Latest / Morning Medical with Dr. Chow / Quebec Funding, Drug Trends, and New Weight-Loss Pill Foundayo

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Quebec Funding, Drug Trends, and New Weight-Loss Pill Foundayo · Morning Medical with Dr. Chow

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  Welcome to another episode of Morning Medical with Dr.
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  Chow.
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  I'm your host, Chi-Ming Chow.
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  Today, we're diving into some fascinating developments in the world of health and
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  medicine.
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  We'll explore new funding initiatives in Quebec, alarming trends in drug use across the
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  United States, potential treatments for long COVID, and an innovative weight-loss pill.
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  Let's start with our first story about a new initiative in Quebec aimed at helping
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  English-speaking patients navigate the province's health system.
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  In Quebec, a new funding initiative has been announced to help English-speaking patients
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  better navigate the provincial health system.
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  This development involves the hiring of eleven new patient navigators who will act as a bridge
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  between English-speaking patients and the predominantly French-speaking health services.
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  These navigators are being deployed beyond Quebec City to reach nine different regions,
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  ensuring more comprehensive coverage and support for patients in need.
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  The initiative recognizes the challenges that English-speaking patients often face when
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  accessing healthcare services in a predominantly French-speaking region.
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  By employing these navigators, the Quebec government aims to improve communication and
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  understanding, ensuring that language barriers do not impede access to necessary medical care.
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  These navigators are expected to assist patients in understanding their treatment
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  plans, scheduling appointments, and navigating the complexities of the healthcare system.
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  This move comes as part of a broader effort to make the health system more inclusive and
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  accessible to all residents, regardless of their linguistic background.
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  By expanding the program to multiple regions, the government hopes to see a significant
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  improvement in patient satisfaction and health outcomes for the English-speaking community.
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  It also addresses some of the longstanding concerns about equitable access to healthcare
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  services in Quebec.
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  Health and government officials in the United States are raising alarms about a potentially
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  deadly substance infiltrating the illegal drug market.
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  The Centers for Disease Control and Prevention, along with the White House Office of National
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  Drug Control Policy, have issued a health advisory concerning reports of medetomidine
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  being found in fentanyl.
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  Medetomidine, also known as "rhino tranq" or "dex," is a veterinary sedative that can cause
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  severe and prolonged sedation.
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  This substance, classified as an alpha-2 agonist, affects the nervous system in a manner
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  similar to other veterinary sedatives, such as xylazine, and can lead to life-threatening
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  withdrawal symptoms.
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  The advisory is based on data from various sources, including forensic drug testing,
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  wastewater analysis, clinical case reports, and overdose investigations.
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  In recent years, the presence of medetomidine in drug samples has skyrocketed, with 247
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  incidences reported in 2023, escalating to over eight thousand in 2025.
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  Notably, about ninety-eight percent of these medetomidine-positive samples also contained
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  fentanyl, highlighting the dangerous combination of these substances.
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  This drug combination has been detected in at least eighteen states and Washington, D.C.,
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  with a concentration in the Northeast and Midwest regions of the country.
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  Dr.
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  Adam Scioli, the chief medical officer of Caron Treatment Centers in Pennsylvania, described
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  this development as a "concerning and rapidly evolving" issue within the illicit opioid
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  supply.
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  The co-occurrence of medetomidine with fentanyl complicates the presentation of overdoses and
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  the management of withdrawal symptoms, increasing the clinical unpredictability and
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  severity of cases.
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  One of the major challenges highlighted by the advisory is that medetomidine is not typically
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  detected on standard toxicology screens, which raises the risk of under-recognition unless
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  there is a high index of clinical suspicion.
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  Furthermore, the usual opioid overdose reversal agent, naloxone, is ineffective against the
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  sedative effects of medetomidine.
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  While naloxone remains crucial for reversing the respiratory depression caused by opioids,
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  it does not address the sedation induced by medetomidine.
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  The initial effects of medetomidine include deep sedation or decreased consciousness, slow
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  heart rate, low blood pressure, and respiratory depression, especially when combined with
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  fentanyl and other opioids.
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  Withdrawal symptoms can begin a few hours after ingestion, peaking between eighteen to
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  thirty-six hours.
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  These symptoms start with rising blood pressure, increased heart rate, agitation, and
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  nausea or vomiting, and can escalate to severe hypertension, altered mental status, and
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  potentially cardiac or neurological complications.
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  Severe cases often require intensive care in a hospital setting.
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  In May 2024, a notable incident in Chicago linked medetomidine in the illicit opioid
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  supply to a cluster of overdoses, with over one hundred seventy-five cases reported.
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  At least sixteen people were hospitalized, and one person died.
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  Despite its alarming spread, surveillance systems face limitations, such as small sample
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  sizes that may not represent all areas, and the possibility of underestimation due to the rapid
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  metabolism of medetomidine in the body.
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  Experts emphasize the need for careful assessment that goes beyond standard opioid
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  toxicity models, as well as the importance of close coordination with toxicology, emergency
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  medicine, and public health partners.
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  Dr.
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  Scioli pointed out that the evolving drug supply strains traditional opioid-focused
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  frameworks and demands increased clinical vigilance.
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  From a treatment perspective, this situation underscores the necessity for addiction care to
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  be adaptive, medically sophisticated, and focused on long-term recovery, rather than
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  solely on acute stabilization.
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  In recent developments, a study has found that fluvoxamine, a commonly used antidepressant,
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  may significantly help adults suffering from long COVID.
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  This low-cost and widely available medication has shown promise in improving fatigue and
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  quality of life among those affected by this condition.
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  The research was co-led by scientists from McMaster University, along with colleagues from
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  Brazil and the United States, and involved a clinical trial with three hundred ninety-nine
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  adults who experienced persistent fatigue ninety or more days after contracting
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  SARS-CoV-2.
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  The findings of the study revealed that fluvoxamine was significantly more effective
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  than a placebo in reducing fatigue at day sixty of the trial.
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  It also improved quality-of-life scores with a high posterior probability.
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  Edward Mills, co-principal investigator of the trial and a professor at McMaster's department
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  of health research methods, evidence, and impact, described the research as an important
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  advancement for patients in need of evidence-based options.
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  He emphasized that fluvoxamine's consistent and meaningful benefits, along with its established
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  use and understanding, make it a strong candidate for clinical application.
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  The sixty-day clinical trial demonstrated a ninety-nine percent probability that
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  fluvoxamine outperformed a placebo in reducing fatigue severity and enhancing quality of life
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  in people suffering from long COVID.
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  The study highlights the debilitating nature of fatigue associated with long COVID, which Roger
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  McIntyre, a professor of psychiatry, pharmacology, and toxicology at the University
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  of Toronto, described as "almost indescribable" and "debilitating."
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  Fluvoxamine is primarily known as a selective serotonin reuptake inhibitor, or SSRI, and is
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  often used to treat depression, bulimia, and obsessive-compulsive disorder.
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  However, its potential benefits for long COVID are linked to its anti-inflammatory properties,
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  which target the immune inflammatory system.
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  This dual action, as McIntyre pointed out, could be why patients report less fatigue,
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  similar to the relief felt when recovering from a common cold.
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  Despite these promising results, experts like Raymond Lam, a psychiatry professor at the
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  University of British Columbia, caution that more research is needed to differentiate the
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  effects of fluvoxamine on long COVID from its potential impact on depression.
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  He noted that depression can often be a symptom of long COVID, making it challenging to
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  determine if fluvoxamine is addressing fatigue directly or alleviating depressive symptoms
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  that accompany fatigue.
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  In the context of long COVID treatment, fluvoxamine's affordability and accessibility
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  make it a viable option, with insurance coverage often ranging from fifty to one
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  hundred percent of the drug cost for many Canadians.
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  Roger McIntyre does not foresee a supply and demand issue for fluvoxamine, as the medical
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  community typically requires replication of findings before widespread adoption of a
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  treatment.
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  Nonetheless, off-label use of medications is common in medicine, and there is no reason
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  fluvoxamine cannot be considered for long COVID treatment even without official approval for
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  this specific purpose.
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  Next up, we have some exciting news in the world of weight management.
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  A new weight-loss pill, Foundayo, has been approved by the Food and Drug Administration,
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  marking a significant development for those seeking to manage their weight more
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  effectively.
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  This pill is a type of glucagon-like peptide-1, or GLP-1, medication, and it's designed to
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  offer greater flexibility than some of its predecessors.
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  Developed by Eli Lilly, Foundayo is unique because it can be taken at any time of the day,
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  without the need for food or water restrictions.
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  This feature offers a distinct advantage for individuals looking for a more adaptable
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  solution to weight management.
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  Clinical trials have shown promising results, with participants losing an average of
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  twenty-seven point three pounds, or twelve point four percent of their body weight, when
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  taking the highest dose of the medication.
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  The approval of Foundayo marks Eli Lilly's second obesity medicine to receive the green
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  light from the Food and Drug Administration, following Zepbound, also known as tirzepatide.
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  Foundayo is intended for adults who are overweight or obese and have associated
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  weight-related health issues.
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  It's important to note that, for optimal results, the medication should be used in
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  conjunction with a reduced-calorie diet and increased physical activity.
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  In addition to its primary use for weight loss, Foundayo is being studied for potential
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  applications in treating other conditions such as type two diabetes, obstructive sleep apnea,
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  osteoarthritis, and hypertension, among others.
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  This broad spectrum of potential uses makes it a versatile option in the realm of medical
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  treatments.
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  Deborah Horn, director of the Center for Obesity Medicine at McGovern Medical School,
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  highlighted the importance of having new treatment options available, noting that fewer
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  than one in ten people who could benefit from a GLP-1 medication are currently taking one.
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  Foundayo's once-daily administration provides an accessible and flexible option for many
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  individuals.
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  However, it's essential to be aware of potential side effects.
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  Like other GLP-1 drugs, Foundayo can cause gastrointestinal issues such as nausea,
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  diarrhea, and stomach pain, among others.
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  There are also warnings regarding possible thyroid tumors, including thyroid cancer, which
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  patients need to monitor carefully.
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  As with any medication, it's crucial to consult with a healthcare provider before starting
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  treatment with Foundayo, especially to discuss any other medications being taken or any family
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  health history that might increase the risk of complications.
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  Eli Lilly advises against combining Foundayo with other GLP-1 medications and has not yet
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  determined its safety for children.
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  The introduction of Foundayo reflects a growing trend towards more convenient and flexible
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  medical solutions, particularly in the field of weight management.
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  With its approval, we hope to see improvements in accessibility and outcomes for those living
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  with obesity and related complications.
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  That's all for today's episode of Morning Medical with Dr.
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  Chow.
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  Thank you for tuning in, and I hope you'll join me again tomorrow for more updates on the
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  latest in health and medicine.
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  Until then, stay informed and take care.