.org.

Dr. Raymond Heilman, Medical Director of the Kidney Transplant Program of Mayo Clinic in Phoenix/Scottsdale, Arizona, gives an overview on the different types of kidney transplantation, including living donor and paired donor exchanges, and explains what kidney donors can expect.

The project building New Zealand’s national health information platform has been put on hold following budget cuts for digital health. 

In a statement to Healthcare IT News, Michael Dreyer, director of the Digital Channels sector at Te Whatu Ora (Health New Zealand), confirmed that the Hira project has been suspended.

“After completing the first stage of Hira and creating a strong foundation for the project, it is now paused while we look at plans for the future.”

Hira, he said, will be part of Te Whatu Ora’s 10-year infrastructure investment plan, which is currently under development. The plan may be released by the end of the year, based on a news report. 

THE LARGER CONTEXT 

The New Zealand government recently decided to recall some NZ$300 million ($200 million) for digital health initiatives over the next four years, including Hira. This also includes funding for free telehealth services provided through the advocacy group, NZ Telehealth Forum. The budget savings come as the government doubled down on improving frontline services in Budget 2024.

Since 2021, the government has invested nearly NZ$1 billion (over $600 million) in enhancing the health system’s data and digital infrastructure and capabilities. 

The digital health budget cut also comes as Te Whatu Ora decided to slow down on health ICT expansion to focus on “more robust” platforms and the transition to the cloud. In a briefing to Health Minister Dr Shane Reti last year, the agency revealed that the health system has a “patchwork” of over 4,000 clinical and business applications, many of which are at or close to their end-of-life and have been incurring debts. 

“We recognise both the challenges of the different data and digital systems inherited from earlier entities, and also the high potential for digital services to improve health services delivery,” Dreyer told this publication.

The first phase of the Hira implementation concluded in June. It is now providing access to health information on My Health Record, including National Health Index details and vaccination records. The National Event Management Service is also live, providing near real-time notification of death events. The project has also developed a connector plane for accessing Hira APIs and a developer portal for testing APIs. 

Hira has also taken initial steps to enable access to information on prescribed and dispensed medicines and primary care summaries.