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The city of Vancouver, Canada has been under a public health emergency driven by the unregulated toxic drug supply since April 2016. Interventions implemented during the crisis have often been driven by electoral interests, and in turn, temporary in nature. Sunsetting of these pilot interventions has the potential to cause acute instability in people's lives. We examine an abrupt government crackdown on revenue sharing between pharmacies and their patients in early 2024. Our qualitative semi-structured interviews (n = 12) explored a government crackdown on revenue sharing between patients and pharmacies, with a focus on the impacts on people directly affected. Our thematic analysis focused on general impacts, trust in healthcare and social services, and the challenges people faced after a sudden loss of resources. Our findings indicate that participants felt an overall loss of trust in the healthcare system, and faced potential exposure to violence, including due to increased engagement with the unregulated drug market after a substantial loss of income. Participants pointed to drug user-led groups and relationships with their pharmacists as stabilizing forces in their lives during this time period. This study explores the perspectives of people impacted by one unilateral policy shift, and traces some public health cautions that should be considered during time-limited or sudden changes to public health interventions and policies, particularly health-related programming amid a toxic drug supply emergency. Findings also point to possible protective factors, such as scaling up peer-to-peer groups, during periods when interventions come to an abrupt end.

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This Viewpoint discusses the enforcement action that the FDA is taking to correct decades of regulatory failure regarding direct-to-consumer pharmaceutical advertising.

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In response to the growing pro-Palestine solidarity movement following October 7, Western State authorities have adopted a strategy of political warfare to suppress dissent. Utilising a multidisciplinary approach, the paper analyses legal documents, media reports, and firsthand accounts to identify patterns of repression. State authorities have used smear campaigns, political policing, and lawfare to punish those who express solidarity with Palestinian rights, stifling and chilling the rights to free speech and assembly - a stepping stone toward the erosion of civil liberties and democratic values. Our analysis suggests that using intimidation, administrative harassment, and State coercion to stigmatise, censor, and criminalise dissenters, Western States may have institutionalised punitive torture. The suppression of pro-Palestinian voices in liberal democracies can be hypothesised as a reflection of the colonial hierarchy embedded in the creation and maintenance of the structural oppression against Palestinians across historic Palestine and beyond, merely replicated to suppress solidarity.

Determine whether there was an increased incidence of hit-by-pitch events in Major League Baseball (MLB) following the decision to enforce the foreign substance ban for pitchers during the 2021 season. Descriptive Epidemiological Study. Major League Baseball hit-by-pitch data from publicly available Web sites ( mlb.com and fangraphs.com ). Major League Baseball players during the 2017, 2018, 2019, 2021, and 2022 seasons. Hit-by-pitch exposure data by season and individual pitch type. Hit-by-pitch incidence rates from the 2017 to 2019 seasons (preenforcement) and the 2021 to 2022 seasons (postenforcement). Rates were compared with incidence rate ratios (IRRs). Hit-by-pitch incidence rate increased from 2.66 to 3.06 per 1000 total pitches (IRR, 1.15 [95% CI, 1.08-1.23]; P < 0.0001) following the enforcement. Incidence rates for 2017, 2018, and 2019 did not differ from each other individually, but incidence rate of all 3 seasons individually were significantly lower than that for the 2021 season ( P < 0.005). Sliders were 29% more likely to hit batters following the enforcement ( P = 0.0015). Major League Baseball batters were hit by pitches at a significantly higher rate following the league's crackdown on foreign substance use for the 2021 seasons compared with the same time of year during the 2017 to 2019 seasons. This was followed by a slight regression toward preenforcement levels during the 2022 season.

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