Big study casts doubt on need for many heart procedures

Big study casts doubt on need for many heart procedures

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https://ift.tt/2qaSI3N November 17, 2019 at 06:29AM https://ift.tt/1R552o9

Concerning Findings About Cannabis Use

While recreational marijuana is legal in 11 states as of November 2019, more states gravitating toward legalizing the recreational use of the substance, and 33 states allowing medical marijuana, there’s apparently no stopping this trend. Cannabis, in the form of marijuana, hemp, and cannabidiol (CBD)  is being used for pain relief, to alleviate stress, cope with anxiety, and a number of other mental health disorders and addictions.

Yet, there’s a dearth of clinical studies that have been conducted on the overall effects on a user’s health. Clearly, as Crain’s Detroit Business points out, more research on marijuana and marijuana-based products is warranted.

Cannabis Medical Research Still Hampered by Schedule I Classification

A survey of 157 accredited medical schools in America revealed low acceptance of the scientific study of cannabis and the endocannabinoid system (ECS), with only 13 percent of the schools teaching endocannabinoid science to medical students, no schools with a department or director of endocannabinoid science, and none teaching endocannabinoid science as an organized course of study. Furthermore, only 21 of the 157 medical schools surveyed mentioned ECS in any course.

Although the ECS controls inflammation, pain, and glucose and fatty metabolism, and its effects include regulation of homeostasis, and prevention of aging and disease, scientific research of cannabis and the ECS is thwarted by the Schedule I classification of cannabis by the federal government. The catch-22 is that there are no studies proving the safety of cannabis, so it should remain a Schedule I drug that prohibits its use in scientific studies. 

However, as reported in Hartford Business, Yale University School of Medicine, teaming up with a Portland-based medical marijuana grower (CT Pharmaceutical Solutions Inc.), will embark on the first state-approved study of marijuana’s impact on mental health and stress. The groundbreaking clinical study aims to investigate various medical marijuana strains commonly used in alleviating stress and pain. Yale said the study may also look at the conditions of post-traumatic stress disorder (PTSD) and opioid replacement. Researchers said they hope the study will result in new findings on how medical marijuana may work to alleviate symptoms of pain and stress, as well as contribute to the development of cannabinoid-based treatments.  

Heavy Users May Need More Anesthesia During Surgery

A study reported in Anesthesiology News of findings published in the Journal of the Osteopathic Association cautions that regular cannabis users required more anesthesia during endoscopy than nonusers. The small study was performed in Colorado, which legalized the recreational use of cannabis in 2012. How much more anesthesia did regular cannabis users require during endoscopy? According to the research findings, regular cannabis users needed an additional: 14 percent of fentanyl, 19.5 percent of midazolam, and “a whopping” 220.5 percent more propofol.

Researchers’ findings already have influenced how some of the Colorado study’s doctors screen patients. They now utilize a pre-procedure question regarding cannabis use that was added to patient intake forms. Researchers said they do not know the effect of regular cannabis use on the patients’ needs for opioids and other types of pain medication, such as whether they’d require higher doses of such medication for pain. They plan to research this during phase 2 of their study.

Since marijuana was legalized prior to meaningful evaluation of its medical effects, drug interactions and other issues, researchers said they’re frustrated that appropriate research wasn’t conducted prior to consumers being able to access and use cannabis recreationally. Still, such use is now a reality, and must be dealt with.

Cannabis May Not Work for Anxiety 

A meta-analysis study published in The Lancet Psychiatry found no clear therapeutic value for various kinds of medical cannabis in a range of disorders, including anxiety, as reported in Forbes. It found that the risks may outweigh the benefits. While researchers noted there’s possibly some advantage for using cannabis with anxiety, the evidence quality is low, making those findings less promising. The medical cannabis used included THC alone, and THC in combination with CBD. There was increased risk of adverse side effects with THC, and the effectiveness of pharmaceutical CBD or THC was limited.

Researchers said the mental health disorders studied included depressive and anxiety disorders, psychosis, post-traumatic stress disorder, Tourette syndrome, and attention-deficit hyperactivity disorder (ADHD). 

On the other hand, Western University researchers, in a study published in Journal of Neuroscience, found what they say may be the reason why cannabis strains high in THC and low in cannabidiol may be more likely to cause psychiatric side-effects. Researchers investigated how the molecule known as extracellular-signal regulated kinase (ERK) triggers THC’s neuropsychiatric effects. In their study with rats, animals given THC had higher levels of activated ERK, displayed greater anxiety behaviors, and were also more sensitive to fear-based learning. Yet, rats given both THC and CBD had normal activated ERK levels, were less anxious and less sensitive to fear-based learning.

As a result of their findings, researchers proposed that CBD stops THC from overstimulation of the ERK pathway in the brain’s hippocampus, thus preventing negative side-effects. CBD, they found, reversed animals’ anxious and addictive-like behavior caused by THC.

Using CBD & THC in Early Pregnancy May Disrupt Embryo Development

A study of mice published in Scientific Reports shows that one-time exposure to both synthetic and natural cannabinoids (cannabis and cannabidiol) in early pregnancy (on day eight) may result in disruption of the embryo development. Researchers said they’re seeing birth defects that are similar to those seen in fetal alcohol syndrome (FAS). When cannabinoids and alcohol are used at the same time, there’s a more than double likelihood of such birth defects. 

The significance of day eight of pregnancy in mice is that it’s comparable to the third and fourth week of human pregnancy. Often, women don’t even know they’re pregnant at this early stage of pregnancy. The cannabidiols administered were within what is considered therapeutic range, while the concentration of cannabis had levels similar to those experienced during marijuana smoking.

Researchers noted that it’s concerning how little is known about marijuana and cannabinoid use during pregnancy, remarking that there’s no safe amount of alcohol to consume during pregnancy and, likely, a similar caution regarding marijuana use. The work was supported by grants from the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

How to Deal with Boredom

Many people struggle with chronic boredom. But what exactly is boredom and what are some ways to move beyond it?

According to Wikipedia, “Boredom is an emotional and occasionally psychological state experienced when an individual is left without anything in particular to do, is not interested in their surroundings, or feels that a day or period is dull or tedious.” We all know the feeling. It is part of life. But sometimes it’s a symptom of something deeper that needs tending.

In my psychotherapy practice, I see a few main causes for chronic states of boredom: 

1. Boredom which functions as a protective defense against emotional pain. Traumatic and adverse experiences during childhood, like being raised in a chaotic household, make a child feel unsafe. The lack of safety triggers overwhelming and conflicting emotions, like rage and fear. To cope alone, a child’s mind compartmentalizes away “bad” feelings to carry on with life. But disconnecting from emotions, as much as it spares us pain, can also manifest as boredom. Boredom in this case is a byproduct of being out of touch with core emotions like sadness, anger, fear, disgust, joy, excitement, and sexual excitement. When we lose access to our core emotions, we cut off a vital source of energy that makes us feel alive. To heal, we must re-connect safely with our vast emotional world through the body.
2. Boredom which functions as a signal that we are under-stimulated. In this case, the feeling of boredom tells us about an underlying need to find interests and novelty in our life. To overcome boredom, we must discover any obstacles that get in our way of finding new interests.
3. Boredom also cuts off access to knowing our true wants and needs. To be in touch with wants and needs, especially when we think they are unattainable, is to feel pain in both the mind and body.
4. For some people, boredom stems from a combination of all of the above and may also be recognized as procrastination or disengagement.

Rachel grew up in a chaotic household. When I met her as a young adult, she didn’t seem to care much about anything, ending almost every sentence with “whatever” and rolling her eyes. This kind of “I don’t care” defense protected Rachel from emotional discomfort. But it also disconnected her from the energy and vitality that being emotionally alive brings. She was plagued by boredom, a feeling she described as deadness, which was only alleviated when she drank wine. 

For Rachel to feel better, we had to understand boredom’s protective purpose. In Accelerated Experiential Dynamic Psychotherapy (AEDP), we invite patients to envision parts of themselves that hold distressing beliefs and emotions so we can help them transform.

I asked, “Rachel, can you imagine the part of you that feels bored sitting on the sofa next to you?”

Rachel could envision the bored part of her. She saw through her adult eyes the image of a 12-year-old girl dressed in goth clothing sitting on the sofa in my office.

By whole-heartedly and without judgement welcoming parts of us that experience boredom, we learn the purpose boredom serves and what we truly need. Almost always, emotions from the past need validating, honoring, and to be felt in the body until they fully move through and out. As a person recovers from past traumas and wounds, defenses like boredom are no longer needed.

Rachel’s vitality and zest for living emerged as she processed the anger at her parents and mourned the pain she experienced in her childhood. She came to understand how “not caring” kept her safe from being hurt and disappointed by life. She learned she was strong enough and supported enough to deal with life’s challenges and the emotions they triggered. And she leaned into more adaptive ways of coping like listening to her emotions and then thinking through how best to get her needs met and solve her problems proactively. Through this work, Rachel ceased to be bored, as she was alive and engaged in all aspects of her life.

A 60-year-old man, Craig, did three years of deep emotional work to heal the trauma from having a mother with narcissistic personality disorder and a contemptuous father. Ready to graduate from therapy, he spent much more time in relaxed states. His mind was quieter. But he also noticed a sense of boredom about life. He told me he was used to being preoccupied by agitation and irritability, which were now gone. “There is so much more room in my head. I guess it used to occupy me, so now I feel weirdly bored,” he told me.

We decided to get very curious about this newfound boredom. As with Rachel, I invited him to get some separation from the bored part so we could talk to it. Craig and I both marveled at the power of talking to discrete parts like they are separate people to figure out what we need.

The trick is when you ask a question to a part of yourself, you must then listen to receive the answer. That part told him he needed to engage more with his hobbies and interests. Craig and I spent fun time discussing the things he enjoyed in life and how he might like to spend his free time. Relief from boredom was immediate as he was excited to discover new interests. After all he had been through, he felt he deserved to care for himself in this new way. 

Boredom is a difficult experience. But one doesn’t need to get stuck in that state. With a stance of curiosity and compassion, we can learn the roots of boredom. When boredom tells us we need more interests, we can set a plan for trying out new experiences, practicing patience with ourselves until we find the proper balance of novelty and familiarity. If we are bored because we are defending against deeper emotions and needs, we can absolutely discover those deeper emotions and needs, honor them, and think through how to address them in safe and healthy ways. In this way, we reconnect to our vital and most authentic self.  

You too can change your relationship to boredom. Want to experiment with talking to your bored parts? Here are some questions to ask:

• Is this boredom longstanding or a relatively new experience?
• When was the first time you remember being bored in such a way that you couldn’t stand it?
• What does boredom feel like physically?
• What’s the hardest part of the experience of boredom: The way it feels physically? The assault to self-esteem? The self-judgment? The impulses to get rid of it? The negative thoughts it causes? Other?
• What, if any, impulses do the bored parts of you have?
• Is the sense of boredom always there or does it come and go? 
• What triggers boredom and what makes it go away?
• Why is boredom a problem for you? Be very specific how boredom affects you.
• What does your bored part need to feel better?

For extra credit: Work the Change Triangle! Where is boredom on the Change Triangle? If you moved your bored part to the side, what underlying emotions might you be experiencing? Once you name them, can you validate them without judging yourself?

A+ just for trying!

(Patient details changed to protect confidentiality)

References:

Fosha, D. (2000). The Transforming Power of Affect: A Model for Accelerated Change. New York: Basic Books

Hendel, H.J. (2018). It’s Not Always Depression: Working the Change Triangle to Listen to the Body, Discover Core Emotions, and Connect to Your Authentic Self. New York: Random House.

Samoa declares state of emergency as measles outbreak claims lives

Samoa declares state of emergency as measles outbreak claims lives

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Samoa declares state of emergency as measles outbreak claims lives

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Climate Change Is Already Hurting Kids’ Health - As cholera, dengue, & malaria spread, that will only get worse.

Climate Change Is Already Hurting Kids’ Health - As cholera, dengue, & malaria spread, that will only get worse.

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Oklahoma Judge Shaves $107 Million Off Opioid Decision Against Johnson & Johnson - In a judgment filed Friday, the drugmaker was told to make a one time payment of $465 million. The state's attorneys had originally asked for over $17 billion over 3 decades

Oklahoma Judge Shaves $107 Million Off Opioid Decision Against Johnson & Johnson - In a judgment filed Friday, the drugmaker was told to make a one time payment of $465 million. The state's attorneys had originally asked for over $17 billion over 3 decades

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https://ift.tt/2NVBgcF November 16, 2019 at 05:29PM https://ift.tt/1R552o9