The 2 Minute Medicine Podcast Episode 21

Welcome to the 2 Minute Medicine Podcast, summarizing the latest medical studies, curated and written by practicing physicians. On this podcast, twice a month, we cover the latest in healthcare news and research evidence.

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[Deepti] Welcome to the 2 Minute Medicine Podcast, summarizing the latest medical studies, curated and written by practicing physicians.

For our full suite of daily medical study summaries and updates written by practicing doctors, please visit our website at 2minutemedicine.com to start reading new daily content right now, for free. On this podcast, twice a month, we cover the latest in health care news and research evidence. We are your hosts Deepti and Andrew. On today’s episode, we’ll start off by discussing our two articles of the week. In the second half of the episode, we will look at health issues that have arisen in popular media. 

[Andrew]  Our article of the week comes from JAMA Network Open and is entitled “Trends in Rates of Opioid Agonist Treatment and Opioid-Related Deaths for Youths in Ontario, Canada, 2013-2021”. The incidence of opioid-related mortality has been increasing among youths in North America. Opioid agonist treatment (OAT) is an evidence-based method shown to reduce opioid-related deaths. Barriers to OAT, including stigma and poor accessibility, reduce the uptake of this treatment. The aim of this cross-sectional study was to assess the rates of OAT and opioid-related mortality in Ontario, Canada among two age groups: 15-24 and 25-44 between 2013 and 2021. Data were collected from the Ontario Drug Policy Research Network, Public Health Ontario, and Statistics Canada. Between 2013 and 2021, opioid-related deaths in the younger cohort increased 369.2%, from 2.6 to 12.2 per 100,000 population. OAT use decreased by 55.9%, from 3.4 to 1.5 per 1000 population. Among the older cohort, opioid-related deaths increased 371.8%, from 7.8 to 36.8 per 100 000, and OAT use increased 27.8%, from 7.9 to 10.1 per 1000 population. This study suggests that while opioid-related mortality is increasing for both youths and adults in Ontario, youths are simultaneously reducing their use of OAT. Further research can examine barriers to accessing OAT in younger populations. Clinicians can work together with Public Health Agencies to increase accessibility and utilization of OAT in this younger demographic, such as by engaging with schools or increasing the use of technology for outreach.

[Andrew] Now for The Scan. The Story: As the biggest women’s soccer event of the year comes to a close, there is more to celebrate than just athletic accomplishments. This year great strides were taken to protect and support female athletes, including using a social media protection service to monitor and eliminate online abuse and implementing kits with period leak protection to combat period anxiety. Many hope that these changes will have a lasting impact on the sport.

Athletes are not immune to online bullying. In fact, female athletes are particularly prone to this abuse. A study from World Athletics found that during the 2020 Tokyo Olympic Games, there was a very high level of online bullying and that female athletes were the target of 87% of these comments. The study found that most of these online comments related to themes of doping allegations or included sexist or racist remarks. Online comments have also contributed to body image issues for many female athletes — a population that already experiences high levels of disordered eating. With the disproportionate burden of online bullying put on female athletes, it is no surprise that female athletes experience higher levels of mental health problems compared to their male counterparts. 

[Deepti] Interestingly, mental wellness is associated with improved performance, injury levels, and athlete recovery. As such, online bullying may affect athletes’ mental health, performance, and overall physical health. The social media protection service put in place during this year’s Women’s World Cup is the same that was employed at last year’s men’s competition which successfully blocked nearly 300,000 abusive comments, protecting athletes from the psychological effects of this maltreatment. Many hope that these protections will become the norm — shielding female athletes in every sport from harmful and inappropriate online comments. 

Along with monitoring social media, this year’s FIFA Women’s World Cup also took strides to alleviate period anxiety. Anxiety experienced before a menstrual cycle is not uncommon and is primarily caused by premenstrual syndrome (PMS)and premenstrual dysphoric disorder (PMDD). This anxiety can be heightened as an athlete, especially when performing on an international level. However, many teams at this year’s World Cup, such as Ireland and New Zealand, are combatting period anxiety by swapping out white shorts for darker-colored kits. This comes just one year after Wimbledon ditched its all-white dress code to alleviate period anxiety for female athletes. Meanwhile, new Nike uniforms will offer period-leak protection with an added base layer for improved security. These new efforts are to help reduce anxiety about period leaks during competition. Prior research shows that over 40% of young girls’ monthly periods prevent them from engaging in sports. With all the physical and mental health benefits accompanying sports involvement, it is a shame that anxiety around menstrual cycles negatively impacts female engagement in sports. Steps to support female athletes on their menstrual cycle, such as uniforms with leak protection, will hopefully allow more girls and women to engage in sports year-round. 

Next, let’s take a look at why in the United States, August is celebrated as National Immunization Awareness Month. 

[Andrew] The month-long event is meant to highlight the importance of routine vaccination and dispel myths about immunization. The event comes at a time when national childhood vaccination rates are declining and outbreaks of vaccine-preventable diseases, such as measles, continue. Another current cause for concern regarding vaccinations is malaria, as locally acquired cases of the disease have been reported in the United States for the first time in 20 years. While the public health risk of malaria remains low in the United States, the disease still represents a significant cause of mortality worldwide, specifically in Sub-Saharan Africa. Luckily, an estimated 18 million doses of a new malaria vaccine are set to be delivered in the coming months to a subset of African countries to curb the global impact of the disease.  

Although COVID-19 put the spotlight on vaccine hesitancy, questions about the safety and efficacy of vaccines existed long before the pandemic. Much of this skepticism originates from an infamous paper published 25 years ago that incorrectly suggested that the measles, mumps, and rubella (MMR) vaccine could cause autism. The paper was later retracted due to inaccurate and misleading science. However, the impact of the publication is still felt to this day: estimates suggest that around 10% of Americans still believe vaccines can cause autism, despite substantial evidence debunking the theory.

[Deepti] That’s right. The vaccine debate has been waged in the world of pop culture as well, with many celebrities sharing anti-vaccination statements over the years, including Jenny McCarthy, Sarah Palin, and Jim Carrey, while athletes such as tennis star Novak Djokovic and NBA point guard Kyrie Irving missed out on competitions due to refusal to get the jab. Meanwhile, many other celebrities publicly supported the COVID-19 vaccine and encouraged fans to get vaccinated. However, this isn’t a new concept — over 60 years ago, Elvis Presley publicly received his polio vaccine, prompting a massive surge in vaccination rates. Whether it be fear of complications or celebrity endorsement, it is clear that public perception significantly impacts immunization rates.  

[Andrew] Next, let’s talk about something that we know is on a lot of your minds – back to school season! Whether heading to preschool or college this year, focusing on eating healthy and caring for your mental health will support a healthy transition back to a school routine. 

 Healthy school lunches should include foods from all four major food groups and reduce the amount of saturated and trans fats, as well as processed and sugary foods. Having access to healthy foods during the school day can positively affect several outcomes, including reducing childhood obesity rates and improving school performance. However, it is essential to note that not everyone has access to healthy food options. As the cost of living increases, more and more students find it hard to get enough to eat. Unfortunately, eating healthy can be costly, and processed food choices are often cheaper than fresh fruits and vegetables. However, planning your meals, buying frozen and canned fruits and vegetables, and purchasing generic brands can help make eating healthy on a budget more feasible.  

Student mental health is another concern during back-to-school season. Recent findings from the CDC report that mental health concerns in adolescents are on the rise, which can negatively affect school performance and overall health. In particular, it was found that over 50% of teen girls felt persistent sadness or hopelessness. More than 40% of all teens indicated that their feelings of sadness impacted their day-to-day activities. Certain groups of young people experience higher levels of mental health struggles, including LGBTQ+ youth. Being on the lookout for some red flags, such as excessive sleeping, mood fluctuations, a drop in academic performance, or a loss of interest in activities, can help identify mental health problems in students so they can get the appropriate support they need. 

Last but not least, a short but important conversation in light of the upcoming international overdose awareness day

[Deepti] The world has lost many prolific figures to overdose, including Heath Ledger, Kurt Cobain, Mac Miller, Taylor Hawkins, Janis Joplin, and many more. August 31st is International Overdose Awareness Day — a time to remember those affected by overdose, raise awareness, and reduce stigma around substance abuse. 

Substance use disorders are relatively common conditions affecting over 20 million Americans. While substance abuse can have several impacts on health, overdose — the consumption of a toxic amount of a substance — is one of the most worrying outcomes of substance use disorders. Estimates suggest that around 100,000 Americans die from overdose each year, most of which involve opioids. Naloxone is a lifesaving overdose reversal drug that can help those experiencing an opioid overdose. Many places provide free training and naloxone kits so more people are equipped with the tools to act in the case of an opioid overdose. Earlier this year, the Food and Drug Administration approved the first naloxone product for sale without a prescription. However, barriers are still in place to accessing the lifesaving medication: many pharmacies do not stock the drug due to the stigma surrounding substance abuse, and the medication cost is quite high. Making naloxone accessible is essential in reducing the number of deaths attributable to drug overdose.

[Andrew] Actress and singer Demi Lovato is one of the lucky ones who received a lifesaving dose of naloxone during her 2018 overdose. She has recently spoken out about the lasting impacts of her overdose, including problems with vision and hearing, which affect her day-to-day life years later. Lovato’s openness around her experience with overdose serves as a reminder that substance abuse can affect anyone and that prompt treatment with naloxone can be lifesaving.

Thank you for joining us today for this episode of the 2 Minute Medicine Podcast. New episodes come out every other week and all of our content has been curated and written by practicing physicians.

Please head to our website at 2minutemedicine.com to learn more and to access all of our content including medical study summaries, visual abstracts, excerpts from our Classics book series which is available on Amazon, and The Scan, which is our medical newsletter.

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©2023 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.