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Wednesday, February 27, 2013

C Everett Koop's Fight Against Big Tobacco

The battle against big tobacco has been going on for over thirty years, perhaps being one of the biggest health battles of the 20th century. It is no secret that billions of dollars have been amassed by tobacco companies at the costs of millions of lives. The restrictions present today are the result of tireless effort by a handful of individuals. One of the biggest advocates of tobacco sanctions and restrictions was the former U.S. Surgeon General C. Everett Koop. Sadly, he died at the age of 96; one of his biggest accomplishments was issuing the first government warning about secondhand tobacco smoke, Bloomberg reports.

During Koop’s eight years as Surgeon General he focused more on tobacco than on any other issue. Accusing the tobacco industry of deceptive advertising, and issued a landmark Surgeon General’s report in 1986 putting forth the first government warning tying secondhand smoke to lung cancer. Koop’s goal was a smoke-free society by 2000 and laws restricting smoking in workplaces and public spaces, which he was able to accomplish before the time of his passing.

While Koop was in office smoking rates dropped from 38 percent to 27 percent, according to The Washington Post. 

The Surgeon General website notes, “Although the Public Health Service had been calling attention to the danger of tobacco smoking since the 1964 Surgeon General’s report on smoking and health, its anti-tobacco campaign was relatively low-key until invigorated by Koop’s persistent efforts to speak out on the subject.”
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Monday, February 25, 2013

Talk to Your Children About Drugs

Parents who speak to their children about the dangers of drugs and alcohol greatly increase the chances that their children will abstain. A new study conducted recently found that middle school students were less likely to think drugs were bad if their parents shared stories of their own past substance use. However, parents who simply warn their children not to use drugs were more likely to stay away, ABC News reports.

Researchers at the University of Illinois at Urbana-Champaign observed 561 middle school students. If parents set rules against drugs and told them about people’s misfortune as a result of using drugs, their children were less interested in using drugs and would stay away.

“Parents should really hit on what are the bad things that can happen, health-wise, from using drugs,” researcher Jennifer Kam told ABC News. ”They should really clearly tell kids that they disapprove of them using drugs. Also, give them strategies to avoid use or decline use in a way that makes them look cool.” She advised parents against lying. “I wouldn’t volunteer the information, but if a child asks, and a parent lies, it could impact the relationship later on,” she noted.  

The study appears in the journal Human Communication Research.
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Wednesday, February 20, 2013

Drug Overdoses On the Rise

Every year thousands of people lose their lives to drug abuse and sadly it seems that with each year that passes more lives are being lost than the year before. Despite education programs and thousands of 12-step meetings, people continue to overdose on drugs - the leading cause, as one might imagine, being prescription drugs. In 2010 a staggering 38,329 people died from drug overdoses, with more than 22,000 resulting from prescription drug use. It is the 11th consecutive year that researchers have seen an increase in overdoses in the United States, the Los Angeles Times reports.

57 percent of overdose deaths involved prescription drugs, with three-quarters due to painkillers like OxyContin and Percocet, according to the National Center for Health Statistics. More than 74 percent of prescription drug related deaths were accidental and 17 percent were considered to be suicides, the article points out.

In many cases, the overdoses came about because of the mixture of opioids and benzodiazepines such as Valium, Xanax or Ativan. In fact, 77 percent of overdoses involved that deadly cocktail. They were also involved in 65 percent of overdoses with antiepileptic or anti-Parkinsonian drugs, 47 percent of overdoses involved antidepressants, and 56 percent of overdoses occurred with fever-reducing and anti-inflammatory medications.  

The findings were reported this week in the Journal of the American Medical Association.
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Monday, February 18, 2013

Healthy Enabling is Crucial to Successful Recoveries

There is rarely a family that does not encounter addiction in one way or another. Learning how to support a loved one battling with addiction is often times harder than learning how to live life without drugs or alcohol. There is no formula when it comes to what constitutes healthy support and in many cases loved ones of an addict often aid them in their own self destruction when it seems like they are helping.

What has become known as "enabling" is misunderstood more times than not, a lot of the time family members of those suffering from the disease of addiction do not understand what it means to enable. There is no question; family is of the up most importance to a successful recovery. However, the line between help and harm can be confusing; if you have a loved one on the road to recovery it is important to be able to distinguish the former from the latter...

Kimberly Kirby, PhD is the Director of the Parent’s Translational Research Center - Senior Scientist of the Treatment Research Institute. Please take a moment to read her thoughts on this crucial subject. Understanding when one is enabling a loved one could very well save them from veering off course,

"The term “enabling” is commonplace in the field of addiction. It is used within support group settings, in treatment programs and throughout the professional literature about addiction and the family. I consider it one of the most frequently misunderstood terms in our field. In fact, as my research about family caregivers of people with substance use disorders has evolved, I have come to loathe the term “enabling.” Here is why.

There is a great deal of misinterpretation about what qualifies as behavior that is “enabling.” Webster’s definition of the term includes: “a) to provide with the means or opportunity; and b) to make possible, practical or easy.” Wikipedia notes that enabling also is used “to signify dysfunctional approaches that are intended to help but in fact may perpetuate a problem….”

Examples include taking responsibility, blaming others or making accommodations for a person’s harmful conduct, so that the person is shielded from the harm it may do and the pressure to change.

Using these definitions, doing your son’s laundry might be considered enabling, as it makes it easier for him and takes responsibility for the chore away from him. In actuality, it may or may not be enabling – depending on the context. If you do this chore to make things easier for your son because he attended a self-help meeting – you probably are supporting recovery – not enabling self-destructive behaviors. On the other hand, if you are doing your son’s laundry because he was drunk all weekend and will be embarrassed to go to school or work in unlaundered clothes, then you are enabling him to continue engaging in self-destructive behavior. You are helping him avoid the negative consequences of drinking.

I find family members often are confused over the issue of what constitutes enabling. Some have ardently been told that any support offered to a recovering child or spouse can be considered enabling. The philosophy seems to be that the person needs to learn to “fend for themselves” or “live life on life’s terms.” This is difficult to argue. We all need to learn the necessary skills to survive and thrive in our environments. Especially as parents, it is our responsibility to foster this in our children. But it does not mean that we cannot help our loved ones in productive ways.

Recovery, especially early recovery, is hard work. Offering to support the intense effort of this work can be helpful. For example – if a loved one does not have access to a car, it is supportive to offer to drive her to AA meetings, or soccer practice or any other recovery-supporting activity.

Some say that the addicted person must take responsibility for coordinating his or her own travel – and indeed – this can be a good goal. But offering to help at first or occasionally does not enable the person to escape the negative consequences of addiction – and it can help to support recovery.

It is loaded with negative and judgmental connotations that are misplaced.

Worse yet, enabling is sometimes described as “dysfunctional,” which can lead family members to the conclusion they are dysfunctional and have let their loved one down. The important distinction that is sometimes missed is that it is the behavior that is dysfunctional, not the person. The vast majority of parents that I have met have only done what most parents do; that is try their best to help their child. They engage in the same behaviors as other parents. It is just that they find themselves in a strange and difficult situation where behaviors that normally are helpful do not function that way.

I believe that the term enabling causes more harm than good. I would like to get rid of the term altogether.

Rather than labeling a family member’s behavior as “enabling,” focus on the consequences of the addicted person’s behavior. Ask yourself – by doing this, do I allow him or her to avoid a negative consequence of the drinking or drug use? If the answer is yes, resist the urge to intervene. It is important that the person experience the negative consequences that substance abuse renders. Also ask yourself – by doing this, am I encouraging efforts he or she has made at recovery? If the answer is yes, go for it! It is helpful to recognize and show signs of support and appreciation for the hard work that an addict undertakes to sustain recovery.

We must remember that addiction is a disease and recovery requires ongoing maintenance. This is a lot of work – and supporting the WORK of recovery can be a loving thing to do."

Wednesday, February 13, 2013

Synthetic Marijuana And Acute Kidney Damage

As time passes and more people consume synthetic marijuana, researchers are seeing just how damaging these drugs are to the human body. A new report found links between acute kidney injury and synthetic marijuana. Researchers at the University of Alabama at Birmingham say doctors who have patients with acute kidney damage should consider the possibility of synthetic marijuana use.

The researchers describe four cases of previously healthy young men in the Clinical Journal of the American Society of Nephrology, whose acute kidney injury was associated with synthetic marijuana, such as Spice and K2. The four went to the hospital with symptoms of nausea, vomiting and abdominal pain after using synthetic marijuana, according to Science Daily.

While the cases were serious, all four men recovered kidney function, and none required dialysis, the article notes. 

Synthetic marijuana generally includes several additives, and these ingredients could have caused the kidney injury, rather than the synthetic marijuana itself, said study co-author Gaurav Jain, MD. “There is very little information regarding the ingredients in synthetic cannabinoids that are sold on the streets, although it is known that additional compounds are added to the preparations,” Dr. Jain noted in a news release.

Although these four patients did not sustain permanent damage, synthetic marijuana has the potential to cause lasting damage, Dr. Jain observed. “If they don’t get to a physician in time, the damage to their kidneys could be permanent, and they could end up on dialysis,” he said.

Doctors should ask their patients about the use of synthetic drugs when evaluating patients with acute kidney injury, especially when the origin of the injury is unknown, and the patient has a negative urine drug test, researchers suggest.
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Monday, February 11, 2013

Americans Consume the Majority of Pain Medication

Americans make up 5 percent of the world’s population yet consume about 80 percent of all prescription pain medication, CNN notes. In England doctors prescribe fewer opioids, which has helped their country avoid the prescription drug epidemic seen in the United States. Doctors in the U.K. encourage their patients do engage in physiotherapy, acupuncture and massage to treat pain.

“We have to protect the patient,” London pharmacist Howard Silver told CNN. He noted a moderate overdose of Tylenol can cause liver damage and even death. He called a bottle of 400 acetaminophen pills, readily available in U.S. drugstores, “a bottle of death.”

In order for one to obtain painkillers in the U.K., patients must be referred to pain clinics by their primary care doctor. On average, the process takes 18 weeks for a patient to be referred to the long-term pain clinic at London’s Royal Free Hospital. However, in extreme cases, clinic founder Dr. Anthony Ordman may be able to see patients as soon as the next day.

British Pain Society guidelines state, “In most situations, for most patients and most pains, opioids should not be considered as first-choice treatment.”

Opioids are not the only painkillers that are tightly restricted in the U.K. The largest bottle of ibuprofen or acetaminophen on a pharmacy shelf contains only 16 pills. With a pharmacist’s approval, a person can buy up to 32 pills.

American doctors should follow suit, there is no question the first line of defense in the prescription drug epidemic is one’s physician. We need to look to alternative forms of pain management if we are ever going get control of the problem we face.
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Wednesday, February 6, 2013

Shame's Role in Recovery

The road to recovery is often a hard road, where demons cross one’s path frequently. It can be hard for recovering alcoholics to let go of the shame they harbor regarding their behavior while actively using. Shame is a powerful feeling that in many cases can break or make one’s recovery. Many who struggle with addiction have a hard time forgiving themselves for their past transgressions; in turn this can make them susceptible to old ways of thinking and even relapse, a new study suggests.

Newly recovering alcoholics took part in the study about shame's role in recovery. In order to gauge participants’ feelings of shame, they were asked to describe the last time they drank and felt badly about it - researchers took their body language into account. They considered a narrowed chest and slumped shoulders to be “shame-related behaviors,” LiveScience reports.

After four months, participants were asked if they had maintained their sobriety. Those showing more shame-related behaviors in the first session were more likely to start drinking again. Keep in mind, participants’ own assessment of whether they felt shame about drinking did not predict whether they relapsed, the researchers report in the journal Clinical Psychological Science.

“How much shame participants displayed strongly predicted not only whether they relapsed, but how bad that relapse was — that is, how many drinks they had if they did relapse,” study authors Jessica Tracy and Daniel Randles of the University of British Columbia said in a journal news release. They added, “Our research suggests that shaming people for difficult-to-curb behaviors may be exactly the wrong approach to take. Rather than prevent future occurrences of such behaviors, shaming may lead to an increase in these behaviors.”
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Monday, February 4, 2013

Dangers With Alcohol and Energy

What is enough energy? 

Over the past decade energy drinks have become a major craze amongst young adults and teenagers, a simple substitute for the age old coffee beverages that are widely used amongst older generations. In the past people would mix coffee with alcohol, sometimes known as an "Irish Coffee" or "Spanish Coffee."

Today’s generation would rather mix their alcohol with energy drinks like Red Bull or RockStar energy drinks, giving one the feeling that the effects of alcohol are dulled by the energy achieved from the stimulant beverage - thus allowing one to drink more for a longer period of time.

Unfortunately, such practices can be create a lethal cocktail as seen by the rise in emergency room visits associated with mixing energy drinks (stimulants) with alcohol (depressants). This fact has been backed by a study conducted by multiple private parties, schools of higher learning, and the government. Combining the two beverages can be particularly dangerous, according to a new report published in a pediatrics journal, CBS News reports.

Last month, a government report released found the number of emergency room visits involving energy drinks doubled from 2007 to 2011, reaching more than 20,000. The report, from the Substance Abuse and Mental Health Services Administration (SAMHSA), found most cases involved teens or young adults. SAMHSA calls consumption of energy drinks a “rising public health problem.” About 42 percent of emergency room cases in 2011 involved energy drinks combined with alcohol or drugs such as Adderall or Ritalin.

Researchers write in Pediatrics in Review that mixing the two beverages can induce:
  • Rapid Heartbeat
  • Insomnia
  • High Blood Pressure
  • Anxiety
  • Obesity
“They contain too much caffeine and other additives that we don’t know enough about. Healthy eating, exercise and adequate sleep are better ways to get energy,” said lead author Dr. Kwabena Blankson, a U.S. Air Force major and an adolescent medicine specialist at the Naval Medical Center in Portsmouth, Virginia.

The majority of teens are not aware that mixing alcohol and energy drinks can make them feel less drunk than they actually are, the study showed. They wrote that drinking just one caffeinated beverage mixed with alcohol can be equivalent to drinking a bottle of wine and several cups of coffee. A 16-ounce energy drink has about 160 milligrams of caffeine, compared with 100 milligrams for an average cup of coffee.

Dr. Blankson stated that a teen should not have more than 100 milligrams of caffeine daily, especially when mixed with the other energy drink additives like sugar, ginseng, and guarana which increase caffeine’s effects.
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