Parents of every student-athlete ABSOLUTELY MUST READ!

Because the medical treatment of concussions and other sports-related brain injuries is still developing, here’s an article parents of every student-athlete ABSOLUTELY MUST READ!

http://www.miaminewtimes.com/2011-08-18/news/student-athletes-suffer-the-stings-of-concussions-while-lawmakers-fail-to-help/

It’s especially important for parents because a young person’s brain is not fully developed or mature until his early to mid-20s and a trauma that may be less significant – “getting your bell rung” – may be potentially far more devastating for a 7, 10, or 18 year iold.

We won’t summarize it or minimize it. We’ll only say that all youth sports carry a risk of traumatic brain injuries – well, maybe with the exception of crocket, tiddlywinks and marbles. In fact, Americans sustain as many as 3.8 million sports- and recreation-related concussions, 235,000 hospitalizations and 50,000 deaths each year, according to the Centers for Disease Control and Prevention. And, “Ninety percent of concussions went undiagnosed. In fact, today you can talk to an athlete and ask the amount of concussion they’ve had and give them an actual definition, and that number will increase,” Chris Nowinski of the Boston-based Sports Legacy Institute told Village Voice Media

Francis J. (Skip) Flynn, Psy. D.

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Testosterone may cause increased probability of dying among teenagers

Testosterone. It makes 18 the old 22 – at least physically.

It’s the male hormone that, from conception to old age, controls the lives of men and boys; and, now there’s evidence that it may be causing an “accident hump” – associated with an increased probability of dying among teenage boys.

The age of sexual maturity has been on a decline – about 2.5months each decade or more than two years per century – at least since the mid-18th Century but, the research has focused primarily on girls and used data analysis documented by medical records.

Testosterone may cause risky behaviour in teenagers“The reason for earlier maturity for boys, as with girls, is probably because nutrition and disease environments are getting favorable for it,” reports demographer Joshua Goldstein, director of the Max Planck Institute for Demographic Research, Rostock (Germany). Goldstein uncovered the male statistics by studying demographic data related to mortality. When male hormone production during puberty reaches a maximum level, the probability of dying increases – an “accident hump.” And the hump, which is statistically well-documented, is consistent in almost all societies.

Reviewing data for Sweden, Denmark, Norway, Great Britain and Italy since 1950, Goldstein discovered that the “accident hump” is getting earlier and earlier. It occurs in the late phase of puberty, after males reach reproductive capability and their voices change. It is attributed to the fact that young men participate in particularly risky behaviors when the release of testosterone reaches its maximum .  (However, it should be noted, that since 1950 the data is not clear but indicates stagnation.)

It is well-known that dangerous and reckless shows of strength, negligence, and a high propensity to violence lead to an increased number of fatal accidents. While the probability of a fatality remains low, the rate jumps considerably.

“Being 18 today is like being 22 in 1800,” reports Goldstein, who attributes the changes to better nutrition and an improved resilience against diseases. Moreover, it appears that the shift in age of maturity is biological and not related to technological advancements or social activities. “Researchers see for the first time how females and males have been equally responsive to changes in the environment,” notes Goldstein.

“The biological and social phases in the lives of young people are drifting apart ever stronger. While adolescents become adults earlier in a biological sense, they reach adulthood later regarding their social and economic roles.”

Sociological and life-cycle research show that for more than half a century the age at which people marry, have children, start their careers and become financially independent from their parents continue to rise.

Goldstein points out that this doesn’t only extend the period of physical adulthood during which young people do not yet have children. “Important decisions in life are being made with an increasing distance from the recklessness of youth.”  He points out that it remains unclear whether the “high-risk phase” of adolescence becomes more dangerous because it starts earlier. Although young men are less mentally and socially mature, their parents tend to supervise their children more closely when they are younger.

Goldstein points out that this doesn’t only extend the period of physical adulthood during which young people do not yet have children. “Important decisions in life are being made with an increasing distance from the recklessness of youth.”  He points out that it remains unclear whether the “high-risk phase” of adolescence becomes more dangerous because it starts earlier. Although young men are less mentally and socially mature, their parents tend to supervise their children more closely when they are younger.

Francis J. (Skip) Flynn, Psy. D.

http://en.wikipedia.org/wiki/Testosterone

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30 minutes a day of exercise adds four years to life expectancy

It’s a promised “return on investment” that, if it involved money, would get folks arrested for running a Ponzi scheme. But, here’s the newest science-based facts: 15 minutes a day or 92 minutes per week of mild to moderate exercise extended lifespan by three years compared to inactivity.

Those were the results of a twelve year study of 416,175 Taiwanese and reported by senior author Xifeng Wu, MD, PhD, professor and chair of The University of Texas MD Anderson Cancer Center Department of Epidemiology. “Exercising at very light levels reduce deaths from any cause by 14 percent,” reported Dr. Xifeng. “The benefits of exercise appear to be significant even without reacting the recommended 150 minutes per week based on results of previous research.”

Benefits Of ExerciseLead author Chi-Pang Wen, MD of the National Health Research Institutes of Taiwan, and colleagues found that a person’s risk of death from any cause decreased by four percent for every additional 15 minutes of exercise up to 100 minutes a day over the course of the study and exercising for 30 minutes a day added about four years to life expectancy – regardless of age group, gender or risk of cardiovascular disease.
At onset, study participants completed a questionnaire covering their medical history of lifestyle information. They characterized their weekly physical activity for the previous month by intensity  – light (walking), moderate (brisk walking), vigorous (jogging) or high vigorous (running) – and time. Participants also characterized their physical activity at work – sedentary to hard physical labor. Those who reported less than one hour a week of leisure time physical activity – 54 percent – were classified in as inactive, while others received ratings of low, medium, high or very high based on duration and intensity of their exercise.

The researchers also analyzed thirteen other variables: age, sex, education level, physical labor at work, smoking, alcohol use, fasting blood sugar, systolic blood pressure, total cholesterol, body mass index, diabetes, hypertension and history of cancer. Those who engaged in low-volume exercise had lower death rates than inactive people – regardless of age, gender, health status, tobacco use, alcohol consumption or cardiovascular disease risk.

At present, the World Health Organization and the US Centers for Disease Control and Prevention recommend at least 150 minutes of moderate-intensity exercise per week – a guideline met by only one-third of U.S. adults. While the study considered only Taiwanese participants, the findings of reduced mortality through even moderately intense exercise are likely to hold true for other populations, said Wu, even though the amount of time spent or workout intensity required for a health benefit might differ. “These findings can stimulate people to exercise as much as they can and to not be frustrated that they can’t reach the 30 minutes per day guideline,” said Wu.
The exercise project was funded by the Taiwan Department of Health Clinical Trial and Research Center of Excellence and the Taiwan National Health Research Institutes.

Francis J. (Skip) Flynn, Psy. D.

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If you want to stop learn HALT!

It’s one of the most basic principles taught in any drug/alcohol/gambling/compulsive eating treatment program: If you want to stop, learn HALT.

The acronym stands for Hungry-angry-Lonely-Tired. They’re four mental/emotional/leading to relapse.

Now, a study that will be published in the November 2011 issue of Alcoholism: Clinical and Experimental Research adds to what physicians and mental health professionals have known for generations: “Drinking alcohol may reduce maintaining a healthy diet, leading to adverse metabolic effects which in turn add to those directly produced by alcohol.” In short, excessive drinking and an unbalanced diet are two preventable contributors to health problems.

← Parental conflict may find its expression in infants sleep difficulties Posted on August 23, 2011 by Brain Training Centers Of Florida  It’s one of the most basic principles taught in any drug/alcohol/gambling/compulsive eating treatment program: If you want to stop, learn HALT.“On average, people who drink excessive alcohol are more likely to be careless in their dietary habits,” noted Miguel A. Martinez-Gonzalez, chair of the department of preventive medicine and public health at the University of Navarra (Spain) and co-author of the report. “A high alcohol intake is especially unhealthy with respect to liver disease. A high-energy food pattern rich in trans fats – such as ‘fast-foods’ or items from a commercial bakery — is also likely to be related to liver disease. In this sense, if both unhealthy lifestyles cluster together, they can act synergistically to produce very adverse effects.”

“The specific influence of alcohol on diet may depend upon the overall quantity of alcohol ingested, frequency of consumption, beverage preference, and whether alcohol intake takes place during meals,” said Jose Lorenzo Valencia-Martin, a doctor at the Universidad Autonoma de Madrid and corresponding author for the study. “Alcohol may indirectly contribute to several chronic diseases such as obesity, diabetes mellitus, cardiovascular disease, or cancer.”

The researchers found “drinking at mealtimes is associated with insufficient intake of healthy foods, such as fruits and vegetables, and with excessive intake of animal protein,” according to Valencia-Martin.

The researchers conducted 12,037 telephone surveys between 2000 and 2005, among other issues, looked at binge drinking. In the end, “Excessive drinkers, either with or without binge drinking, showed a poor adherence to dietary recommendations,” said Valencia-Martin. “Although drinking at mealtimes has traditionally been considered a safe or even a healthy behavior, our results point to some unintended consequences that the general population should be aware of. In particular, drinking at mealtimes is associated with poor adherence to most of the food consumption guidelines.”

“’What do I have to change?’ is a standard question from men and women new to recovery from alcoholism and substance abuse. Most of the time, the answer is ‘Everything,’” noted Francis J. (Skip) Flynn, Psy.D., CAP  director of clinical services of the Brain Training Centers of Florida and an addictions counselor. “And we always caution them about HALT. If you’re hungry, alcohol is quick and easy calories. Angry? Have a drink or two and you won’t be angry – until you are again. Lonely? Substance abusers have a relationship with their drugs of choice; alcohol or drugs are often their closest friends. And tired? The extra calories can be a quick picker-upper until it slams you,” said Flynn. “This new research takes the conventional wisdom about recovery one step further and applies it to many men and women who are not yet in trouble because of their alcohol use.”

Francis J. (Skip) Flynn, Psy. D.

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Parental conflict may find its expression in infants sleep difficulties

It’s one of the great self-deluding myths of marital conflict: “We don’t argue in front of the children; we protect the kids from everything that is happening; the kids don’t know that we’re having trouble.”

Parental conflict may find its expression in infants’ sleep difficulties, according to a new report in the July/August 2011 edition of the journal Child Development.

Brain Training & Sleep IssuesPoor sleep patterns in children from nine to eighteen months are likely influenced by conflict in their parents’ marriage, notes Penn State professor of psychology Jenae M. Neiderhiser. While past research has shown a connection between marital distress and child sleeping habits, this study looked specifically at adopted infants and their parents. Studying adopted parents and their infants allowed researchers to focus on environmental issues and eliminate genetic factors that might affect children’s sleep problems.

“It is important to understand how parenting comes in to play here,” said Neiderhiser. “Looking at the marital relationship is not direct parent-child interaction, but it is an index of stress in the family.”

The research team interviewed 357 sets of adoptive parents – together and separately and assessed their habits and emotions as well as their children’s behaviors. Parents where interviewed twice – when children were nine and 18 months old.

Parents were asked a series of questions, including “Have you or your partner suggested the idea of a divorce?” They were also asked to describe their children’s bedtime behavior by rating several behaviors including “Child needs parents in room to fall asleep” or “child struggles at bedtime.”

The researchers found that marital conflict in the first survey at nine months predicted that the child would be more likely to have sleep problems at the time of the second survey. However, if the child had sleep problems at nine months, the parents were not more likely to have marital stress at eighteen months.

According to Neiderhiser, “Research indicates that stress can negatively impact sleep. We also know that infancy is an important time for the development of sleep patterns. Our study suggests that marital instability is impacting change in the child’s sleep patterns over time, and it could be that this is setting the child up for a pattern of problematic sleep.”

“The implications of the Penn State study is especially important for many contemporary adults with sleep patterns,” notes Francis J. (Skip) Flynn, Psy.D., clinical director of the Brain Training Centers of Florida. “Too often we see clients who have never – almost since infancy – experienced a good night’s sleep and awakened refreshed.

“Our experience indicates that clients frequently have brain wave patterns that were adversely affected by early-life experience and have never allowed them to experience healthy, refreshing sleep. By allowing them to achieve a new appropriate balance of their brain wave activity, we allow them to experience refreshing and restorative sleep – often for the first times in their lives,” reported Flynn.

Francis J. (Skip) Flynn, Psy. D.

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Factors that may contribute to long-term and recurring depressions

New scientific research from London may provide a key into the recent success of a South Florida firm assisting individuals with long-term and previously intractable depressions.

Individuals with histories of childhood abuse or mistreatment are twice as likely to develop multiple and long-lasting depressive episodes as those without such experiences, according to a new report by a Psychiatry team from King’s College London Institute of Psychiatry and published in the American Journal of Psychiatry.

The British researchers studied 16 epidemiological studies involving more than 20,000 participants and 10 clinical trials involving more than 3,000 participants. At present, one in ten children exposed to maltreatment – psychological, physical or sexual abuse or neglect – and the World Health Organization predicts that by 2020 depression will be the second leading contributor to the cost of disease across all ages. Significantly, individuals with multiple and long-lasting depressive episodes represent the largest societal impact of depression.

While previous studies have shown that maltreated individuals are more likely to show abnormalities in biological systems sensitive to psychological stress – the brain, the endocrine, and the immune systems – both in childhood and adult life, and they may have important clinical implications.

Helping Child Abuse Victims - Brain Training Centers “Identifying those at risk of multiple and long lasting depressive episodes is crucial from a public health perspective,” notes Dr. Andrea Danese, senior investigator of the King’s study. “The results indicate that childhood maltreatment is associated both with an increased risk of developing recurrent and persistent episodes of depression, and with an increased risk of responding poorly to treatment. Therefore prevention and early therapeutic interventions targeting childhood maltreatment could prove vital in helping prevent the major health burden owing to depression. Knowing that individuals with a history of maltreatment won’t respond as well to treatment may also be valuable for clinicians in determining patient’s prognosis,” she added.

Dr. Danese noted, “The biological abnormalities associated with childhood maltreatment could potentially explain why individuals with a history of maltreatment respond poorly to treatment for depression.”

“Our study has shown that antidepressant medication, psychological treatment and the combination of these two are less effective in those who have a history of childhood maltreatment,” noted Dr. Rudolf Uher, co-author of the article “Childhood Maltreatment Predicts Unfavorable Course of Illness and Treatment Outcome in Depression: A Meta-Analysis,” appearing in the August 14, 2011 edition of The American Journal of Psychiatry.

“Research on the brain is only now beginning to recognize the myriad of factors that may contribute to long-term and recurring depressions,” observed Francis J. (Skip) Flynn, Psy.D., director of clinical services of the Brain Training Centers of Florida. “So many of our clients with histories of long-term and recurring depressions report physical, emotional and sexual abuse in childhood or the fear that occurs when one grows up in a family with an alcohol or addicted or violent pattern that our experience reflects the British findings.

“More importantly, however, we’ve also found that using the tools of neurobiofeedback and individual counseling we are frequently able to assist clients in overcoming depression, sleeping better, and living without the stress of being perpetually hyper-vigilant,” said Flynn.

Flynn is careful to avoid making promises regarding individual clients, again noting the “multitude of factors – including childhood trauma – that may result in adult depression.

“Our experience, assisting dozens of clients with histories of chronic depression, appears to indicate that early life trauma affects the balance of brainwave activity throughout the brain,” notes Flynn. “By helping clients achieve a healthier balance of this activity, we have been able to assist many adults find significant and long-term relief from otherwise unresponsive depressions.”

Dr. Flynn is quick to emphasize that future research should emphasize biological and neurological changes associated with childhood abuse in all its forms.

Francis J. (Skip) Flynn, Psy. D.

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Importance of setting boundaries around your use of technology

If ever there were a “perfect story” of reasons for the parents of college students to lose sleep, here it  is: Nearly half of all college students have received sexually suggestive images through text messages – sexting – and nearly 80 percent have received suggestiver messages and, depending on the state, minors and adults who possess or forward such images of anyone younger than 18 may be charged with violating child pornography laws.

The importance of setting boundaries with your technologyUniversity of Rhode Island assistant professors Sue K. Adams and Tiffani S. Kisler examined the impact of technology use on physical and mental health, as well as interpersonal relationships with college students.  In their study of 204 students conducted during the Spring 2011, they found that 56 percent had received sexually suggestive images, and 78 percent had received sexually suggestive messages.  Potentially more criminally dangerous, two-thirds of the group had sent suggestive messages. Granted almost three-quarters – 73 percent – were sent to a relationship partner, 10 percent were forwarded without consent of the original sexter.

“It is important to help everyone, especially students, understand the importance of setting boundaries around their use of technology,” notes Kisler.

In August, Rhode Island Governor Lincoln Chafee signed a bill outlawing sexting by minors. It provides that minors who create and send sexually explicit images of themselves may be charged with a “status offense” and referred to family court. Minors and adults who possess or forward sexual images of anyone younger than 18 may be charged under the state’s child pornography law.

“College freshmen are right at that 17- and 18-year old threshold,” observed Professor Adams.  “Whether it is classmates in college or friends from high school, we have to wonder how many students are thinking about the ages of the people they are communicating with.” And Kisler pointed out that many students don’t recognize the lack of control they have over who is seeing their messages.

“At the young age of most college students, people are filtering through relationships at a faster rate. People want to feel a sense of belonging, so they are sharing more of themselves with people they are still getting to know. Once they click that ‘send’ button, they don’t know where else a message will end up,” said Kisler.

In an earlier study, Kisler and Adams found that texting and cell phone use affect important aspects of students’ physical health. Forty-seven percent of the 236 college juniors and seniors in their study reported being awakened by text messages and then responding before falling back to sleep. Forty percent of student answered phone calls during sleep; students who use technology throughout the night were losing an average of 44 minutes of sleep per week due to text messages and calls. And, this pattern of loss sleep was also associated with particularly poor sleep quality, depression and anxiety.

“At first glance 44 minutes doesn’t seem like much, but combined with the fact that college students are the most sleep deprived population across all age groups, the implications are significant,” notes Adams. “More often than not, the interruptions caused by texting come with the first few hours of sleep, which is the most important time for restorative sleep. If students are constantly interrupting their sleep cycle, they place themselves at risk for sleep debt, which can impact multiple areas of their life, including academic performance. “

Francis J. (Skip) Flynn, Psy. D.

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Can’t shed those pounds and inches despite all your best intentions?

Remember that really junk science stuff about how we only use x-y-z percent of our brain. Well, besides being just that – Junk Science – we now have evidence that at least a few parts of our brain are hiding in waiting (or is that weight-ing???) as part of an on-going conspiracy to make some people fat.

Can’t shed those pounds and inches despite all your best intentions? Blame it on your anterior cingulate cortex and the medial orbitofrontal cortex — brain areas that have been implicated in an addict’s urge to use drugs.

Weight loss informationResearcher Ashley Gearhardt, a clinical psychology doctoral student at Yale University and her team studied 48 women with an average age of 21 whose body mass ranged from lean to obese. Subjects completed a research questionnaire that included statements like “I find that when I start eating certain foods, I end up eating much more than I had planned.”  Subjects rated how closely the questionnaire statements, which were based on an established assessment tool for measuring drug addiction, matched their own experience.  Functional magnetic resonant imaging (fMRI) studies were also completed to allow researchers to understand how subjects brains’ responded to the anticipation and consumption of chocolate milkshakes and a tasteless solution

The researchers found that the brains of subjects who scored higher on the food-addiction survey exhibited brain activity similar to that seen in drug addicts, with greater activity in regions of the brain responsible for cravings and less activity in the regions that curb cravings or urges. And, both lean and obese subjects who scored high in the test for food addiction showed the same brain activity indicative of addiction. The researchers reported that simply seeing images of a milkshake triggered brain activity in the anterior cingulate cortex and the medial orbitofrontal cortex — brain areas that have been implicated in an addict’s urge to use drugs.

And more food, diet and anti-obesity news:

Before the Idaho Potato Commission sues me for defaming their spuds’ collective reputation, let me be the first to declare that extra-large, well-baked Idaho potatoes – with crisp skins and garnished with my homemade pesto sauce – are a culinary delight.

But (Isn’t there always a but!), a new study in the June 23, 2011 edition of the New England Journal of Medicine puts a big part of the blame for American obesity at the feet of extra servings of potatoes – French fried, mashed with butter, boiled, baked or crispy chips. (BTW, I know potatoes have eyes, but can they have feet?)

The Harvard University based researchers tracked the lifestyle choices of more than 120,000 health professionals from around the country for at least 12 years. They found that participants gained an average 0.8 pounds a year – 16 pounds over 20 years.

While potatoes have been certified as “heart healthy” by the American Heart Association and good sources of Vitamin C, several B vitamins, and minerals including iron, potassium, phosphorus and magnesium, individuals who ate an extra serving of French fries every day gained an average of 3.4 pounds over a four-year period. An extra serving of potato chips each day added an average of 1.7 pounds every four years.

Problem is that, while taters might be great food if we eat them raw, pack on sour cream or butter or fry ‘em. Ooooooops! Besides, those tubers prompt a quick spike in blood-sugar levels and cause the pancreas to go into overdrive attempting to bring levels back down to normal. While the blood sugar levels spiral down, many individuals experience hunger, resulting in snacking. And this cycle can result in significant weight gain, pancreatic fatigue, and, in the worst cases, the development of Type 2 Diabetes.

And, those taters can hold a lot of calories: 278 in a large backed potato even before you pile on any of the good stuff or 500-600 calories in a serving of French fries

But to be fair to the poor potato, it’s not the only cause of American obesity. Every additional sugary soft drink per day represented an additional one pound per year and extra servinvg of red and processed meats were just under that. And, consuming an extra alcoholic drink equaled close to half a pound more every four years and extra glass of 100 percent fruit juices each day  packed on almost one-third of a pound over four years.

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Drinking or consuming drugs when driving account for many accidents

That line we hear from teens and young adults about being safe drivers when they’ve been smoking marijuana is just that: A line of pure bovine by-product. And there’s good new scientific evidence for calling bull by-product just what it is.

The call came in at O’Dark Thirty and I slept through it. So, I responded as soon as I could see to hit the REDIAL button.

Dad is concerned that Junior is abusing alcohol and marijuana and doesn’t know how to proceed. While I wasn’t sure how he found my name and number, I pretty much knew the answers I would be getting to a few questions. Junior is an especially bright, rising senior at a Top 50 university, preparing for his med school admissions test, 21 years old. No, he hasn’t won the lottery, he’s not independently wealthy, and he’s not a trust-fund baby.

My answer: “Exercise the POWER OF THE PURSE STRINGS. The car is in your name. If he thinks he can get away with drinking, smoking marijuana and driving, he’s putting your and your family’s financial wellbeing at risk – especially if he has an accident and injures or kills someone. Oh, and he just might kill himself.”

Go ahead drink and driveIn the July 2011 edition of the Journal of Studies of Alcohol and Drugs, Eduardo Romano, Ph.D. and Robert B. Voas, Ph.D. of the Pacific Institute for Research and Evaluation analyzed data from the Fatality Analysis Reporting System (FARS) and found that approximately 25% of US drivers who died in a crash tested positive for drugs. Marijuana and stimulants, including cocaine and amphetamines, each accounted for about 23% of the positive tests.

While it is unclear whether or not drugs were to blame for the crashes, the 2007 National Roadside Survey found that 16% of nighttime weekend drivers tested positive for illegal drugs and the fact that drug use was almost twice as high among drivers in fatal crashes suggests that drugs do contribute to road deaths.

The researchers examined data from 1998 to 2009 for 44,000 fatally injured drivers involved in single-vehicle crashes and in which drivers were tested for drugs other than alcohol and had a known result. About 25% of drivers tested positive for drugs. Cannabinoids (marijuana and marijuana –related drugs) and stimulants (amphetamines and cocaine) each contributed to about 23% of the drug-positive results (6% among all fatally injured single-vehicle drivers). More than cannabinoids, stimulants were found to be associated with the four types of crashes under the study: speeding, failure to obey/yield, inattention, and seatbelt non-use. Marijuana was strongly linked only to speeding and seatbelt non-use.

Ultimately, however, alcohol is still the biggest roadway danger. Other drugs appear to be key only when drivers have not been drinking and drugging. That is, when someone drinks and uses drugs, the alcohol is the main reason for impaired – sometimes fatal – driving.

“Alcohol is still the largest contributor to fatal crashes,” reports Romano.

“The suspicion is there, because when you look at drivers who’ve been in fatal crashes, the percentage using drugs is a good deal higher,” said co-author Voas, For parents, teens and young adults, the answer is simple: “Don’t drink or don’t consume drugs when you’re going to drive,” said Romano, the lead author on the study.

And I remind parents whose kids don’t believe scientific research applies to them “You have the Power of the Purse Strings. Exercise it. It’s one helluvalot cheaper that losing home and everything you’ve ever worked for if Junior kills someone in your car. And is a infinitely better than spending a lifetime of grief and self-recrimination because you didn’t and he killed himself.”

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Finding Relief from Chronic Pain

It costs more than heart disease, cancer and diabetes.

It may be the most pervasive epidemic in American history – affecting at least 116 million US adults – almost four in 10 – and costing as much as $635 billion a year, an estimate that may be extremely low because it does not include children and members of the US military.

Finding relief from chronic painChronic pain is defined as pain that lasts more than several months. It is a hard-to-diagnose-and-treat but highly common condition that demands a much more comprehensive strategy for dealing with lost productivity and skyrocketing healthcare costs, according to a report from the Institute of Medicine (IOM) release in late June 2011. For many patients, the condition is complicated by the fact that many physicians see it as a less than legitimate condition.

Chronic pain commonly sets in after other illnesses, injuries and medical treatments; remains difficult for physicians to diagnose; is often self-treated and is too often greeted with skepticism (and ridicule) by patients’ physicians and family members.

“Many health care professionals are not adequately prepared to provide the full range of pain care or to guide patients in self-managing chronic pain,” IOM researchers wrote in the report mandated by Congress through the 2010 US healthcare overhaul.

The IOM researchers also excluded costs associated with pain in children and members of the US military – making the estimate conservative; and the federal Medicare program bears approximately one-quarter of the expense, the report said. Lower back pain is the most commonly reported pain in the US, followed by knee pain, severe headaches (migraines) and neck pain. As a result, many sufferers resort to painkillers, including morphine and oxycodone and other opioids. In 2007 more than 33 million people abused opioids, resulting in more overdose deaths than heroin and cocaine combined, according to the latest government data.

“It’s a conundrum of opioids,” according to Noreen Clark, vice chair of the IOM committee that organized the study. “There are people who really need access to pharmaceuticals to manage their pain and there are some who abuse the pharmaceutics, but the abusers are a very, very small proportion of those who need but don’t have access to the treatment.”

According to one study cited in the IOM report, only five of 133 US medical schools have course on pain and 17 have elective courses.

“Chronic pain is real pain and too often can be indescribably debilitating,” notes Francis J. Flynn, Psy.D., clinical director of the Brain Training Centers of Florida. “Ultimately, there are almost as many underlying causes as there are individuals living and dealing with chronic pain. And there is no one-size-fits-all solution. However, we encourage many individuals with chronic pain– especially after significant physical trauma.”

Flynn has special empathy for chronic pain sufferers. An automobile accident resulted in bilateral temporal mandibular joint dislocations, two years of debilitating pain and headaches, and three surgeries before final relief. “I consulted more than a dozen physicians and was repeatedly told it was all in my head.  And the problem was all in my head – actually all in my jaw. In my case, the problem was genuinely mechanical – my jaw joints were dislocated. However, for many patients with chronic pain the on-going problem results from the brain’s habituated response to a very real, original problem. By breaking the brain’s habituated response patterns, we can allow patients relief from this kind of pain without the use of medications.

“We encourage chronic pain sufferers to explore every possible avenue of relief. And, before considering radical surgery, we encourage individuals to consider a non-invasive alternative that allows the brain to re-find and re-establish healthier ways of functioning,” notes Flynn.

Chronic pain costs U.S. up to $635 billion a year

By Alina Selyukh | Reuters – Wed, Jun 29, 2011

WASHINGTON (Reuters) – Addressing chronic pain, a hard-to-treat yet highly common condition, costs the United States as much as $635 billion a year and requires a much more comprehensive strategy for curbing lost productivity and healthcare expenses, according to a new government report.

At least 116 million U.S. adults — or about four in 10 — suffer from chronic pain every year, leading to extra sick days, lost wages and productivity, the Institute of Medicine (IOM) said on Wednesday.

Chronic pain is defined as pain that lasts more than several months. It remains hard for doctors to diagnose, is often self-treated by patients and commonly perceived as less than a legitimate condition.

“Many health care professionals are not adequately prepared to provide the full range of pain care or to guide patients in self-managing chronic pain,” IOM researchers wrote in the report mandated by Congress through the 2010 U.S. healthcare overhaul.

The IOM report excluded costs associated with pain in children or members of the U.S. military, making the estimate conservative and yet higher than economic costs of heart disease, cancer and diabetes, according to its researchers. The federal Medicare program takes the brunt of the medical costs of pain, bearing a quarter of expenditures, the report said.

Chronic pain commonly sets in after other illnesses, injuries and medical treatments. Similar to that, acute pain — also addressed in the report — is a sudden, short-lived kind of pain, but can be a recurrent and equally complex problem.

Pain in the lower back is the most commonly reported pain in the United States, followed by knee pain, severe headaches or migraines and neck pain.

Looking for ways to manage pain, many sufferers resort to painkillers, including prescription opioids such as morphine and oxycodone. More than 33 million people abused opioids in 2007, resulting in more overdose deaths than heroin and cocaine combined, according to the latest government data.

“It’s a conundrum of opioids,” said Noreen Clark, vice chair of the IOM committee that organized the study. “There are people who really need access to pharmaceuticals to manage their pain and there are some who abuse the pharmaceuticals, but the abusers are a very-very small proportion of those who need but don’t have access to the treatment.”

Drugmakers including Pfizer Inc have been developing painkillers that are tamper-resistant to prevent abuse, including pills that make it difficult to snort or inject the drugs.

IOM’s report urges more professional education as well as more data collection and research into the phenomenon of chronic pain, in part to get rid of various social stigmas associated with pain as a disease.

The call comes a day after the American Society of Interventional Pain Physicians lobbied Congress to pass a bill that would require physicians to go through special training before prescribing painkillers.

Citing a recent study, IOM said only five of 133 U.S. medical schools have required courses on pain and 17 have elective courses.

The IOM report also calls on federal and state insurance programs, Medicare and Medicaid, together with private health plans and workers’ compensation programs to address lags in pain care coverage.

(Editing by Michele Gershberg, Dave Zimmerman)

Posted in: Chronic Pain

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