David Juurlink
@davidjuurlink.bsky.social
Internal Medicine, Clinical Pharmacology & Toxicology, and drug safety research at the University of Toronto. Inexplicably fortunate husband.
Canadian MDs are relying less on opioids. That is a good thing. New commentary from me in @cmaj.ca
www.cmaj.ca/content/197/...
www.cmaj.ca/content/197/...
Opioid prescribing in Canada: a continued retreat from God’s own medicine
[See related article at www.cmaj.ca/lookup/doi/10.1503/cmaj.250670][1]
Key points
In this issue’s research article, Rebić and colleagues show that rates of opioid prescribing across 6 Canadian provin...
www.cmaj.ca
October 27, 2025 at 6:27 PM
Canadian MDs are relying less on opioids. That is a good thing. New commentary from me in @cmaj.ca
www.cmaj.ca/content/197/...
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.
October 9, 2025 at 10:50 PM
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…
- drug interactions
- NSAID allergy
- within-class safety differences
- complex polypharmacy
- pharmacogenetics
- SGLT2 inhibitors
- buprenorphine
Register here: eventbrite.com/e/the-drugs-we…
September 16, 2025 at 3:09 PM
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…
- drug interactions
- NSAID allergy
- within-class safety differences
- complex polypharmacy
- pharmacogenetics
- SGLT2 inhibitors
- buprenorphine
Register here: eventbrite.com/e/the-drugs-we…
Reposted by David Juurlink
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
Funded Research - PSI Foundation
List of projects funded by PSI Foundation.
www.psifoundation.org
August 28, 2025 at 6:03 PM
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
- Relevant topics
- Great speakers (but also me)
- You will be fed
- You will get CE credits
Register here: tinyurl.com/mr447y5n
August 13, 2025 at 12:05 AM
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
- 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
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
May 30, 2025 at 5:32 PM
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
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
Reposted by David Juurlink
🚨 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
💊 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
Dr. David Juurlink: Relieving pain in the era of fentanyl
YouTube video by Therapeutics Initiative
www.youtube.com
May 16, 2025 at 4:58 PM
🚨 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
💊 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
May 8, 2025 at 12:56 AM
Every time I hear someone mention tramadol
Let's talk about using carbapenem antibiotics in patients with valproic acid (VPA) poisoning
/1🧵
/1🧵
April 10, 2025 at 6:50 PM
Let's talk about using carbapenem antibiotics in patients with valproic acid (VPA) poisoning
/1🧵
/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.
April 6, 2025 at 6:52 PM
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
I feel like I've not used bicarbonate for hyperkalemia in an extraordinarily long while already, but who is brave enough to hold off from calcium in the face of ECG changes?
#medsky #nephsky
medicineminute.substack.com/p/the-end-to...
#medsky #nephsky
medicineminute.substack.com/p/the-end-to...
The End to Bicarbonate and Calcium for Hyperkalemia?
No, not necessarily – but the evidence in support is severely lacking.
medicineminute.substack.com
March 18, 2025 at 4:46 AM
Not me
Reposted by David Juurlink
It takes a unique kind of genius to fuck up the US-Canada relationship.
March 6, 2025 at 9:41 PM
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....
Identification and Treatment of Alcohol Use Disorder | NEJM
Several clinical and biologic methods are available to identify alcohol use disorder.
Pharmacologic treatment is available, but it is underused.
www.nejm.org
January 15, 2025 at 11:24 PM
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
January 1, 2025 at 10:57 AM
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
They don’t
December 29, 2024 at 2:39 PM
For those contemplating a detox or cleanse in the new year, here’s a toxicologist’s explanation of how they work:
They don’t
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.
December 28, 2024 at 1:13 AM
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
December 25, 2024 at 3:37 AM
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?
December 23, 2024 at 7:18 PM
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
December 2, 2024 at 12:02 AM
If only OxyContin worked as well as people seem to think
Reposted by David Juurlink
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
- 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
November 28, 2024 at 11:32 PM
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
- 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.
November 26, 2024 at 3:24 PM
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
Resurgence of #scurvy highlights issues of food insecurity in Canada's rural and remote areas.
www.ctvnews.ca/health/scurv... via @ctvnews-rss.bsky.social @avisfavaro.bsky.social #sdoh
www.ctvnews.ca/health/scurv... via @ctvnews-rss.bsky.social @avisfavaro.bsky.social #sdoh
Scurvy resurgence highlights issues of food insecurity in Canada's rural and remote areas
A disease often thought to only affect 18th century sailors is reemerging in Canada.
www.ctvnews.ca
November 24, 2024 at 7:31 PM
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.
November 21, 2024 at 11:31 AM
Yes, yes, I will post more here eventually. Until then, please remember that tramadol is garbage.