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CRISPR-Cas Gene Editing May Treat The Genetic Cause Of Cystic Fibrosis
Kratom: Fear-worthy foliage or beneficial botanical?
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Depending on what you read, kratom is a dangerous, addictive drug with no medical utility and severe side effects, including overdose and death, or it is an accessible pathway out of undertreated chronic pain and opiate withdrawal. How can the US Drug Enforcement Agency (DEA), media professionals, and millions of regular kratom users have such divergent views of the same plant?
What is kratom?
Kratom (Mitragyna speciosa) is a tropical tree from the coffee family native to Southeast Asia, with properties that range from stimulant-like, energizing and uplifting, to opiate-like, causing drowsiness and euphoria. Kratom has dozens of active components, which makes it difficult to characterize as one particular type of drug such as “stimulant” or “opiate.” The two main chemicals, mitragynine and 7-hydroxymitragynine, have strong activity at the main opioid receptor, the “mu” receptor, which is the same one stimulated by heroin and oxycodone. Kratom is commonly consumed orally, with added sweetener to overcome its harsh bitterness, made into tea or swallowed as a pill. Side effects can include agitation, tachycardia, drowsiness, vomiting, and confusion. There can also be grave side effects such as seizures, as well as respiratory and cardiac arrest.
Kratom can be found in gas stations and paraphernalia shops in most parts of the US, except in the handful of states and cities that have banned it. Many people purchase kratom over the Internet, where it is sold “for soap-making and aromatherapy” to avoid the fact that in 2014 the FDA made it illegal to import or manufacture kratom as a dietary supplement.
What are some of the problems with kratom?
There is little to no control or reliable information on the growth, processing, packaging, or labeling of the kratom sold in the US, which adds to the already considerable uncertainty of its health risks. In 2018 the FDA instituted a mandatory recall over concerns about Salmonella contamination of kratom-containing products. The DEA has recently placed kratom on its Drugs and Chemicals of Concern list, but has not yet labeled it as a controlled substance.
Kratom can be addictive due to its opiate-like qualities, and a small minority of users end up requiring addiction treatment. The CDC claims that between 2016 and 2017, there were 91 deaths due to kratom, but this claim should be greeted with skepticism, as all but seven of these casualties had other drugs in their system at the time of death, making it impossible to uniquely implicate kratom.
Why do people use kratom?
The DEA maintains that kratom has no medical uses or benefits, but in Asia kratom has been used for hundreds of years to treat cough, diarrhea, opiate withdrawal, and chronic pain, and to boost energy and sexual desire. More recently, in the US there has been an uptick in the use of kratom by people who are self-treating chronic pain and acute withdrawal from opiates and seeking alternatives to prescription medications. Despite a vocal community of supporters, and numerous anecdotal testimonials of effectiveness, these treatment practices using kratom have not been rigorously studied as either safe or effective.
A patient wishing to use kratom for pain or to mitigate withdrawal symptoms would encounter several problems, not all of which have to do with the intrinsic properties of kratom itself.
- First of all, the DEA is threatening to make it a Schedule 1 controlled substance, in the same category as heroin or methamphetamine, which would make it difficult to access, and would likely make the supply as a whole even more dangerous. Generally, it’s not a good idea to use something for pain or addiction which is about to become less available and less safe.
- Secondly, the complete lack of oversight or quality control in the production and sale of kratom makes its use potentially dangerous.
- Thirdly, kratom has not been well studied for any of the uses its proponents claim, though as the saying goes, “absence of evidence of benefit isn’t evidence of absence of benefit.”
- A final problem is that kratom doesn’t show up on drug screens, and one can argue that the wider adaptation of another potentially addictive opiate-like substance in the midst of an opiate epidemic is the last thing we need.
Is there a sensible path forward with kratom?
I’m not sure that anyone has the answer to this question. At bare minimum, safety could be improved with:
- Regulation: it would be safer if people knew the exact dosages they were consuming and that it was free of contamination.
- Education: educated consumers, who know the dangers and potential benefits, are far less vulnerable to misleading claims.
- Research: if it does have benefits for either addiction or chronic pain, we should know, and it is critical that we better define the risks of using kratom, so that people are more accurately informed.
If all of the above could somehow be accomplished, by scientists and public health specialists, without overdue distortion from corporate interests, antidrug ideology, and romanticism by kratom enthusiasts, we could then have enough clarity to answer the question: is kratom harmful or helpful?
The post Kratom: Fear-worthy foliage or beneficial botanical? appeared first on Harvard Health Blog.
When Your Job Requires Brilliant Ideas, But Brainstorming Feels Like Pulling Teeth
It sounds terribly cliché, but sometimes coming up with ideas really does feel like pulling teeth. It feels painful and frustrating. It feels messy and hard. And it’s the last thing you want to do.
But maybe your job requires you to come up with great ideas. On a regular basis.
Maybe you’re a writer, speaker, designer, artist, podcast host, publicist, teacher, researcher, or entrepreneur. Either way, idea generation is a priority in your position.
And, unfortunately, you feel utterly and completely uninspired.
Mary Potter Kenyon, an author, certified grief counselor, and program coordinator at the Shalom Spirituality Center, typically feels uninspired when she’s tired or overwhelmed, and after she’s submitted a manuscript or big project.
“I feel spent, as if it took everything creative out of me,” Kenyon said.
For author and productivity expert Paula Rizzo lack of inspiration comes from lack of structure. If she doesn’t plan for creativity, it’s hard for her to “think of anything!”
Alexandra Franzen, a prolific writer who helps clients complete all kinds of creative projects, feels uninspired when she spends too much time sitting in front of her computer and not enough time moving her body. She feels uninspired when she’s been too isolated and “shut off from the fascinating and beautiful world.”
That’s one way to kick-start our creativity: Find out why the heck you feel uninspired—and work to turn it around. Be honest about what’s going on and be compassionate with yourself, Franzen said.
For instance, maybe you’re tired or lethargic because your lifestyle leaves little room for leisure. Maybe you’re bored of your career or afraid to take an emotional risk, she said. Maybe you’re not getting enough sleep. Maybe you’re saying yes to projects you’re not even interested in.
Franzen also suggested getting help, whether that’s from a close friend, creative partner, therapist, or coach. Below you’ll find eight other ways to feel inspired and ignite your creativity.
Carve out creative time. “Oftentimes creative people think that adding boundaries or structure will make them less creative but it’s simply not true,” Rizzo said.
She puts her creativity sessions on her calendar—and sticks to them. When she started writing her second book Listful Living: A List-Making Journey to a Less Stressed You (published in September 2019 by Mango Publishing), she carved out Fridays for researching and writing, and wouldn’t schedule any other calls or appointments.
Now that the book is finished, her Fridays are devoted to other forms of creativity. She tries to assign a project or theme for each session. For example, a few weeks ago, she wrote about a funny scene from her vacation in Greece:
When she and her husband were in Santorini, they decided to walk to the next town, which people told them would take 25 minutes. It turned out to be one hour. “[T]he signage was terrible and we weren’t sure where we were going half the time. But on our way, I kept joking about why they didn’t give us better directions when we would come across something on the path [like] ‘Then you’ll come to an abandoned flip flop—just keep going.'”
File it away. Kenyon keeps a file folder with magazine articles on topics she finds interesting—everything from research to random facts. She also has a file folder with book ideas. Years ago, she considered writing a book about exploring and expanding creativity as an adult.
So, she started collecting fascinating articles and quotes on creativity. If she read a book about creativity that resonated with her, she jotted down the title, and put it in the folder, too. In 2020, Kenyon will be publishing a book on creativity with Familius Publishing.
Reconnect to your world. Instead of getting stuck inside your own mind, Franzen recommended having conversations, being in nature, and looking up at the sky (“not down at a digital screen”).
For instance, Franzen cited research that found that spending 3 days immersed in nature “acts like a ‘neural reboot’ and significantly boosts creativity.” “I’ve definitely experienced this myself,” she said. “For me, even just 3 hours in nature can make a huge difference in how I think and feel.”
Play with prompts. At her writing classes and retreats, Franzen loves to assign small writing prompts, “not to write something ‘glorious’ or ‘perfect’—the point is just to have fun, wake up your brain, and flex your creative muscles in a new way.”
Here’s one she recently made up: “Imagine you’re a detective in a small town. A new client walks into your office with a very unusual mystery for you to solve. He’s willing to pay cash up front, and you could definitely use the cash. Set a timer for 5 minutes and write a fictional scene featuring you and this client. If you don’t ‘finish’ the scene, no worries. Just see how far you can get!”
Rizzo also uses prompts to create stories about people she sees on the street or news headlines she reads. For instance, she’ll ponder “What if?” as in “What if the homeless man I just saw on the street used to be a CEO on Wall Street?”
“Even if I don’t use the story for anything, it’s fun to think about,” Rizzo said.
Read. A lot. Kenyon reads about 30 to 40 books on a topic before, during, and after she’s writing a book about that topic. “Part of it is research that I might include in my book, but it also helps me clarify what I do, or don’t want to do with my own writing,” she said.
Another practice is to read books that you normally wouldn’t pick up to shake up your routine, and therefore shake up your thinking. This could be anything from children’s books to political thrillers to poetry.
Wander (and wonder) around. If you’re able to, take a day off work to meander without a strict agenda, said Franzen, author of several books, including You’re Going to Survive. “Lin-Manuel Miranda got the idea to write Hamilton while on vacation—proof that unwinding and unplugged leads to genius, creative ideas.”
Maybe you take a day trip to the botanical gardens or the beach. Maybe you browse a museum, bookstore, or library, focusing on whatever catches your eye (and leave your phone in the car).
Think in circles. When Kenyon needs to plan a speech, write an article, or work on a new book, she makes a mind map. Start by jotting down the core concept or topic in a circle in the center of your paper. Next draw lines from that circle for other ideas, which you also put in circles. Kenyon does this quickly, and some of the words, phrases, and ideas don’t even make much sense.
However, she finds that the farther she gets from her main topic, “the more creative and innovative my ideas are.” In fact, this technique has helped her on different occasions to come up with ideas that a traditional outline just couldn’t coax out.
Turn to others. For Kenyon, being around others who are creating jumpstarts her own creativity, so much so she formed two groups: a monthly writer’s group and a lifelong learner’s creativity group. “We feed off each other’s creative energy. I always want to go home from a meeting and start writing,” she said.
Rizzo often gets together with a friend to bounce ideas off each other. As a former television producer, she’s used to working collaboratively and sometimes needs “someone else in the room to get the creative juices flowing.”
It can be hard to play when you’ve got the pressure of producing useful, profitable ideas. However, as Rizzo pointed out, sometimes it’s OK to write (and create) without a purpose.
“I think all of us are focused on the finished product and the fastest way to get there. But some of the great stuff happens in the in between.”
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