For those contemplating a detox or cleanse in the new year, here’s a toxicologist’s explanation of how they work: They don't.

Canadian MDs are relying less on opioids. That is a good thing. New commentary from me in @cmaj.ca www.cmaj.ca/content/197/...

PSA: When a naturopath recommends chelation “to remove the metal from your body,” that is exactly what you should not do.

Join us for UofT Therapeutics Day November 1st - drug interactions - NSAID allergy - within-class safety differences - complex polypharmacy - pharmacogenetics - SGLT2 inhibitors - buprenorphine Register here: eventbrite.com/e/the-drugs-we…

Drs. Jessica Kent ‪Rice @jessicakentrice.bsky.social ‬& David Juurlink @davidjuurlink.bsky.social study on trends in opioid agonist therapy retention after non-fatal #OpioidOverdose: www.psifoundation.org/funded-resea... #InternationalOverdoseAwarenessDay #IOAD2025 @sunnybrookhsc.bsky.social

Toronto-area MDs and pharmacists: Join us for Therapeutics Day 2025 - Relevant topics - Great speakers (but also me) - You will be fed - You will get CE credits Register here: tinyurl.com/mr447y5n

I'm not saying these "ivermectin cured my cancer" testimonials are entirely fabricated but THEORETICALLY if someone: 1) no longer had a medical license, and 2) profited from pushing ivermectin, and 3) had no qualms about lying to desperate people ... Just putting this out there

🚨 ICYMI - #Opioids prescribing webinar recording featuring pharmacologist @davidjuurlink.bsky.social 🚨 💊 What have we learned about #prescribing? 💊 How should we treat pain when opioids overdoses have become an intractable epidemic? 👉🏽 ti.ubc.ca/juurlink-ana... #pain #MedEd #medsafety

Every time I hear someone mention tramadol

Let's talk about using carbapenem antibiotics in patients with valproic acid (VPA) poisoning /1🧵

Returning home from an international medical conference in Vancouver. In 25 years of attending these meeting I have *never* heard so many American physicians talk so openly about possibly moving to Canada.

Not me

It takes a unique kind of genius to fuck up the US-Canada relationship.

So important. Glad NEJM has made this open access. www.nejm.org/doi/full/10....

Not starting a detox today because I have a liver and kidneys

For those contemplating a detox or cleanse in the new year, here’s a toxicologist’s explanation of how they work: They don’t

I don’t know who needs to hear this but short, focused progress notes are better than long, detailed progress notes. By a mile.

Worth reading Roald Dahl’s account of the death of his daughter Olivia, age 7

Is anyone else seeing patients who’ve been on the same dose of rosuvastatin for years develop new-onset myotoxicity without an obvious explanation?

If only OxyContin worked as well as people seem to think

BRASH syndrome ECG: - subtle peaked T-waves from hyperkalemia - bradycardia is *disproportionately* severe, as compared to the extent of hyperkalemia-induced morphology changes (more on BRASH: emcrit.org/ibcc/brash/) (ECG credit: ecg.bidmc.harvard.edu/maven/dispca...) #ECGsky

In theory, if there were a class of medications that, with regular use and *especially* at higher doses, caused patients to become horribly ill when the drugs were stopped, we'd be very, very careful about starting them, continuing them, increasing the dose, and stopping them.

I've diagnosed scurvy twice and often wonder how many times I've missed it

Yes, yes, I will post more here eventually. Until then, please remember that tramadol is garbage.