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Pain Management Should Soon Be Possible Without Fear of Addiction or Overdose
60% of pain patients find that tolerance buildup significantly impedes their treatment over time.
There is an epidemic going on today that you hear almost nothing about. Yet it effects around 50 million Americans, according to the National Institutes of Health (NIH). That’s more than those diagnosed with diabetes and cancer combined. It’s a chronic pain epidemic and it’s everywhere. Such pain is not only devastating for the person and their family, it is also the leading cause of disability. A higher number of cases puts more of a burden on the healthcare system and hampers economic growth. So it isn’t only the person and their closest kin who suffer, but society as a whole.
Unfortunately, therapies haven’t changed much over a hundred years or more, as little is really known about the phenomenon of pain itself. There are really two main options in terms of therapy. The first is non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Bayer), acetaminophen (Tylenol), and naproxen (Aleve). There are stronger prescription varieties of these as well.
The second option is opioid painkillers. Derived from opium, the most common types prescribed are morphine, OxyContin, Vicodin, Percocet, oxycodone, hydrocodone, and fentanyl. Of course there are many others. Though effective in the short-term, 60% of patients find that building up a tolerance significantly impedes treatment over time. Unfortunately, three to four percent of Americans receive morphine or one of its derivatives to manage severe or chronic pain, long-term.
In the last decade, an increase in the prescribing of opioids has followed the pain crisis’s upward trend. When taken as prescribed, opioids are safe and effective. But as the body begins to build up a tolerance, pain tends to bleed through. Oftentimes, increasing dosage is not recommended past a certain point. Alternative therapies such as acupuncture, tai chi, yoga, and physical therapy are usually proposed alongside opioids. Even so, patients don’t always find these options effective.
Cupping is the latest trend in alternative therapes. But many of these don’t reduce pain significantly enough.
Medical marijuana advocates have suggested cannabis therapy alongside opioids. Some studies have found that it does not increase the risk of addiction or overdose, and in fact gives additional pain relief. In fact, one study out of the University of Michigan found a 64% reduction in opioid use, when medical marijuana was made available to pain patients. But for many, this option may not be viable.
For those patients with bleed through pain, the motivation to take more than prescribed is great. Though they may find relief in the near term, the patient will soon find themselves increasing dosage once again when tolerance has increased, and so inching ever closer toward an overdose. It is through this process, and through teens and young adults swiping pills from medicine cabinets, that the prescription opioid epidemic has taken hold.
Medical marijuana may help. But it’s not a viable option for all patients for a number of reasons.
2.1 million in the US were addicted to prescription painkillers in 2012, according to the NIH—the latest numbers on record. And overdose deaths have increased fourfold since 1999. It is also fueling a heroin epidemic, as the street drug is less expensive and more readily available.
Big pharma has responded by offering extended release opioids, in an attempt to give patients more relief and discourage them taking more than prescribed. Other drugs have abuse-deterrent features, such as pills one is unable to crush, and so cannot snort or use intravenously. Yet, many see this as a technological fix, putting a Band-Aid on an already out-of-control problem. Also, it does not address the issue of bleed through pain.
Besides being little understood, not enough research is conducted to learn more about chronic pain. Today, the race is on to find ways to overcome these problems, and deliver better pain relief to those who are suffering. One new study, published in the journal Neuropsychopharmacology, has located the brain mechanism that causes opioid tolerance. Researchers have even devised a way to overcome it.
An opioid overdose kit. These are ubiquitous now across the country due to the opioid addiction epidemic.
Investigators from Emory and Georgia State Universities found, for the first time, how morphine tolerance comes about. This is an inflammatory response triggered when chemical messengers called cytokines are released inside the brain. By blocking cytokines, researchers say pain could be relieved consistently with morphine over time, at only half the dosage. These scientists were able to illustrate how the inflammatory response occurred in rats’ brains, and that blocking cytokines could undermine tolerance.
The mechanism for tolerance buildup works like this. Over time, morphine interferes with homeostasis, or the body’s ability to manage functions in a rhythmic and timely manner. Since it no longer recognizes pain, the body moves to rid itself of this foreign agent and reestablish balance within the system. To do that, it triggers the immune response, which causes inflammation—used to drive the agent out.
Another find, tolerance occurs quickly. One dose each day for three days was enough to cause the tolerance response to kick in. When rats were given a drug that blocked inflammation, tolerance to morphine plummeted. Researchers concluded the study by writing, “Our findings provide a novel pharmacological target for the prevention of opioid-induced immune signaling, tolerance, and addiction.”
To learn more about the prescription painkiller epidemic click here:
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Construction of the $500 billion dollar tech city-state of the future is moving ahead.
- The futuristic megacity Neom is being built in Saudi Arabia.
- The city will be fully automated, leading in health, education and quality of life.
- It will feature an artificial moon, cloud seeding, robotic gladiators and flying taxis.
The Red Sea area where Neom will be built:
Saudi Arabia Plans Futuristic City, "Neom" (Full Promotional Video)<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="c646d528d230c1bf66c75422bc4ccf6f"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/N53DzL3_BHA?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
Frequent shopping for single items adds to our carbon footprint.
- A new study shows e-commerce sites like Amazon leave larger greenhouse gas footprints than retail stores.
- Ordering online from retail stores has an even smaller footprint than going to the store yourself.
- Greening efforts by major e-commerce sites won't curb wasteful consumer habits. Consolidating online orders can make a difference.
A pile of recycled cardboard sits on the ground at Recology's Recycle Central on January 4, 2018 in San Francisco, California.
Photo by Justin Sullivan/Getty Images<p>A large part of the reason is speed. In a competitive market, pure players use the equation, <em>speed + convenience</em>, to drive adoption. This is especially relevant to the "last mile" GHG footprint: the distance between the distribution center and the consumer.</p><p>Interestingly, the smallest GHG footprint occurs when you order directly from a physical store—even smaller than going there yourself. Pure players, such as Amazon, are the greatest offenders. Variables like geographic location matter; the team looked at shopping in the UK, the US, China, and the Netherlands. </p><p>Sadegh Shahmohammadi, a PhD student at the Netherlands' Radboud University and corresponding author of the paper, <a href="https://www.cnn.com/2020/02/26/tech/greenhouse-gas-emissions-retail/index.html" target="_blank">says</a> the above "pattern holds true in countries where people mostly drive. It really depends on the country and consumer behavior there."</p><p>The researchers write that this year-and-a-half long study pushes back on previous research that claims online shopping to be better in terms of GHG footprints.</p><p style="margin-left: 20px;">"They have, however, compared the GHG emissions per shopping event and did not consider the link between the retail channels and the basket size, which leads to a different conclusion than that of the current study."</p><p>Online retail is where convenience trumps environment: people tend to order one item at a time when shopping on pure player sites, whereas they stock up on multiple items when visiting a store. Consumers will sometimes order a number of separate items over the course of a week rather than making one trip to purchase everything they need. </p><p>While greening efforts by online retailers are important, until a shift in consumer attitude changes, the current carbon footprint will be a hard obstacle to overcome. Amazon is trying to have it both ways—carbon-free and convenience addicted—and the math isn't adding up. If you need to order things, do it online, but try to consolidate your purchases as much as possible.</p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a>, <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>
Chronic irregular sleep in children was associated with psychotic experiences in adolescence, according to a recent study out of the University of Birmingham's School of Psychology.