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Human trafficking is way too common, and Flibanserin gets official approval! This is Healthcare Triage News.


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Human trafficking is way too common and Flibanserin gets official approval. This is Healthcare Triage news.

 Human Trafficking study


Our first study comes to us from BMJ Open. Human trafficking and health: a cross-sectional survey of NHS professionals' contact with victims of human trafficking.

Researchers wanted to estimate how many National Health service or NHS professionals come into contact with trafficked people. They also wanted to measure their professionals' knowledge and confidence in dealing with human trafficking. 

They surveyed almost 800 NHS professionals from emergency medicine, maternity, mental health, pediatrics, and other specialties.

Questions were asked about their training in the area as well as their contact with potential victims of trafficking. 

They were also tested for knowledge on the subject, and how confident they were in dealing with it. 

About 13% of participants reported previous contact with a patient they suspected or knew was involved in human trafficking.

More than 20% of maternity professionals reported this.

Unfortunately, about 87% said they lacked knowledge of what to ask to identify potential victims

More than 78% reported that they lacked training to assist trafficked people.

More than 90% of health professionals were unaware if the scale of human trafficking in the United Kingdom. 

And more than 76% were unaware that calling the police could put patients in more danger.

The bottom line is this: NHS professionals (and likely professionals all over the world) are in contact with potential victims of human trafficking, but don't necessarily know how best to respond. We need to teach them. (1:30)

 Flibanserin


What's making news this week is that the FDA officially approved Flibanserin. Get ready for Addyi (as it will be called) to hit the market.

You should remember Flibanserin from our episode entirely on that drug.

It's sometimes - we would say mistakenly - called the female Viagra. As that episode tried to make clear, the drugs are nothing alike. 

Controversy still reigns. Many people are arguing that the drug should not have been approved, and here's a quick summary of their arguments. 

The drug only appears to work in fewer than 15% of those who take it. And, when it does, women see, on average, about half an additionally sexually satisfying episode per month. 

And there are significant side-effects. One in five women will have at least one. It comes with a "black box warning" which is the highest level of alert the FDA does. The warnings include low blood pressure and a real risk of fainting.

The problems get worse if patients who take the drug also drink alcohol or use hormonal contraceptives. Lots of women use birth control! Especially women who want to have sex! Lots drink alcohol too. Finally, the women who were studied were only those who weren't on any sleep aids or anti-anxiety drugs. Those aren't uncommon either. (2:38)

The alcohol bit is especially concerning. The data provided to the FDA about Flibanserin's alcohol interaction came from a study involving only 25 participants. And, of those 25 participants, only 2 were women. The study confirmed that alcohol can boost the real risk of bad side-effects. 

But the fact that in a study for women who have low sex-drive, 92% of the people studied were men is WEIRD. Women metabolize alcohol differently than men. 

 Fibransin Regulations


Because of all this, the drug comes with a specific set of rules under the risk evaluation and mitigation strategy, or REMS program. 

The rules require that doctors who want to prescribe the drug register, and undergo a training module on its uses and precautions. 

Pharmacies also have to be certified to dispense the medication, on behalf of approved prescribes.

On the other hand, advocates argue that given the millions of women who suffer from a low libido, many still might find a benefit here. Even one additional satisfying sexual encounter per month shouldn't be sneered at. 

Some argue that there are many drugs for men with low sexual desire, but that's not true. Viagra, and drugs like it, don't improve sexual desire. They improve a physical issue when the desire is already there. Comparisons to Viagra don't help
(3:53)

 Credits


Health Care Triage is supported in part by viewers like you through Patreon.com a service that allows you to support the show through a monthly donation. We especially like to thank our honorary research associates: Cameron Alexander and Qadeem SalehMohamed. Thanks Cameron and Qadeem!

If you'd like to support the show more information can be found at Patreon.com/healthcaretriage.