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Drug-Induced Psychosis and Neurological Effects Following Nitrous Oxide Misuse

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Drug-Induced Psychosis and Neurological Effects Following Nitrous Oxide Misuse December 2019: 61:10 Pages 369–408 IN THIS ISSUE The influence of breast density on breast cancer diagnosis Canada’s revolutionary new food guide The age of mushrooms is upon us Drug-induced psychosis and neurological effects following nitrous oxide misuse bcmj.org BC MEDICAL JOURNAL VOL. 61 NO. 10 | DECEMBER 2019 369 December 2019 Volume 61 | No. 10 Pages 369–408 Psychedelic medications, including mushrooms, are on the verge of becoming mainstream practice. Article begins on page 390. The BCMJ is published by Doctors of BC. The 372 Editorials Clinical journal provides peer-reviewed clinical and review articles written primarily by BC physicians, for My selfish Christmas wish, BC physicians, along with debate on medicine 376 The influence of breast density and medical politics in editorials, letters, and David R. Richardson, MD essays; BC medical news; career and CME listings; New research on hormones and on breast cancer diagnosis: physician profiles; and regular columns. breast cancer: The headlines A study of participants in the Print: The BCMJ is distributed monthly, BC Cancer Breast Screening other than in January and August. don’t convey what women need Web: Each issue is available at www.bcmj.org. to know, Caitlin Dunne, MD, Program, Colin Mar, MD, Janette Subscribe to print: Email [email protected]. Timothy Rowe, MBBS Sam, MRT, Colleen E. McGahan, Single issue: $8.00 MSc, Kimberly DeVries, MSc, Canada per year: $60.00 375 President’s Comment Foreign (surface mail): $75.00 Andrew J. Coldman, PhD Subscribe to notifications: Strength in numbers: The power of To receive the table of contents by email, visit 385 Drug-induced psychosis and www.bcmj.org and click on “Free e-subscription.” cooperation, Kathleen Ross, MD neurological effects following Prospective authors: Consult the “Guidelines for Authors” at www.bcmj.org nitrous oxide misuse: A case for submission requirements. report, Matthew Mo Kin Kwok, MD, Jane de Lemos, PharmD, Mazen Sharaf, BSc Pharm ON THE coVER Editor Managing editor Proofreader Printing Drug-induced psychosis and David R. Richardson, MD Jay Draper Ruth Wilson Mitchell Press neurological effects following Editorial Board Associate editor Web and social media Advertising nitrous oxide misuse Jeevyn Chahal, MD Joanne Jablkowski coordinator Kashmira Suraliwalla Nitrous oxide is becoming a popular David B. Chapman, MBChB Amy Haagsma 604 638-2815 Senior editorial and recreational drug all over the world. Brian Day, MB or [email protected] production coordinator Cover concept and Caitlin Dunne, MD Users can easily obtain it by puncturing Kashmira Suraliwalla art direction, Jerry Wong, ISSN: 0007-0556 David J. Esler, MD small cannisters used in whipped Peaceful Warrior Arts Established 1959 cream dispensers. Our case study on Yvonne Sin, MD Copy editor Cynthia Verchere, MD Design and production drug-induced psychosis following Barbara Tomlin Laura Redmond, Scout Creative its misuse begins on page 385. 370 BC MEDICAL JOURNAL VOL. 61 NO. 10 | DECEMBER 2019 n Celebrating a family medicine milestone and 1969 trailblazers n Naloxone kits encouraged for those who smoke or snort n New international exercise guidelines for cancer survivors n Patients with mood, anxiety disorders share abnormalities in brain’s control circit n New DNA “clock” could help measure development in young children 399 Obituaries Dr Donald Wilson Lang Dr Pascualito Aquino Seminiano Mr James ( Jim) Edward Gilmore 401 GPSC The current role of genomics/genetics in medicine and possible future applications and implications. Article begins PSP supports for quality on page 388. improvement activities: Refreshed compensation policy, simplified 388 BCMD2B 394 BC Centre for Disease Control certification process, Alana Godin The role of genetics in medicine: Shared decision making and 402 Council on Health Promotion A future of precision medicine, breastfeeding: Supporting families’ Yue Bo Yang, BSc informed choices, Sarah Munro, Canada’s revolutionary new food PhD, Cynthia Buckett, MBA, guide, Michael Lyon, MD 390 Premise Julie Sou, MSc, Nick Bansback, 403 WorkSafeBC The age of mushrooms is upon us PhD, Henry Lau, RD in medicine, Mark Elliott, MD Workplace exposure to rabies, 395 News Geetha Raghukumar, MBBS, n 392 SSC Book review: Essential Caregiving Olivia Sampson, MD Physician engagement gains Guide: How to optimize the extended care your loved one needs 404 CME Calendar traction across BC, Sam n BC’s top family physician of 2019 Bugis, MD, Cindy Myles n Hear from patients: New GPSC 405 Classifieds Patient Experience Tool n Mushroom poisonings on the rise in BC 407 Club MD Environmental impact Postage paid at Vancouver, BC. Canadian Publications Mail, Product Sales Agreement #40841036. Return undeliverable copies The BCMJ seeks to minimize its negative impact on the to BC Medical Journal, 115–1665 West Broadway, Vancouver, BC V6J 5A4; tel: 604 638-2815; email: [email protected]. environment by: Advertisements and enclosures carry no endorsement of Doctors of BC or BCMJ. • Supporting members who wish to read online with an e-subscription to bcmj.org © British Columbia Medical Journal, 2019. All rights reserved. No part of this journal may be reproduced, stored in a retrieval system, or trans- • Avoiding bag use, and using certified-compostable plant-based mitted in any form or by any other means—electronic, mechanical, photocopying, recording, or otherwise—without prior permission in bags when needed writing from the British Columbia Medical Journal. To seek permission to use BCMJ material in any form for any purpose, send an email to • Working with Mitchell Press, ranked third in North America for [email protected] or call 604 638-2815. sustainability by canopy.org Statements and opinions expressed in the BCMJ reflect the opinions of the authors and not necessarily those of Doctors of BC or the • Printing with vegetable-based inks institutions they may be associated with. Doctors of BC does not assume responsibility or liability for damages arising from errors or omis- • Using FSC-certified paper sions, or from the use of information or advice contained in the BCMJ. • Printing locally in British Columbia The BCMJ reserves the right to refuse advertising. BC MEDICAL JOURNAL VOL. 61 NO. 10 | DECEMBER 2019 371 EDITORIALS My selfish Christmas wish hristmas is a magical time for a child. reflected through a gift well chosen warms the Our journal’s circulation is roughly 14 000, Does anyone else remember the long- heart. I would rather watch a loved one’s reaction which includes practising and retired physicians, anticipated arrival of the Sears cata- to opening a gift than open one myself. Being students, and residents. I have heard that every Clogue? My brothers and I would pour over the with family, sharing food and drink during this person has at least one good novel in them. I pages circling desired toys for my parents’ later time, is about as perfect as it gets. would prefer to think that each of you has at perusal. Unable to sleep on Christmas morning, least one good essay, opinion piece, scientific we would lie in bed tortured by the slow move- “All I want for Christmas is you!” study, theme issue, letter, or back-page feature ment of time until the anointed hour arrived floating around in your consciousness. So, for and we were free to empty stockings and open As another Yuletide approaches, I find my- Christmas, that is what I want. Write them presents. My parents seldom bought any of self in an interesting position. My children are down, type them up, finish that last paragraph, the circled items, explaining they looked cheap grown and my parents have passed on. Grand- and send them in. Don’t be intimidated. Our and wouldn’t last. I am sure there was a lesson children are awesome and I love spoiling them journal is written by the physicians of BC for in there somewhere. Regardless, I was blessed on Christmas; however, I find myself restless the physicians of BC, so that means you. Please to grow up in a home that could afford all the and longing for the good old days. Therefore, I do your part to make this aging editor’s dream a trappings of the holidays. have decided that this Christmas should once reality this Christmas. You all have something Over the years Christmas has become less again be all about me and my wants (don’t valuable to share and I want to read it. about receiving and more about giving. The focus judge me). So, what does an editor desire for Happy Holidays. n shifted to shopping for my spouse and children. the year ahead? To paraphrase Mariah Carey, —David Richardson, MD This can be stressful, but the joy and happiness “All I want for Christmas is you!” 2,300 BC pedestrians are injured in car crashes every year. Doctors of BC has launched a safety campaign to help make the province’s roadways a safer place for pedestrians. BE SEEN KEEP YOUR USE EYE HEAD UP CROSSWALKS CONTACT IS KEY Let British Columbians know that the province’s physicians care about their safety by hanging a armbands for your patients. To get posters and armbands for your practice, email: [email protected] 372 BC MEDICAL JOURNAL VOL. 61 NO. 10 | DECEMBER 2019 EDITORIALS New research on hormones and breast cancer: The headlines don’t convey what women need to know esearchers in the UK recently pub- As doctors, we are continually challenged to estrogen, normally produced by the ovaries, and lished the results of a worldwide analy- interpret scientific research and then distill the the body’s struggle to re-equilibrate. Although sis on menopausal hormone therapy relevant parts into language that our patients they are not life threatening, these complaints Rand breast cancer risk in the Lancet.1 The anal- understand.
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