Painkiller Dependency is a National Problem
Approximately 70 percent of Americans use prescription drugs which raises serious concern for the potential levels of pill addiction in this country. Leading health organizations, including the Center for Disease Control, have documented the increase of painkiller purchases over the past decade. A recent study showed how prescription sales in Iowa alone have increased, and this increase has paralleled painkiller-related deaths from overdose.
The New York Times recently reported how many doctors are misprescribing opioids to expectant mothers. The report says that doctors are prescribing painkillers to pregnant women despite the lack of information regarding the drugs impact on the fetus.
As the controversial painkiller Zohydro enters the market there are growing concerns that the ease-of-access won’t be limited soon. As such, Holistic Light, a Panama-based addiction rehab program, says that it is paramount for the American population to become aware of what is a painkiller addiction as well as the risks associated with the drugs.
Vladimir Kogan, founder of Holistic Light rehab center, says that the challenge with painkillers is that many patients naively take them believing them to be safe because they were prescribed by a doctor. Many patients are unaware of how to use the drugs or even to recognize dependency in its early stages.
The inability to recognize dependency early isn’t just a problem that attacks soccer moms in Smalltown, USA. Hollywood stars, who usually guide trends for others to follow, present some high-profile cases of having abused prescription painkillers for years.
“Opioid abuse and addiction in America cuts through all cultural and financial lines,” said Kogan. “A person could be living in a coal town in West Virginia or a celebrity bringing down $30 million with each movie project.”
While anyone can develop a dependency on prescription painkillers, addiction often may begin with an emotional dependency. “People often start self-medicating their depression or loneliness,” Kogan said. “That is the reason you see a great deal of Hollywood stars fighting opioid addiction.”
Winona Ryder, for many years, was a respected actress with several Oscar nominations on her resume when she started to struggle with prescription painkiller addiction. In 2001, Ryder was busted at Saks Fifth Avenue for slipping $5,000 of clothing and accessories into her purse. While the shoplifting charges made the news, law enforcement officials also found eight different prescription painkillers in her purse.
In an interview with Vogue magazine, Ryder said that she had broken her arm two months before the shoplifting arrest. Her doctor prescribed oxycodone and she was taking it initially to manage the pain. Ryder admitted in the Vogue interview that she crossed a “weird point” where she wasn’t sure if she was still in pain, but was still taking the oxycodone. How many other Americans have crossed the same line?
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Upstreamism advocate Rishi Manchanda calls us to understand health not as a "personal responsibility" but a "common good."
- Upstreamism tasks health care professionals to combat unhealthy social and cultural influences that exist outside — or upstream — of medical facilities.
- Patients from low-income neighborhoods are most at risk of negative health impacts.
- Thankfully, health care professionals are not alone. Upstreamism is increasingly part of our cultural consciousness.
- A huge segment of America's population — the Baby Boom generation — is aging and will live longer than any American generation in history.
- The story we read about in the news? Their drain on social services like Social Security and Medicare.
- But increased longevity is a cause for celebration, says Ashton Applewhite, not doom and gloom.
Some evidence attributes a certain neurological phenomenon to a near death experience.
Time of death is considered when a person has gone into cardiac arrest. This is the cessation of the electrical impulse that drive the heartbeat. As a result, the heart locks up. The moment the heart stops is considered time of death. But does death overtake our mind immediately afterward or does it slowly creep in?
Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.
- Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
- They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
- The research raises many ethical questions and puts to the test our current understanding of death.
The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?
But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.
What's dead may never die, it seems
The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. Think a dialysis machine for the mind. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.
BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.
The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.
As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.
The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.
"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.
An ethical gray matter
Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.
The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.
Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.
Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?
"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."
One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.
The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.
"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.
It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.
Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?
The dilemma is unprecedented.
Setting new boundaries
Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."
She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.
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