Feb
03
2018

Drugs Are Not An Escape

We have a drug epidemic, but drugs are not an escape. Along with this epidemic there have been thousands of lethal overdoses. I like to review why so many people use street drugs or prescription pain pills. It started years ago with heroin injections had become more popular. But then heroin was getting a bad name, it became illegal, and prescription pain pills replaced heroin. Percocet, OxyContin and morphine prescriptions took off. Together with it the number of people with addiction increased drastically. The latest fashion craze is Fentanyl.  Fentanyl works faster than morphine, but also wears off faster. One of the deadly side effects is respiratory depression. This  means that a person cannot breathe and as a result will die. This is what is happening right now and what creates the news headlines.

Pain receptors

There are pain receptors all over the body, in muscles, organs and the skin. They are called nociceptors. Many medical conditions lead to pain in various parts of the body. For instance, with end stage degenerative arthritis bone rubs on bone. This causes a lot of pain in joints like the knees or the hips. Physicians often prescribe narcotics like OxyContin to control the pain. It may help for some time. But after a few weeks patients complain that the strength of OxyContin has worn off. The same dosage that gave them relief from the pain initially just does not give them relief any more. This observation is crucial. It is exactly what people who use OxyContin as illicit street drug found as well. The drug wears off, because the opioid receptors are getting weaker.

Pain receptor resistance

Nociceptors or opioid receptors are pain receptors. These receptors report pain to the body, and they have connections through the spinal cord to the brain. When an opioid is interacting with the pain receptor it inhibits acute pain to a large extent. But when the pain becomes chronic, the pain receptor is not working as well. More and more of the pain medication is necessary to achieve pain relief.  Eventually the opioid medication is not working to relieve pain any more. The name for this phenomenon is “pain receptor resistance”. Scientific work behind why pain receptors get lazy in responding to opioids is still ongoing. In the meantime it simply is an observation. This is the reason why drug addicts are tending to increase the dosage of OxyContin or of Fentanyl. The toxic threshold of Fentanyl that is exceeded in the process is the reason for the deaths.

Insulin resistance

You may have heard of insulin resistance in diabetics. This is a very similar problem. With insulin resistance the diabetic no longer has a 100% response to insulin. This means that blood sugar is not going through cell membranes effectively as it should when the insulin receptor is working. The blood sugar values stay high and make the diabetes worse.

With pain receptor resistance the opioid is not giving the relief from pain it used to give. No wonder that the patient is feeling frustrated that the pain medication is no longer working properly.

Therapeutic index

The layperson does not normally know that there is a dosage for any drug where it becomes toxic. There is also a lower dosage where the drug is becoming effective. The difference between the two dosages is the “therapeutic window” or the “therapeutic index”.

Morphine has a therapeutic index of 70:1. Compare that to alcohol with a therapeutic index of only 10:1. Fentanyl has a therapeutic index of 300:1.

The danger of Fentanyl

One would think that Fentanyl should be safer than morphine, because the therapeutic index is larger. But the onset of Fentanyl is much faster than that of morphine and by the time drug users take Fentanyl they often are desperate for the drug to take their pain away and they overdose, which causes respiratory depression. If they are not intubated by an anesthetist and connected to artificial respiration, they die very quickly. Janssen Pharmaceutica first developed Fentanyl in 1959. Fentanyl was strictly part of the pre-anesthetic medicine for patients before going into surgery requiring a general anesthetic. The anesthetist was right there and would intubate the patient. That’s why we never heard of deaths from Fentanyl in the past.

If a person gets no pain relief from any opioid because of receptor resistance, the tendency is to increase the dosage. But this is what pushes the person into toxic ranges and this is what causes death from inadvertently suppressing the ability to breathe. People can get into trouble with alcohol overdoses, but the ordinary person usually knows how to handle alcohol. Fentanyl is a lot different due to the fact that respiratory depression (not being able to breathe) is one of the early symptoms that hits you suddenly.

What drugs do to your brain

Dr. Daniel Amen, a psychiatrist and brain researcher has used SPECT brain scans to produce images of different clinical conditions. This link shows the effect of a stroke, of Alzheimer’s disease and of drug abuse on the brain. Dr. Amen says that a brain can be rehabilitated. He has other SPECT images showing the images of an addicted brain and that of a rehabilitated brain. Spect scans are expensive.  But they may be worth it, to impress a drug addict to stop the drugs and get rehabilitated.

Big Pharma and opioid drugs

In 1995 the FDA approved the use of OxyContin for chronic pain. Perdue Pharma, the drug company that had developed this opioid convinced the FDA that OxyContin stayed in the blood for 12 hours and they claimed that by being active longer than other opioids this would lead to better pain control and less addiction. It turns out that this was a slick sales pitch, however it was not true. Pain receptor resistance is as much a problem with OxyContin as with any other opioid. And the drug is as addictive as all the others. But the problem is that the FDA had approved OxyContin. What’s more, Purdue Pharma sent aggressive drug representatives to all the practicing physicians misleading them as well as the FDA that OxyContin would not be as addictive as other opioids.

Penalty for misrepresentation of OxyContin

In 2007 Purdue Pharma had to pay a fine of 634 million $ for misrepresenting the addiction potential of OxyContin. But the drug company was allowed to continue to market OxyContin. Since 2015 Purdue Pharma has been cashing in 2.4 billion $ annually from the sales of opioids including OxyContin. In the meantime Fentanyl, despite its danger of suppressing the ability to breathe, has taken off with regard to sales. Fentanyl also has taken over in terms of causing deaths across the US and other countries.

Alternative treatment of pain

According to Ref. 1 chances are that 70% of patients with back pain will get better with a few visits to an acupuncturist. In 1972 Dr. Ulett’s laboratory at the University of Missouri succeeded in getting the first NIH research grant for the study of acupuncture in the US. During these studies they found remarkable facts, the most important perhaps that electrical stimulation of acupuncture needles resulted in a doubling of the effectiveness of traditional Chinese acupuncture. After extensive research Dr. Ulett stated: ”The ancient practice of traditional Chinese acupuncture is now obsolete” (Ref.1). in the meantime the more effective electro-acupuncture has replaced acupuncture needles with the use of electrical skin pads.”

Other applications for electroacupuncture

Beside pain relief many other applications exist for electro-acupuncture. Addiction medicine makes use of electro-acupuncture in weaning people from morphine or heroine etc. It is effective to treat psychiatric illness, particularly depression. It is useful in relieving nausea and vomiting due to chemotherapy with cancer treatments or associated with pregnancy without affecting the pregnancy.

Prolotherapy

Prolotherapy has been successful for the treatment of back and neck pain, for arthritic pain and pain from chronic muscle spasm. When prolotherapy is done by itself 12.5% Dextrose is injected into the area of injury. Dr. Fields said that the reason it works is that there is activation of local stem cells in the injured area in the area of the Dextrose injection site. These stem cells will do the healing (details explained in an interview with Dr. Reeves). Further improvement of this technique and better results are possible by injecting a small amount of platelet rich plasma (PRP) very focally to an area of ligament rupture. PRP is obtained by centrifuging blood from the patient’s vein. The red blood cells are not necessary, but the platelet fraction and some of the plasma are part of the the PRP preparation.

It is often striking how much pain control occurs after only one or two prolotherapy treatments.

Stem cell therapy with PRP and low-dose laser therapy

This is a more direct way to get stem cells where the doctor wants them to do their work. Stem cell therapy with PRP and low-dose laser activation is the latest in terms of controlling pain. At the 22nd Annual Anti-Aging Conference in Las Vegas (Dec.10 to 14, 2014) Dr. Purita gave an overview of this method of pain control. He discussed the importance of the proper harvesting of PRP. He explained that apart from white blood cells (WBC) and platelets an important component of PRP are very small embryonic like stem cells (VSELs). They are visible through the microscope. The missing link has been the observation that white blood cells produce inflammatory substances, which have been detrimental in stem cell injections with PRP in the past. There was a poor survival rate of stem cells.

Low dose laser activation of stem cells and PRP

Photo-activation of the PRP before injection leads to anti-inflammatory behavior of the WBC in PRP. Dr. Purita calls this “light activated PRP”, which leads to the best results with stem cell/PRP injections.

Soft laser stimulation with red, green and blue soft lasers have also been effective to improve tissue healing significantly when stem cells and PRP are used together with light activation. The main sources for good stem cells are the fat tissue (from the “love handles”) and the bone marrow (obtained from pelvic bone). The stem cells mesenchymal stem cells (from fatty tissue) and bone marrow stem cells. The mix of all of this can mend osteoarthritic joints, degenerative disc of the spine, in short all musculoskeletal injuries that may be painful. The hallmark of healing with stem cells is that chronic pain disappears.

Curative treatment versus symptomatic treatment

It is one thing to treat a patient for pain symptomatically by prescribing OxyContin or other opioids. It is a completely other thing when the physician cures the pain by one of these alternative methods. Let us assume that a patient has a fall of a few step from a ladder and sustains a contusion of the lower back. This can be painful and may require a few pain pills. But if it does not improve within one week and diagnostic tests show that there is no fracture, electroacupuncture may be the solution to treat the pain rather than the use of an opioid. If this does not help, consider the combination stem cell/PRP/low-dose laser therapy. Chances are better than 80% that this will help. The patient will no longer suffer of pain. With healing life can go on: no pain pills. No addiction. No death.

Drugs Are Not An Escape

Drugs Are Not An Escape

Conclusion

Conventional medicine treats pain symptomatically instead of treating the cause. It gets the physician to prescribe opioids, which can be the beginning of a series of tragic events. It can lead to drug addiction, dose acceleration, toxic effects of opioids including possible death through asphyxiation from no longer being able to breathe.

Stem cell therapy

The physician who concentrates on treating causes will use alternative methods to treat pain. The most effective of these methods is stem cell therapy. It is a mixture of adipose mesenchymal stem cells with bone marrow stem cells that are part of the therapy. The addition of platelet rich plasma is another part of the mix, and the final step is activation of stem cells with low-dose laser therapy. The cell mix is injected in the critical area. The end result is that the patient’s pain disappears, and it leads to a cure. The only situation where short-term opioids are justifiable is following surgical procedures. But even in these cases the narcotics should only be necessary for a few days to avoid serious side effects.

Reference 1: George A. Ulett, M.D., Ph.D. and SongPing Han, B.M., Ph.D.: “The Biology of Acupuncture”, copyright 2002, Warren H. Green Inc., Saint Louis, Missouri, 63132 USA

More info about electroacupuncture: http://www.askdrray.com/electro-acupuncture-twice-as-effective-as-conventional-acupuncture/

More about prolotherapy stem cell therapy: http://www.askdrray.com/prolotherapy-and-stem-cell-therapy/

Nov
18
2017

You May Want To Cut Down Coffee Consumption

Many people drink too much coffee, so you may want to cut down coffee consumption. With all the good news about the health benefits when drinking coffee, some people went too far. They have overdone what was supposed to be good for them. Recently a study came out that tells you how to cut down coffee consumption.

But first I like to review the issue whether to drink caffeinated or decaf coffee. Next I will tell you how you can switch to decaf coffee.

Caffeinated and decaffeinated coffee have the same health benefits

  1. Recently a large study showed that coffee, caffeinated or not, has a connection with lower overall mortality.
  2. Coffee has long been a subject of heated discussions. Some praise it, and others condemn it. There are multiple past studies; some showed health benefits, some did not. This is why the Department of Nutrition, Harvard School of Public Health in Boston, MA. did a larger study. The purpose was to re-examine the health benefits for both caffeinated and decaffeinated coffee.

Mortality data regarding people who drank decaf coffee or regular coffee

Researchers assessed mortality among 74,890 women in the Nurses’ Health Study (NHS). Another 93,054 women in the NHS 2 study became part of this. And 40,557 men in the Health Professionals Follow-up Study were also part in this large study. The medium follow-up for all of these three groups was 22.5 years. 19,524 women and 12,432 men died during that time period. Ming Ding is a doctoral student at the Harvard School of Public Health department of nutrition. She was the lead author of this study. She pointed out that in the past there were confounding problems. Many studies had shown that both caffeinated and decaffeinated coffee consumption lowered the risk of cardiovascular disease. But the results in many studies were blurred. Studies often did not distinguish between smokers and non-smokers. This meant that the cardiovascular risk from smoking wiped out a beneficial effect from coffee drinking.

Confounding and other factors

Ding’s studies took this into account and also other confounding factors like how much sugary soda pop people were drinking and whether or not they were eating well. In addition they normalized for other factors that could interfere like drinking alcohol and eating red meat. Without normalizing for the factors mentioned above the study results were as follows. Study participants who had less than a cup of coffee and three cups a day had a 5% to 9% lower risk of dying than those who drank no coffee. Those who drank more than three cups a day did not see any benefit.

Dose response curve for regular and decaf coffee

After eliminating all the confounding factors researchers compared the various groups again, and the following linear dose-response curve emerged:

  • Less than 1 cup of coffee per day: 6% lower death rates than non-coffee drinkers.
  • 1 cup to 3 cups of coffee per day: 8% lower death rates.
  • 3 to 5 cups of coffee per day: 15% lower death rates.
  • More than 5 cups of coffee per day: 12% lower death rates.

Coffee consumption reduces diabetes and heart disease

Ming’s study connected with another research paper that had shown that coffee drinkers have a lower risk of developing type 2 diabetes and also less heart disease. She found that both, caffeinated and decaffeinated coffee, reduced the risk of getting diabetes later in life. When asked about what would be responsible for the reduced death rates with coffee consumption, she explained: “There are at least two known chemicals in coffee, namely lignans and chlorogenic acid that could reduce inflammation and help control blood sugar, both of which could help reduce the risk of heart disease”. You may want to cut down coffee consumption because you know decaf coffee does the same as regular coffee.

Other details about the caffeinated/decaf coffee study

Although there seems to be a linear response up to 5 cups of coffee consumption, above 5 cups this linear relationship disappeared. It was not explained whether there was a saturation point, whether there was yet another hidden confounding factor or whether there were detrimental effects on the adrenal glands with too much caffeinated coffee consumption.

Another finding was that it did not matter whether the coffee was regular (caffeinated) coffee or decaffeinated coffee. The results were identical.

Many other studies did not have the large numbers to show whether or not decaffeinated coffee was as effective in preventing heart disease as regular coffee.

Suicide rates and coffee consumption

There was another peculiar finding: suicides were down by 20% to 36%, if a person drank at least one cup of coffee per day. If a person consumed less than 1 cup of coffee per day the suicide rate was 36% higher than the control group with no coffee consumption. This is a rather peculiar finding, particularly for the consumption of less than 1 cup of coffee. Other studies also showed a decrease in suicide rates with coffee consumption.

Although previous studies had shown a reduction in liver and prostate cancer, after the removal of confounding factors this study did not show any effects on cancer causation or cancer death rates with coffee consumption.

Discussion

The Department of Nutrition, Harvard School of Public Health in Boston, MA has excelled in high quality nutritional studies for decades. This study is particularly important, because it is so large, giving it more statistical power. Secondly, the observation time of an average of 22.5 years is longer than most coffee studies in the past. Add to this the removal of the “noise” (called confounding factors) that interfered with the objective of the study, and you end up with a very meaningful result.

Clear results after confounding factors were removed

The important findings were that both caffeinated and decaffeinated coffee have the same effect of saving and extending lives. Perhaps you want to drink not more than 5 cups of coffee per day. That lowers your risk of premature death by 15%. It is most likely that it is the effect of lowering the rate of diabetes and heart attack rates that is responsible for the risk reduction. At least this was the opinion of the chief investigator. Cancer rates were not lowered by coffee consumption.

I sleep better when I drink decaffeinated coffee, so for me the notion that decaffeinated coffee and regular coffee have the same effect was important.

Revisit the statement: “you may want to cut down coffee consumption”

Now we know that there is no difference in benefits whether the coffee is caffeinated or not. Those of you who consume 3 to 5 cups of decaf coffee already enjoy a 15% reduction in risk of cardiovascular disease.

Those of you who take the same amount of regular coffee may get into a caffeine dependency problem. Because every time the caffeine stimulation wears off, you yearn for yet another cup of coffee. You need your fix, and this becomes a dependency problem. You have conditioned your body to that regular dose of caffeine, even though it is the bioflavonoids that are reducing mortality while caffeine is neutral.

My experience of coffee withdrawal

When I came across Ding’s research findings I was glad that now there was clarification about whether decaf coffee was as good as regular coffee. The next step for me was to cut out regular coffee and replace it by decaf coffee. Formerly I had been drinking 5 mugs of coffee daily (translated into 500 mg of caffeine daily). When I decided to quit this habit, I figured I should do it cold turkey from one day to the next. To my surprise this was a much bigger deal than I had thought.

Withdrawal symptoms

I craved the next cup of coffee, and I drank a decaf coffee. It did not help: Still, there was this craving for regular coffee! Yawning, restlessness and tiredness were symptoms that followed me all day long. Then there was irritability, a mild headache and almost flu-like symptoms. Eventually I went to sleep and woke up one hour later feeling a bit more energetic. But two hours later I had to lay down again. I was feeling that bushed. The following few days went better. There was more energy. But I still liked a noonday nap of about 1 hour.

Benefits of getting off regular coffee

This was not like me! Normally I have lots of energy and I don’t need naps. It took me 1-½ weeks to get over my 5-cup a day coffee withdrawal. But it was 100% worth it! Since then my energy is back to normal. I don’t have to chase coffee houses on a trip or ensure there is always a cup of regular coffee available for me at home (work does not apply, because I am retired). If I want I can replace my beloved coffee with another fluid. I love lemon juice sweetened with stevia instead of my decaf coffee. It is liberating that I no longer depend on the caffeine. But I still like the flavor of decaf coffee, and there is something enjoyable about the fragrance of freshly brewed coffee. And so I drink 3 to 4 cups of decaf coffee a day.

How to cut down coffee consumption

Here is a 2016 study from the Johns Hopkins University where 34 patients on 600 mg of caffeine per day received a 1-hour lecture about coffee withdrawal followed by a 6-week diary of their coffee consumption. They were asked to reduce their caffeine consumption down to 50 mg by week 6 of the coffee elimination program. Tests followed with salivary caffeine levels 6, 12 and 26 weeks after coffee cessation. There was also a 1-year follow-up telephone conversation. The results were that there was good compliance. Saliva caffeine levels verified this. The diaries over the first 6 weeks showed that the participants had gradually eliminated caffeine consumption. Perhaps this was a more humane way than my “cold-turkey” approach.

You May Want To Cut Down Coffee Consumption

You May Want To Cut Down Coffee Consumption

Conclusion

Many people are sensitive to too much caffeine consumption in coffee and other caffeinated beverages. But since the Harvard study that I mentioned above there is no need to overdose coffee or tea consumption. Decaf coffee has the same effect on lowering death rates by 15%, as does regular coffee. It pays to avoid caffeine, as you will avoid caffeine dependency. Drink decaf coffee instead!

I also discussed that withdrawal from regular coffee can be done more gently over a 6 week period. I did it from one day to the next and had a 1-½ week long withdrawal reaction. Do it slower or faster, whatever works best for you. The end result will be the same. Then enjoy it that you no longer depend on caffeine!

More info: http://www.askdrray.com/coffee-could-be-a-lifesaver/

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