Leslie Glass's Blog, page 323

People With Internet Addiction React The Worst When WiFi Fails

From Science Daily:

Do you get frustrated and angry when your WiFi connection stops working? It could be because of your personality. When digital technology stops working, people with a fear of missing out (FOMO) — the anxiety that you’re missing a social experience others might be having while you’re not online — or an internet addiction have more extreme reactions, according to a new study in Heliyon.

The researchers behind the study, psychologists Dr. Lee Hadlington and Dr. Mark Scase from De Montfort University in the UK, also show that certain personality traits directly influence people’s responses to failures in digital technology: people who were seen as being more neurotic and extroverted had more extreme reactions to failures in digital technology.

“The ‘frustration’ response is one of the things we all experience on a daily basis, so it seemed to be a logical step in our research,” said lead author Dr. Lee Hadlington. “Much of the existing research on this topic is from the 1940s — you could say that this research is the first of its kind to actually explore how individual react to failures with digital technology, and more importantly, places this in the context of the modern digital era.”

If something goes wrong with digital technology that prevents us from being online, we will react in different ways. ‘Maladaptive’ responses include getting angry, panicking or feeling depressed; these responses are not only unhelpful, they have also been shown to have a detrimental impact on productivity and achieving goals, and can therefore lead to poor job performance. If the digital technology failure is due to a malicious cyberattack, this could affect many people and businesses, so it’s important to understand the responses in order to limit the negative effects.

“If we can understand what leads individuals to react in certain ways, and why these differences occur, we can hopefully make sure that when digital technology does fail people are better supported and there are relevant signposts for them to follow to get help,” said Dr. Hadlington.

In the study, 630 participants aged 18-68 completed an online questionnaire in which they self-reported their responses to failures in digital technology, fear of missing out, internet addiction and answered questions that scored them on the BIG-5 personality traits: extraversion, agreeableness, openness, conscientiousness and neuroticism

The results showed that the fear of missing out, internet addiction, extroversion and neuroticism all have a significantly positive influence on maladaptive responses, meaning the people most psychologically dependent on digital technology are most likely to have maladaptive responses when it goes wrong.

They also showed a link between age and response: as age increases, the level of frustration that a person experiences decreases.

“The more we use our devices, the more we get attached to them, so when they don’t work, we tend to just go a little bit ‘crazy’ or just switch off and stop doing things altogether,” said Dr. Hadlington. “But there are things people can do when technology fails to make their lives a lot easier — extreme reactions only make things worse!”

The post People With Internet Addiction React The Worst When WiFi Fails appeared first on Reach Out Recovery.

Cutting Societal Alcohol Use May Prevent Alcohol Disorders Developing

From Science Daily:

Society must take collective responsibility to reduce the harm caused by alcohol use disorders, a University of Otago academic says.

Dr Charlene Rapsey, of New Zealand’s Dunedin School of Medicine’s Department of Psychological Medicine, says while alcohol is commonly enjoyed by many people and only a minority of people develop an alcohol use disorder, the negative consequences of such a disorder can be severe and long-lasting.

Her research paper, published in Alcohol and Alcoholism, used data from Te Rau Hinengaro, The New Zealand Mental Health Survey, to study transitions from alcohol use to disorder.

Of the nearly 13,000 participants, 94.6 per cent had used alcohol at least once, 85.1 per cent had had at least 12 drinks in the past year, and 16 per cent had developed an alcohol disorder.

Of concern was that with each 10 per cent rise in the number of people who use alcohol in an individual’s age and gender group, there was an increased likelihood of them developing an alcohol disorder in the following year.

“We already knew that for young people, peer group norms influence drinking. If people in my peer group drink then I am more likely to drink, but it was interesting that the broad social context of general alcohol consumption — alcohol consumption by people I don’t even know — was associated with an increased likelihood of the subsequent onset of a disorder,” she says.

Most people’s drinking started in high school and transitioned rapidly from consuming alcohol to having an alcohol use disorder.

“Considering many teenagers leave high school at 18 years of age, by then 79 per cent of 18-year-olds had used alcohol, with 57 per cent regularly drinking,” Dr Rapsey says.

Of those to develop an alcohol use disorder, 50 per cent did so by age 20 and 70 per cent by age 25.

Another key finding was that people live with alcohol use disorders for a long time before they experience remission — 45 per cent of people still met criteria for an alcohol disorder after 10 years.

Men are also at greater risk of developing a disorder and are less likely to quit.

“This research highlights our collective responsibility to each other; by reducing the drivers of overall levels of consumption, we have the opportunity to reduce harm to others.

“Relatively small inconveniences, such as limiting availability of alcohol and higher alcohol prices, can have significant influences on reducing alcohol related harms,” she says.

Dr Rapsey argues the research adds to a body of work pushing for policies aimed at reducing overall consumption.

“The Law Commission Report Alcohol in our Lives: Curbing the Harm made a number of evidence-based recommendations to reduce alcohol related harms in New Zealand. Unfortunately the Sale and Supply of Alcohol Act (2012) did not adopt many of the recommendations that had the potential to change people’s lives. There is clear research to guide policy makers if there is social and political will.

“This latest research also indicates that resources to prevent and to treat alcohol use disorders need to focus on those under 25 years of age in particular.

“In addition, while the majority of disorders develop in young people, an alcohol disorder is a chronic condition and therefore treatment needs to be available over many years.”

The post Cutting Societal Alcohol Use May Prevent Alcohol Disorders Developing appeared first on Reach Out Recovery.

Take The Gratitude Challenge

What are you grateful for in this season of your life? Take the gratitude challenge for five days to love yourself and others more. How appreciative are we of the many people in our lives? How much love do we show them? Perhaps more challenging, many of us are suffering from the negative impact of addiction in our lives. How can we feel good about loved ones who cause us pain? Acceptance helps us and them.

Over 100 years ago, philosopher William James, who happens to be the father of American psychology, wrote

‘The deepest craving of human nature is the need to be appreciated.”

Attitude of Gratitude Challenge

Here’s the challenge: show your appreciation of those around you simply appreciating them, regardless the behavior they exhibit. When we take time to acknowledge the people in our lives, our world become richer. We have a more meaningful connection to those we love. This in turn helps them feel good about who they are.

Take The Challenge

Begin by telling one person what you love and appreciate about them. Do this for five consecutive days. By making gratitude and appreciation part of our daily ritual, we program ourselves to recognize the good in ourselves and others. We will, therefore, hard-wire our thoughts to have more positive feelings than negative ones. This really works.

Professor Robert A. Emmons, world-renowned expert on gratitude, has shown through extensive research that gratitude effectively increases happiness, confidence and all-around well being.

Share what you love about others and in the process, you will find out that you love and appreciate yourself more too.

The post Take The Gratitude Challenge appeared first on Reach Out Recovery.

Depression Drug Combination Not Effective

From Science Daily A large clinical trial, looked at the effectiveness of adding mirtazapine to an SSRI or SNRI in patients who remain depressed after at least six weeks of conventional (SSRI or SNRI) antidepressant treatment. They found that this combination was no more effective in improving depression than placebo and call on doctors to rethink its use.

Psychiatrists and GPs increasingly combine mirtazapine with an SSRI (selective serotonin reuptake inhibitor) or SNRI (serotonin-noradenaline reuptake inhibitor) antidepressant for patients whose depression does not respond to a single antidepressant. A large clinical trial led by researchers at the Universities of Bristol, Exeter, Keele, Manchester and Hull York Medical School, and published in the British Medical Journal today, looked at the effectiveness of adding mirtazapine to an SSRI or SNRI in patients who remain depressed after at least six weeks of conventional (SSRI or SNRI) antidepressant treatment. They found that this combination was no more effective in improving depression than placebo and call on doctors to rethink its use.

The study, funded by the National Institute for Health Research, also found that patients taking mirtazapine in combination with another antidepressant had more adverse effects and were more likely to stop treatment than those who took an antidepressant and placebo.

Depression is one of the top five contributors to the global burden of disease and by 2030 is predicted to be the leading cause of disability in high income countries. People with depression are usually managed in primary care in the UK and antidepressants are often the first line of treatment. However, many patients do not respond to antidepressants.

The National Institute for Health and Care Excellence (NICE) advises GPs to reconsider treatment if there has been no response after 4-6 weeks of treatment. The practice of adding mirtazapine has grown as psychiatrists and GPs search for effective ways of treating those who don’t respond to a single antidepressant. Previous small-scale studies had shown that this combination might be effective.

Dr David Kessler from the Centres for Academic Mental Health and Academic Primary Care at the University of Bristol, and lead author of the study, said:

“Half of patients in primary care who take antidepressants remain depressed despite sticking to their treatment, yet there is little evidence about how to treat those for whom the drugs don’t work.

“Our study has found that there is unlikely to be a clinically important benefit for mirtazapine over placebo in addition to an SSRI or SNRI antidepressant in primary care patients with treatment resistant depression, and that the combination is not well tolerated. We recommend that GPs think very carefully before adding mirtazapine as a second antidepressant in this group of patients. This is particularly important when there are clear alternatives such as cognitive behavioural therapy, which has been shown to be effective in this group of patients.”

About the study

Patients were aged over 17 years, were being treated for depression in primary care, and had been taking an SSRI or SNRI antidepressant for at least six weeks. They were still depressed using International Classification of Diseases (ICD-10) criteria. All 480 patients who took part continued to take their SSRI or SNRI and were randomly assigned to one of two groups: either additionally taking mirtazapine or a placebo. Neither the patients nor researchers knew to which group each patient had been assigned. They were followed up at 12, 24 and 52 weeks to see whether their depression had improved.

At 12 weeks just under 40% of patients had responded to treatment as measured by a halving of the severity of their depressive symptoms; there was a small difference in favour of the mirtazapine group but it was not clinically important and the study could not rule out the possibility of ‘no effect’. Outcomes at the later time points showed even smaller differences between the groups with no evidence of worthwhile benefit over the longer term.

Story Source:

Materials provided by University of Bristol. Note: Content may be edited for style and length.

The post Depression Drug Combination Not Effective appeared first on Reach Out Recovery.

Studies On Student Alcohol Use Inform Interventions-Reduce Blackouts

From Science Daily:

While most college students who drink alcohol don’t intend to drink to the point of blackout, many don’t fully understand the specific behaviors and risk factors associated with alcohol-induced memory loss, a suite of new studies found.

Prior research has found that between 30 and 50 percent of young adults who drink regularly report that they have experienced alcohol-related memory impairment in the past year, whether full “blackouts,” where they can’t remember anything for some period of time, or “brownouts” — episodes of on-and-off memory loss, where memories may be recovered with reminders.

“We don’t yet know what long-term effects having a blackout or repeated blackouts has on the brain,” said Kate Carey, a professor with the Center for Alcohol and Addiction Studies at Brown’s School of Public Health. “We do know that having alcohol-related memory impairment is associated with other negative consequences.”

Those consequences can range from hangovers or missed classes to fights, overdoses, mental health problems or sexual assault. Given the seriousness of those risks, Carey and her colleagues conducted a series of focus groups to better understand college students’ knowledge of what causes blackouts, understanding of the distinctions between blackouts and brownouts, and perspectives on the consequences of both. Their findings were published in three recent papers.

“Studies like these, addressing attitudes toward blackout drinking as well as what students know and do not know about blackouts, give us clues about how we might intervene to reduce this high-risk outcome,” said Jennifer Merrill, an assistant professor of behavioral and social sciences at Brown who was involved in the studies. “This work helps us to identify where there is room to correct any misconceptions students have about the causes and consequences of blackouts.”

Focus on focus groups

Each of the three studies was based on analyzing transcripts from a series of eight single-gender focus groups of college students who had reported a blackout in the prior six months. The focus groups included a total of 50 students, 28 women and 22 men, from four-year colleges and universities in the Providence, Rhode Island, area.

In the first paper, the researchers report that students were aware that drinking hard liquor, drinking large quantities of alcohol and drinking quickly increased the risk of blackouts. However, Carey said, many students didn’t understand that biological factors — things like biological sex and genetics — play a role in the risk of blackouts, or that mixing alcohol use with other drugs could increase risk as well.

“The kind of drinking that results in alcohol-related memory impairment is common, but it’s also not typically done with the intent of blacking out,” Carey said. “And those who regularly drink and report blackout experiences don’t have a full understanding of what causes them. The interesting thing is that regardless of how much you drink, there are ways to drink so that you don’t black out.”

Specifically, drinking in smaller quantities or pacing drinks across a longer period of time can prevent the rapid rise in blood alcohol concentration that is known to cause blackouts, she said.

The focus groups also provided other insights into how best to draw college students’ attention to the consequences of blackouts.

The second paper analyzed perspectives from students who were asked: “What is a person’s typical reaction when he/ she blacks out?” and “Overall, what makes a blackout a negative, neutral or positive experience?”

Generally, students described blackouts negatively, using terms such as “embarrassing,” “annoying” and “scary.” But some described the experience as exciting.

“You’re a little nervous cuz [sic] you definitely could have done something really stupid, but you don’t know and it’s kind of like a little bit of fear, but at the same time, you’re kind of excited that you did something awesome,” a 19-year-old male participant said of blackouts.

The researchers found that social factors — whether a student’s friends thought blackouts were common or acceptable and who they were with during the blackout period — influenced their perspective. The severity of the memory loss, and learning whether they did anything embarrassing during the blackout, also affected their opinions, Carey said.

In the third study, the researchers found that college students used the phrase “blackout drinking” hyperbolically to describe drinking very heavily, yet without the intent to lose memories. On the other hand, “a blackout” more precisely meant an episode with periods of as much as an hour of complete memory loss. The students called shorter periods of missing memory or fuzzy memories “brownouts,” Carey said.

While the free-form conversations gave the researchers new insights into nuances of the blackout experience and the language students use, the focus groups were not designed to provide quantitative data on how common blackouts and brownouts were. For that reason, the research team also conducted an online survey of 350 full-time college students from across the U.S. who reported lost memory after drinking in the past year.

The survey found that students experienced brownouts more frequently than blackouts. Specifically, 49 percent of those surveyed had experienced both blackouts and brownouts in the past month, 32 percent had experienced only brownouts, 5 percent experienced only blackouts, and 14 percent hadn’t experienced any alcohol-related memory impairment in the past month.

The surveyed students also voiced less concern about brownout experiences compared to blackouts.

“We found that brownouts were indicators to the students that they were drinking in a manner that could lead to a blackout someday,” Carey said. “But they were discounting the earlier signs of memory loss, suggesting that they weren’t serving as red flags or even as a yellow light.”

Education and interventions

General education on the consequences of heavy alcohol use hasn’t been shown to be effective for anyone, including college students, Carey said, but personalized feedback can reduce the riskiest kinds of drinking.

She hopes to use insights from these studies to develop additional education modules for alcohol prevention programs that specifically address the risks of the high-volume, fast-paced drinking that is likely to lead to blackouts. Particularly, that behaviors like “pregaming” — drinking before attending a larger event or activity where alcohol will be available — participating in drinking games and “chugging” increase the risk of blackout.

The role that biological factors play in the risk of blackout is another area that needs to be addressed with better education, she said.

Walking students through their blackout experiences to reframe them as risky rather than inconsequential and sharing statistics that illustrate that blackouts aren’t actually the norm among peers are other targeted ways to reduce behaviors that lead to blackouts, Carey said.

“We hope that focusing in on this one particular consequence of a certain style of drinking will provide lots of opportunities for interventions,” she said.

The post Studies On Student Alcohol Use Inform Interventions-Reduce Blackouts appeared first on Reach Out Recovery.

Diagnosing Addiction

Addiction is a chronic condition that is difficult to diagnose and treat. While the signs can be clear, diagnosis first relies on the person with an addiction or people close to them acknowledging and wanting to address the problem.

The diagnosis of addiction caused controversy in previous editions of the Diagnosis and Statistical Manual for Mental Disorders (DSM). The newest edition has combined substance abuse and dependence into a new category, substance use disorder.

DSM-V was the first edition to include gambling addiction in the definition, as the behavior triggers similar reward circuits.

The diagnostic process

A GP will be able to diagnose and refer an individual showing signs of a substance use disorder.

The first step in diagnosis relies on a friend, family member, or the person with addiction themselves acknowledging a need for treatment.

This can often be the most difficult step and might sometimes involve a personal or group intervention if an individual with substance use disorder is not aware of the extent of the problem.

The person with suspected substance use disorder visits a family doctor or primary care physician, who may then refer them to an addiction or rehabilitation specialist.

The doctor will ask questions about frequency of use, impairment of daily living, and whether the use of a substance is increasing and how the pattern of use is impacting important social, occupational, educational or other functional areas.

They will also ask about withdrawal symptoms which may have occurred at times when the person attempted to decrease or stop use.

The doctor will complete a physical examination and run some blood work to assess overall health. This helps to determine if medical treatment is needed.

Criteria

The DSM-5 separates substance use disorder into nine different categories:

alcohol-related disorders
caffeine-related disorders
cannabis-related disorders
hallucinogen-Related Disorders
inhalant-related disorders
opioid-related disorders
sedative-, hypnotic-, or anxiolytic-related disorders
stimulant-related disorders
tobacco-related disorders
other, or unknown, substance-related disorders
non-substance-related disorders

DSM-V lists varying criteria for each of these categories, and many dependencies have different withdrawal symptoms that occur when an individual does not have access to the substance.

To receive a diagnosis of substance use disorder, a person must demonstrate two of the following criteria within a 12-month period:

regularly consuming larger amounts of a substance than intended or for a longer amount of time than planned
often attempting to or expressing a wish to moderate the intake of a substance without reducing consumption
spending long periods trying to get hold of a substance, use it, or recover from use
craving the substance, or expressing a strong desire to use it
failing to fulfill professional, educational, and family obligations
regularly using a substance in spite of any social, emotional, or personal issues it may be causing or making worse
giving up pastimes, passions, or social activities as a result of substance use
consuming the substance in places or situations that could cause physical injury
continuing to consume a substance despite being aware of any physical or psychological harm it is likely to have caused
increased tolerance, meaning that a person must consume more of the substance to achieve intoxication
withdrawal symptoms, or a physical response to not consuming the substance that is different for varying substances but might include sweating, shaking and nausea

The number of criteria a person demonstrates defines the severity of the dependence. If a person regularly fulfills two of three of these criteria, the DSM advises that they have mild substance use disorder.

A person with four or five of these criteria would have moderate substance use disorder. Six criteria would denote a severe addiction.

As new evidence emerges around addictive disorders, researchers attempt to determine whether or not they can develop reliable diagnostic criteria.

Some addictive disorders appear in the International Classification of Disease, Tenth Edition (ICD-10), such as sex addiction, which the ICD-10 classes under the category of “other sexual dysfunction not due to a substance or known physiological condition”.

The DSM-5, however, does not acknowledge sex addiction as a diagnosis.

One study from 2016 suggests that smartphone addiction is a developing condition and fits within the criteria of addiction.

The concept of video game addiction and the validity of the phenomenon as a diagnosable condition is currently controversial, as it involves the same brain circuitry as other addictions. In some parts of East Asia, clinics already exist to treat gaming addiction.

Content originally published by Medical News Today By Adam Feinman

The post Diagnosing Addiction appeared first on Reach Out Recovery.

F.D.A. Approves Dangerous New Opioid

From the New York Times by Abby Goodnaugh


ImageThe drug Dsuvia is a form of sufentanil, a synthetic opioid used intravenously and in epidurals that is 10 times stronger than fentanyl, a parent drug associated with tens of thousands of overdose deaths in recent years.CreditCreditCraig Sherod/AcelRx Pharmaceuticals, via Associated Press

The Food and Drug Administration on Friday approved a new form of an extremely potent opioid to manage acute pain in adults, weeks after the chairman of the advisory committee that reviewed it asked the agency to reject it on grounds that it would likely be abused.

The drug, Dsuvia, is a tablet form of sufentanil, a synthetic opioid that has been used intravenously and in epidurals since the 1980s. It is 10 times stronger than fentanyl, a parent drug that is often used in hospitals but is also produced illegally in forms that have caused tens of thousands of overdose deaths in recent years.

Although the F.D.A. advisory committee charged with evaluating the new formulation ultimately recommended in a 10-3 vote last month that the agency approve it, the panel’s chairman, Dr. Raeford Brown, wrote a letter to top F.D.A. officials afterward expressing deep concern.

In the letter, which he wrote with leaders of the consumer advocacy group Public Citizen, Dr. Brown, an anesthesiology professor at the University of Kentucky, described Dsuvia, made by AcelRx Pharmaceuticals, as “an extremely divertible drug,” adding, “I predict that we will encounter diversion, abuse and death within the early months of its availability on the market.”

After the final approval on Friday, Dr. Scott Gottlieb, the F.D.A. commissioner, released a lengthy statement defending the agency’s decision. He emphasized that Dsuvia is delivered through a “pre-filled, single-dose applicator,” and said that its only permitted use will be in hospitals, surgical centers and other medically supervised settings. It is ideally suited for certain special circumstances, he said, particularly for soldiers wounded on the battlefield who might not have access to intravenous painkillers.

Dr. Gottlieb wrote that Dsuvia will not be dispensed to patients for home use or available at retail pharmacies, and that it should only be administered by health care providers with the single-dose applicators. It will likely hit the market early next year.

“These measures to restrict the use of this product only within a supervised health care setting, and not for home use, are important steps to help prevent misuse and abuse,” he wrote.

He also pointed to the agency’s new powers to require post-market studies evaluating the efficacy of opioid medications that the F.D.A. might be having second thoughts about, and to consider abuse risk as a factor in making regulatory decisions about drugs after, as well as before, they’re on the market. Last year, the F.D.A. asked the maker of Opana ER, another super-potent opioid, to take it off the market because of concerns about abuse.

Vince Angotti, the chief executive of AcelRx, said in a statement that the company would diligently follow a safety program, known as a risk evaluation and mitigation strategy, that the F.D.A. had approved for Dsuvia, including monitoring distribution of the drug and auditing wholesalers’ data; evaluating whether hospitals and other health care providers are using the drug properly; and monitoring for any diversion or abuse.

The divisions over the new drug’s approval comes after opioid overdose deaths surged to more than 40,000 last year, including more than 30,000 from fentanyl and other synthetic opioids. States and the federal governments have cracked down on the prescribing of opioids, and many chronic pain patients have complained about being undertreated or losing access to opioids entirely.

Dr. Brown, who heads the advisory committee on analgesics and anesthetic drug products, was not present for the committee vote last month. But in the letter he wrote afterward, he described trying to resuscitate doctors, medical students and other health care providers — “some successfully” — who had overdosed on the IV form of sufentanil at the medical center where he works

“It is so potent that abusers of this intravenous formulation often die when they inject the first dose,” he wrote.

Dr. Brown also questioned whether the F.D.A. would succeed in enforcing regulations once dangerous drugs hit the market.

“It is my observation that once the F.D.A. approves an opioid compound,” he wrote, “there are no safeguards as to the population that will be exposed, the post-marketing analysis of prescribing behavior, or the ongoing analysis of the risks of the drug to the general population.”

Critics of the approval include four Democratic senators — Edward Markey of Massachusetts, Richard Blumenthal of Connecticut, Claire McCaskill of Missouri and Joe Manchin of West Virginia.

In a letter to Dr. Gottlieb on Tuesday, they questioned why Dr. Brown’s committee went ahead and recommended approval on Oct. 12 without him present. They also asked why a different F.D.A. advisory group, the Drug Safety and Risk Management Advisory Committee, had not been involved.

An F.D.A. spokeswoman said that while the issue was not brought formally in front of the drug safety committee, “there were drug safety and risk experts on the committee whose expert input was taken very seriously throughout this process.”

The post F.D.A. Approves Dangerous New Opioid appeared first on Reach Out Recovery.

Are E-Cigarettes Safe? Here’s What Science Says

From Time:

In 1965, when Herbert Gilbert was granted the first patent on a smoke- and tobacco-­free cigarette, he wrote that the product would “provide a safe and harmless means for and method of smoking.”

More than 60 years later, however, modern iterations of Gilbert’s invention have sparked debate in the public-health community. E-cigarettes, which have grown increasingly popular in the past five years, were designed as a tool to help people quit ­smoking—and by doing so they should drastically reduce rates of lung cancer and other diseases. But the question is, does that potential outweigh their possible risks to human health?

No easy answer

Traditional cigarettes work by simple combustion: when tobacco is lit, it combines with oxygen and creates an inhalable smoke. E-cigarettes, sold by brands including Juul, Blu and Vuse, heat a chemical-­packed liquid that typically contains nicotine and often a flavoring agent, creating an aerosol. By delivering ­nicotine without tar and other nasty by-­products of combustion, e-cigarettes purportedly give smokers a healthier alternative to cigarettes while still satisfying cravings.

It seems like a win-win. But in practice, there is no consensus yet about whether or not e-cigarettes effectively help smokers ditch cigarettes. Vapes, as they’re called, contain fewer of the cancer-­causing chemicals found in traditional cigarettes (like arsenic, benzene and formaldehyde), but there is little long-term data about their effects on health—and preliminary science suggests that they may harm the lungs and heart. Plus, while e-cigs are made for and legally available only to adults, they’re popular among ­teenagers—­potentially priming a new generation for nicotine addiction and tobacco use, experts worry.

While public-health officials in some places, like the U.K., are strongly in favor of e-cigarettes, the World Health Organization is more wary. In the U.S., Dr. Scott ­Gottlieb—­commissioner of the Food and Drug Administration (FDA), which regulates the ­devices—says he believes e-cigarettes are good for public health, despite the unknowns. E-cigs are “not risk-free,” Gottlieb says, but the possibilities they hold for adult smokers trying to quit, like reduced rates of lung cancer and better overall respiratory health, are important.

“If we were able to switch every adult smoker completely onto an e-cigarette product, we would have a significant impact on overall public health,” Gottlieb says. Tony Abboud, executive director of the e-cig trade group Vapor Technology Association, agrees, calling e-cigarettes “among the most promising public-­health innovations of the 21st century.”

But some researchers studying their effects aren’t convinced. They believe there’s not enough evidence showing that e-cigarettes help adults quit smoking to outweigh a growing number of studies that suggest they come with health harms, including a higher risk of heart disease and increased rates of respiratory conditions. “What are the effects of [e-cigarettes] when a user takes 200 puffs a day for 20 years?” asks Thomas Eissenberg, director of the Center for the Study of Tobacco Products at Virginia Commonwealth University. “Anyone who says they know the answer to that question needs to present some data.”

The long-term effects of e-cigarette use aren’t the only unknowns. It’s also unclear whether vapes actually help smokers quit in the first place.

Mixed results

Some studies (supported by plenty of anecdotal evidence from users) have found that e-cigarettes can make smoking cessation easier. But others have found the opposite: that they make smokers more likely to continue using cigarettes, potentially because they sustain a nicotine habit. E-cigarettes are not FDA approved as smoking-­cessation devices, and vaping companies cannot make health claims about their products without this approval; manufacturers usually call them cigarette alternatives for adult smokers.

Juul is the most popular e-cigarette. According to recent data from the Centers for Disease Control and Prevention (CDC), Juul sold 16.2 million of its sleek, flash-drive-­resembling devices in 2017, 641% more than the year before. The company says it’s conducting studies on smoking cessation, toxicology and more. “We want to understand everything and we want to share all that data, because that’s ultimately what’s going to move the needle for the public-health conversation,” says Ashley Gould, Juul’s chief administrative officer. Gould also emphasizes that Juul was founded “to provide a satisfying alternative to cigarettes, with the objective of completely eliminating cigarettes.”

But many smokers who turn to e-cigarettes are not making the switch completely. Research from the CDC found that in 2015, about 59% of adults who used e-cigarettes also smoked. (­Adolescents who vape are also more likely than their peers to smoke cigarettes as well, according to a recent RAND Corporation study.) While some experts believe that replacing any amount of cigarette smoking with vaping is a good thing, some research suggests that dual use may be riskier than either smoking or vaping alone. An August study published in the American Journal of Preventive Medicine found that both daily smoking and vaping are associated with a higher risk of heart attack, and that doing the two concurrently compounds those risks.

E-cigarettes may also have a large impact on lung cancer. Compared with cigarettes, they contain far fewer of the ingredients known to cause cancer, and the ones they do contain are present at lower levels. There is also no evidence proving that e-cigarettes cause cancer. Given that cigarette smoking is the number-one risk factor for lung cancer, the assumption is that if smokers switched from cigarettes to vapes, lung-­cancer rates would potentially plummet.

But scientists still don’t know how long-term use of e-cigarettes affects health—in part because the devices just haven’t been around long enough for the necessary rigorous research to have been done.

Plus, comparisons with cigarettes go only so far, since e-cigarettes are a radically different product, says Silvia Balbo, assistant professor of environmental health sciences at the University of Minnesota School of Public Health. “When you’re looking at chemicals that are present both in tobacco regular cigarettes and e-cigarettes, you can do a comparison,” she says. “But if you consider the mixture on its own and how all the different compounds and chemicals are interacting, then that poses a different question.”

Though studies in this area are preliminary, some research suggests that e-cigs may carry health risks. In a small study this year, Balbo and her colleagues found that 15 minutes of vaping produces compounds that can damage DNA in the mouths of e-cigarette users. The study involved only five people and did not track their health over time. But Balbo says the kind of DNA changes they observed could be related to multiple types of cancer, including oral and lung.

Other early studies have reached similar conclusions. One, published this year in the journal PNAS, found that e-cigarette aerosol causes DNA damage in mice. Another, published in Scientific Reports in May, found that e-cigarettes contain more of the potential carcinogen formaldehyde than previously estimated.

There are other potential lung concerns. Diacetyl, a chemical commonly found in flavored e-liquids, has been linked to respiratory disease. And research presented in May at the American Thoracic Society’s international conference finds that e-cigarette use may be associated with the development of respiratory conditions like COPD and bronchitis.

Those results are reason for ­caution—but letting unknown health risks stamp out e-cigarettes would be “throwing the baby out with the bathwater,” says ­Dr. Michael Siegel, professor of community health at the Boston University School of Public Health. Siegel has devoted his career to curtailing tobacco use—and that’s why he says he believes that e-cigarettes are a good thing. “We know the harms of smoking: when people smoke, it’s going to kill them,” Siegel says. “We shouldn’t let the fact that there are some unknown risks blind us to the fact that we know that smoking is killing people.”

In an ideal world, of course, a smoker who wants to quit would ditch nicotine entirely. But that’s difficult to do, and ­Siegel says e-cigarettes can offer a ­valuable bridge to smokers who can’t or won’t quit by other means. “Anything they can do to move toward smoking cessation is a great thing,” he says.

An uncertain future

The FDA’s biggest concern is how to stop teens from vaping. Teen use of e-cigs is sharply rising, according to federal data; they are now more popular than cigarettes among high school students. In September, the FDA intensified its efforts to regulate e-cig sales, galvanized by what Gott­lieb called an “epidemic” of youth use that is “simply not tolerable from a public-health standpoint.” The agency ordered e-cig companies to figure out how to keep their products away from underage users—and threatened to ban the sale of some flavored e-cigarettes if they didn’t. (Flavored products—­everything from cotton candy to mint—accounted for about 60% of e-cigarette sales in 2016, CDC data shows.)

Doing so might be the only way the FDA can meet its mandate of proving that e-cigarettes are good for public health overall, Gottlieb says. “In order to close the on-ramp for kids, unfortunately, we’re now going to have to take a step that’s going to narrow the off-ramp for adults,” Gottlieb says. “If we don’t bring down the teenage use of these products, it’s going to be hard to fairly argue, through a scientific process, that this is providing a net public health benefit.”

Siegel agrees that curtailing teen use should be a priority, and says it could be achieved by regulating e-cigs’ marketing and sales, as well as how much addictive nicotine they contain. But he says sweeping actions like removing many products from the market would also harm adult users, many of whom like to use flavored products. Without palatable e-liquids, he says, recovering smokers might be lured back to cigarettes.

“If anything, we’re helping the tobacco industry, because we’re protecting cigarettes from competition and we’re putting all the attention on this other product,” Siegel says. “We’re doing what the cigarette industry wants us to do.”

Time will tell how the government tackles the e-cigarette conundrum. But as studies continue and youth use increases, one thing is certain: the debate around e-cigarettes is just beginning to heat up.

The post Are E-Cigarettes Safe? Here’s What Science Says appeared first on Reach Out Recovery.

Adjust With Ease Daylight Savings Is Here

When the clocks go back an hour, there’s a good chance fatigue, fogginess, and restless energy in the evenings will set in. Here’s a flow to help your body find a new rhythm.

Try this yoga for daylight savings to help your circadian rhythm adjust.

When we “fall back” an hour for daylight savings time, it can be tempting to think of the time change as a boon. After all, we gain an extra hour of sleep! However, it’s important to recognize that the time change can actually be really disorienting. Whether you’re a night owl or morning person, there’s a chance daylight savings time may prompt you to experience symptoms such as fogginess, fatigue, restless energy in the evenings, disrupted sleep, and irritability. The good news? You can use your yoga practice to help adjust your body’s rhythm and ease the transition.

Daylight Savings and Yoga: A TCM Perspective

In Traditional Chinese Medicine (TCM), there are 12 organ systems and each organ’s energy is what we call “active” for a 2-hour period, which gives a 24-hour clock, or cycle of energy, throughout the body.

The TCM perspective for proper bedtime is somewhere before 11 p.m., so that the liver and gallbladder energy is not disrupted. The liver and gallbladder are active from 11 p.m. to 3 a.m., and they are the Judge and General of the body and mind: The liver allows for planning and strategizing, while the gallbladder makes decisions and clear judgements. If you’re up during this time, you might impede these attributes within yourself.

When daylight savings time rolls around, a 10 p.m. bedtime is really an 11 p.m. bedtime, prior to the switch. So, to help our bodies adjust to this new “clock,” we will focus on yoga poses that move the energy of the liver and gallbladder channels, calm our minds, and clear any stress from our day. A stimulation of the kidneys through compression, in our last pose, will also assist the secondary system of circadian rhythm management: the adrenals. (Note, while TCM does not recognize the adrenals, we incorporate the adrenals with the kidneys in the modern view of TCM).

Before You Begin

I recommended you do this sequence two hours before your preferred bedtime (as this would correlate to an hour before your bedtime, previous to the time change). This will allow for a smoother transition in your body and mind.

Make sure the room is brightly lit, which communicates to the pineal gland to delay the secretion of melatonin and decrease sleepiness. You will need a blanket, block, and wall space.

TCM-Inspired Yoga for Daylight Savings

About the Author

Teresa Biggs, AP, DOM is a board-certified Doctor of Oriental Medicine and Yoga Medicine Instructor and founder of Biggs Acupuncture & Wellness Center in Naples, Florida. You can find her at the upcoming Women’s Health Immersion for Yoga Medicine. Learn more at biggsacupuncture.com.

The post Adjust With Ease Daylight Savings Is Here appeared first on Reach Out Recovery.

Gratitude Outside Of The Box: Thankful For Rock Bottom?

I’ll never forget my rock bottom, an hour long phone call. I sobbed, literally sobbed, gasping for breath. She was callous to my pain. She was cruel and selfish. I vowed: NEVER again will I allow myself to be used like this. The very next week, I went to my first meeting. Here’s how that rock bottom still propels me to move forward into recovery.

How Did I End Up There?

The path that led me to accept abuse and manipulation was as long and tangled as everyone else’s. All I really need to know is:

Alcoholism is a family disease that affects generations even if your loved one is no longer drinking.

Alcoholism seeped into every aspect of my family of origin. Fears, manipulation, and power struggles oozed down every corner of our house. Unfortunately, these behaviors are invisible. I had no idea I was carrying them with me to every job and relationship.

Recovery Is Like A Slow-Motion Explosion

At that first meeting, there was a table filled with handouts. I grabbed these sheets and hid them in my purse, too embarrassed to admit I needed help with:

Codependency For Women
Common Characteristics Among Adult Children Of Family Dysfunction
Depression – Problem And Solution
Freedom From Anger For Women

Confirming that my childhood family dysfunction actually caused my adult relationship problems was an explosion of knowledge, but turning my life-long habits around was like turning a cruise ship on a dime. It just didn’t happen in one day. I’ve been in recovery for codependency for three years now. I’m still amazed by the quick bursts of knowledge followed by the lag time my brain needs to implement the change.

Grateful For The Change

When I recall my rock bottom and that cruel and abusive phone call, and I’m actually grateful. I’m not thankful for her but for how I responded by changing. Since that horrible day, I:

Moved to Florida, something I always wanted to do.
Started writing, which was my life-long dream job.
Paid off all of my credit cards and bought a house.

These dreams seemed impossible because I was believing the lies of addiction and family dysfunction. Recovery gives me the courage to live the life I want. I’m not a slave to anyone else’s ideas of what my life should look like. Nor am I alone. I have a Higher Power I can trust and friends in recovery who love me, character flaws and all.

Ongoing Lessons And Tools

I’m still learning. I still struggle with setting boundaries and saying “NO.” How I expect others to behave still sneaks up on me and casts a net of resentment around me. Some days, I completely lose my serenity and feel like I haven’t made any progress at all. On those days, that horrible phone call sneers in my face and I fight back harder. I will never again beg anyone for anything. I dig deep into my recovery tool box to find the right tool to fix the problem. My favorite tools include:

Nothing changes if nothing changes, and I can only change me.
Expectations are predetermined resentments.
The C’s of addiction: I didn’t cause it. I can’t cure it, and I can’t control it.
Other people’s opinions of me are none of my business.
Just because he’s mad or sad doesn’t mean I’m bad.
Just for today…
I’m not responsible for anyone else’s feelings.

Looking back at my rock bottom is surreal. I vividly remember the pain but I no longer feel it. Instead, I’m incredibly grateful that my life is forever changed.

The post Gratitude Outside Of The Box: Thankful For Rock Bottom? appeared first on Reach Out Recovery.