'13 Reasons Why' tied to rise in online suicide searches
On one end, fans of the binge-able show applaud the series for raising awareness about the tragedy of youth suicide and shedding light on how to spot warning signs of depression or suicidal thoughts.
On the other end, mental health experts describe the show as worrisome and point to how its relatable characters and graphic depiction of suicide can pose a health risk for young people already struggling with mental health issues.
After the premiere of "13 Reasons Why," the search phrase "how to commit suicide" rose 26% above what would normally have been expected for that time; "suicide prevention" went up 23%; and "suicide hotline number" climbed 21%, based on the paper's data.
"The time for rhetorical debate is over," said John Ayers, research professor at San Diego State University and lead author of the paper.
"While '13 Reasons Why' has certainly caused the conversation to begin -- it's raised awareness, and we do see a variety of suicide-related searches increasing -- our worst fears were confirmed," he said. "That is, thousands of people, thousands more, are searching online about ways to kill themselves."
Based on best-selling author Jay Asher's 2007 young adult book of the same title, the show follows the fictional story of a teenage girl named Hannah Baker, played by actress Katherine Langford. Hannah leaves behind 13 mysterious cassette tape recordings after killing herself. Each audio recording is addressed to a person who Hannah says played a role in her devastating decision to end her own life.
The show, co-produced by actress and pop star Selena Gomez, has been renewed for a second season.Filming for the upcoming season
reportedly has commenced in parts ofCalifornia's Bay Area
Due to the findings in the new paper, Ayers called for the second season to be postponed and changes to be retrofitted to the already released first season.
In a statement that Netflix provided to CNN, the entertainment streaming company said, "We always believed this show would increase discussion around this tough subject matter. This is an interesting quasi experimental study that confirms this. We are looking forward to more research and taking everything we learn to heart as we prepare for season 2."
A surge of suicide searches
For the paper, researchers collected data on suicide-related Google search trends in the United States from March 31, when "13 Reasons Why" premiered, through April 18, before former NFL playerAaron Hernandez's suicide
, which would have skewed the search data.
The researchers also eliminated search terms in the data related to the popular superhero movie "Suicide Squad," resulting in a final database of 20 suicide-related search terms.
The researchers found that searches for 17 of those 20 terms were higher than expected for 12 of the 19 days that were studied following the release of "13 Reasons Why."
For instance, suicide-related searches were 15% higher on April 15 and then 44% higher on April 18, the researchers found. The queries that focused on suicidal ideation had the largest increases, the data showed.
Overall, the increase over the 19-day period represented a total of about 900,000 to 1.5 million more searches than otherwise expected, Ayers said.
Netflix gave"13 Reasons Why" a TV-MA rating
, which is for mature audiences, and the first season's episodes 9, 12 and 13 - which contain more explicit material - had specific warnings prior to the beginning of each episode.
At midnight on the day of the show's debut,13ReasonsWhy.info
, a website built by Netflix, launched. It includeslinks to various suicide helplines
Additionally, during production of the first season, "13 Reasons Why" executive producers consulted with several mental health professionals and doctors who helped guide the show's storytelling approach to suicide, sexual assault and bullying, according to the Netflix statement.
Yet in the new paper, the researchers wrote that the show could have done more to reduce associations with suicidal ideation by closely following theWorld Health Organization's media guidelines
For instance, the guidelines recommend avoiding detailed descriptions or portrayals of a suicide method, among other recommendations.
"Psychiatrists have expressed grave concerns because the show ignores the World Health Organization's validated media guidelines for preventing suicide. The show's staff instead continue to prefer their gut instincts," Ayers said. "The show's makers must swiftly change their course of action, including removing the show and postponing a second season."
In anop-ed published in Vanity Fair
in April, a writer for the "13 Reasons Why" series defended the decision not to shy away from main character Hannah's suicide and to include a gruesome scene of her death in the first season.
"From the very beginning, I agreed that we should depict the suicide with as much detail and accuracy as possible. I even argued for it -- relating the story of my own suicide attempt to the other writers," wrote Nic Sheff, one of the show's writers.
In the op-ed, Sheff detailed how a woman once told him about her painful suicide attempt and her account caused him to reconsider his own suicide attempt.
"If that woman had not told me her story, I wouldn't be here now. I would've missed out on all the amazing gifts I have in my life today," Sheff wrote.
"So when it came time to discuss the portrayal of the protagonist's suicide in '13 Reasons Why,' I of course immediately flashed on my own experience. It seemed to me the perfect opportunity to show what an actual suicide really looks like -- to dispel the myth of the quiet drifting off," he wrote.
CNN contacted Netflix for comment but has not heard back from a representative affiliated with "13 Reasons Why."
The risk of suicide 'contagion'
All in all, the new paper suggests an association between "13 Reasons Why" and suicide-related Google searches. However, the analyses cannot definitively conclude that the show caused the searches. Also, it could not be ascertained from the data whether any of the searches actually led to a suicide attempt.
More research is needed to determine the true risk-benefit when it comes to the association between "13 Reasons Why" and heightened interest in suicide among viewers, said Madelyn Gould, a professor of epidemiology in psychiatry at Columbia University, who was not involved in the new paper.
"These analyses, by Ayers and his team, seem to indicate that suicide awareness was heightened and I think that that is a relief, but unfortunately at what price was that awareness raised?" Gould said.
A separate paper previously suggested that some online searches for suicide-related terms could be tied to suicide deaths. In that paper, searches such as "complete guide of suicide" correlated with actual suicide deaths between 2004 and 2009 in Taiwan. That research published in theJournal of Affective Disorders
As for the new paper, although there were some limitations in the study design, the authors took a creative first step in examining the influence of "13 Reasons Why" by analyzing online search trends, said John Ackerman, suicide prevention coordinator at Nationwide Children's Hospital in Columbus, Ohio.
He was not involved in the new paper, but wrote ablog post in April about "13 Reasons Why"
and guidance for parents.
"It addresses an important question: Are we seeing actual suicidal thinking and behavior being influenced by a television show?" Ackerman said about the paper.
"I believe most people working on the show felt like by raising awareness of youth suicide and portraying it graphically, they would somehow discourage young people from engaging in suicidal behavior. Sadly, this is not how suicide contagion works," he said.
Suicide contagion refers to when exposure to suicide within a family, group of friends, military unit, or through the media may be associated with an increase in suicidal behaviors, according to theUS Department of Health and Human Services
Gould said that such contagion can be demonstrated in a theory termed theWerther Effect
, which refers to how negative stories about engaging in suicidal behavior can be linked to an increase in deaths by suicide.
The Werther Effect's name stems from Johann Wolfgang von Goethe's 1774 novel, "The Sorrows of Young Werther
," which ends in suicide and was reportedly linked to a wave of young men in Europe deciding to kill themselves in the late 1700s.
" 'The Sorrows of Young Werther' elicited a kind of epidemic of copycats, of people dressing up like this character in the book," said Dr. Victor Schwartz, clinical associate professor of psychiatry at the New York University School of Medicine, who was not involved in the new paper.
While most teens can read novels or watch shows, like "13 Reasons Why," and not have suicidal thoughts or behaviors as a result, not all can, said Schwartz, who serves as chief medical officer of the JED Foundation, a nonprofit that focuses on emotional health and suicide prevention among teens and young adults.
"Looking at it from a prevention standpoint, it's concerning when a young person already has a prehistory or an existing mental health problem with anxiety, depression, and, for a smaller group, actually psychotic illnesses," Schwartz said, adding that such illnesses are risk factors for suicidal behavior.
"If a young person has a history of serious mental health or substance concerns, then obviously that adds a layer of vulnerability" when consuming media about suicide, he said.
On the other hand, positive contagion has been more recently termed thePapageno Effect
, which refers to how positive stories of overcoming suicidal thoughts can be linked to a decrease in deaths.
So, fictional tales or news reports about a character finding coping strategies for suicidal thoughts can have an inverse relationship with suicidal behaviors. ThePapageno Effect's
name stems from the character Papageno in Mozart's opera "The Magic Flute." In the opera, the character overcomes a suicidal crisis.
The new "13 Reasons Why" paper adds to a body of research conducted by Ayers and his colleagues that highlights the influence that celebrities and the media can have on public health outcomes.
Previously, Ayers and his colleagues analyzed how actor Charlie Sheen's HIV disclosure two years ago was associated with an increase in Google searches for HIV testing kits and a boost in kit sales. Their study published in the journalPrevention Science
The researchers wrote in their new paper that further examinations of "13 Reasons Why" might reveal whether the show also could be tied to actual changes in behaviors, from calls placed to national suicide hotlines or estimated suicide attempts.
Globally, suicide is thesecond leading cause of death
among 15- to 29-year-olds, according to the WHO. In the US, about 4,600 young people between 10 and 24 die by suicide each year, according to theCenters for Disease Control and Prevention
"Maybe this will have some impact on the producers of '13 Reasons Why' as they develop their second season," Gould said about the new paper. "None of us know what that second season is going to be about. I hope that they recognize that it's not just suicidal behavior that can get modeled and that there are other deleterious behaviors that can get modeled as well."
via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF
July 31, 2017 at 10:19AM
Earth to warm 2 degrees by the end of this century, studies say
This rise in temperature is the ominous conclusion reached by two different studies using entirely different methods published in the journal Nature Climate Change on Monday.
"The likely range of global temperature increase is 2.0-4.9 [degrees Celsius] and our median forecast is 3.2 C," said Adrian Raftery, author of the first study. "Our model is based on data which already show the effect of existing emission mitigation policies. Achieving the goal of less than 1.5 C warming will require carbon intensity to decline much faster than in the recent past."
"Even if we would stop burning fossil fuels today, then the Earth would continue to warm slowly," said Thorsten Mauritsen, author of the second study. "It is this committed warming that we estimate."
Taken together, the similar results present a grim reality.
"These studies are part of the emerging scientific understanding that we're in even hotter water than we'd thought," saidBill McKibben
environmentalist not affiliated with either study. "We're a long ways down the path to disastrous global warming, and the policy response -- especially in the United States -- has been pathetically underwhelming."
Because both studies were completed before theUnited States left the Paris Agreement under President Trump
earlier this year, that has not been accounted for in either study.
"Clearly the US leaving the Paris Agreement would make the 2 C or 1.5 C targets even harder to achieve than they currently are," said Raftery.
Why two degrees?
The 2 degree mark -- that's 3.6 degrees Fahrenheit -- was set by the 2016 Paris Agreement. It was first proposed as a threshold by Yale economist William Nordhaus in 1977. The climate has been warming since the burning of fossil fuels began in the late 1800s during the Industrial Revolution, researchers say.
If we surpass that mark, it has been estimated by scientists that life on our planet will change as we know it. Rising seas, mass extinctions, super droughts, increased wildfires, intense hurricanes, decreased crops and fresh water and the melting of the Arctic are expected.
The impact on human health would be profound. Rising temperatures and shifts in weather would lead to reduced air quality, food and water contamination, more infections carried by mosquitoes and ticks and stress on mental health, according to a recent report from theMedical Society Consortium on Climate and Health
Currently, theWorld Health Organization estimates
that 12.6 million people die globally due to pollution, extreme weather and climate-related disease. Climate change between 2030 and 2050 is expected to cause 250,000 additional global deaths, according to theWHO
Our potential future
The first study used population, carbon emission and gross domestic product data from 152 countries (accounting for 98.7% of the world's population as of 2015) over the past 50 years to develop a new statistical model, said Raftery, a professor of statistics and sociology at the University of Washington.
Many studies come from the Intergovernmental Panel on Climate change and use climate model scenarios -- not forecasts -- to use as examples of what might happen, based on specific assumptions about economics, population and carbon emissions in the future.
"This leaves open the question of how likely they are, or whether they cover the range of possibilities," Raftery said. "In contrast, our results are statistically based and probabilistic, in that they aim to cover the range of likely outcomes."
What Raftery and his colleagues discovered is that population is not a factor.
"This is due to the fact that much of the expected future population growth will be in Africa, in countries whose carbon emissions are currently very low," Raftery said.
The study confirms conclusions of many other studies, said Bill Hare, director and senior scientists of nonprofit Climate Analytics. Hare was not affiliated with either study.
"This interesting paper confirms the conclusion about where the world is headed unless there is a major increase in the ambition of climate and energy policies," Hare said.
The other finding of the study suggests that achieving a goal of less than 1.5 Celsius warming would require carbon intensity to decline faster than it has in the past. "The whole purpose of climate and energy policy is to accelerate decarbonisation and this will necessarily be faster than what we have seen globally," Hare said.
Mauritsen, author of the second study and climate researcher at Max Planck Institute for Meteorology, also shared thoughts on Raftery's findings.
"It seems interesting in that it uses an economic statistical model that accounts for an increasing energy efficiency as societies develop," Mauritsen said. "It shows that the 1.5 to 2 degrees targets will not be met without additional mitigation, and suggests that a focus on energy efficiency is the best way forward."
The impact of our past
By combining observations of past global warming and how much heat and carbon is being captured and taken in by the ocean, Mauritsen and his co-author, Robert Pincus, found that even though CO2 has an incredibly long lifetime in the atmosphere, the ocean's absorption capacity may reduce estimates of global warming by 0.2 degrees Celsius.
They arrived at the "committed" warming of 1.3 Celsius by 2100, and the estimate including the ocean factor is 1.1 degrees Celsius. But that is still nearly 2 degrees Fahrenheit: 1.8, to be precise.
"What the study is not concerned with is how future emissions might develop," Mauritsen said. "This is a societal problem where we as physical scientists have fairly little to add. These future emissions will, however, add warming on top of the already committed warming and so our study can act as a baseline for estimating how far we are from reaching various temperature targets."
Hare also found this study to be consistent with previous papers on global temperatures on the rise.
"It shows, in effect, that unless we start reducing emissions quickly -- soon there is a risk that we will overshoot temperature limits like 1.5 or 2 degrees C," Hare said. "It is just another confirmation of how dangerous the present situation is unless CO2 emissions, which have flatlined in the last few years, really start dropping.
"This addresses a somewhat different question, namely how much warming should we expect if fossil fuel emissions were to suddenly cease," Raftery said. "In contrast, our study tries to assess how much warming we should expect given realistic future trajectories of emissions. Thus the other study provides a lower bound on expected emissions and warming, and this is indeed lower than the likely range we find, as we would expect."
What can be done?
Researchers know that if there is any hope of preventing the outcomes they include in their findings, changing public policy is key.
"The next few years are going to be key in the fight against global warming," said Dargan Frierson, co-author of the first study. "Are we going to get to work installing clean energy, or stick to old polluting sources? If we don't act quickly, we better get to work preparing for many severe consequences of a much hotter world."
"There are only two realistic paths toward avoiding long-run disaster: increased financial incentives to avoid greenhouse gas emissions and greatly increased funding for research that will lead to at least partial technological fixes," said Dick Startz, economist and co-author of the second study. "Neither is free. Both are better than the catastrophe at the end of the current path."
Silver linings and hope are hard to find in climate change studies, but they also don't account for every factor.
"The only bright point is that, as the study authors say, they haven't factored in the plummeting cost of solar power," McKibben said. "That's the one way out we still might take -- but only if our governments take full advantage of the breakthroughs our engineers have produced."
via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF
July 31, 2017 at 10:19AM
Dear Mark: Keto Reset Eating Plan Better Weight Scales PB Fitness Carb Requirements and the Best Fish Sauce
Dear Mark: Keto Reset Eating Plan, Better Weight Scales, PB Fitness Carb Requirements, and the Best Fish Sauce
For today’s edition of Dear Mark, I’m answering/addressing four questions/comments. First, will my new Keto Reset book provide detailed meal plans or vague recommendations? Second, is there a better weight scale than the scale? Mathieu thinks there is, and I agree. Third, if you’re doing the Primal Blueprint Fitness program, do the recommendations I made in the Crossfit and carbs posts apply? And fourth, what’s the best fish sauce?
First, Vee asks:
Oh, yeah. I include not just one, but two 21-day meal plans. Each is incredibly detailed.
The first is for the 21-day metabolism reset—which helps you build the necessary metabolic machinery to make keto work better and go more easily. The second 21-day plan is for actually going keto—for getting into and staying in nutritional ketosis. Both remove the guesswork. If you eat the food and follow the recipes and portion recommendations, you’ll hit the macronutrient ratio that results in ketosis (for most people).
While you very well could stick to the 21-day meal plans laid out in the book for the rest of your life, I’d urge you to branch out a bit. You might want to adjust your level of ketosis to include more carbohydrates and protein. You might want to pick up a new sport or attempt a new physical challenge that requires a different macronutrient ratio. You might get tired of the same meals. Basically, you should be able to adjust on the fly depending on what you need out of your body. My upcoming book provides that information, if you’re willing to give it a shot.
Stay tuned for it. It sounds like it’s exactly what you’re looking for.
Mathieu made a great comment that I had to build upon and support with evidence because I think it’s so important:
Or a belt. Or a tape measure. Or that one article of clothing you’ve been trying to fit into.
People may think Mathieu and I are being flippant, but we’re not. Subjective impressions are often more reliable and representative of a person’s health than objective measurements. Take apparent age based on facial appearance—it’s a better predictor of health and longevity than objective biomarkers.
There’s a big difference between true sprints (where you’re achieving full or close to full recovery in between sprints), HIIT (where you keep rest periods short to promote endurance adaptations), and strength training.
You can sprint quite effectively on low-carb, especially if you stick to shorter sprints (10 seconds and under). At that length, you’re primarily hitting the ATP-PC pathway. That’s when you convert the creatine phosphate stored in the muscle directly into ATP. It doesn’t last long—we can’t store much creatine phsophate at once—but it produces incredible power and refills rather quickly with adequate rest. Longer sprints will start really tapping into the glycolytic (sugar-burning) pathway.
Lower-rep, higher-intensity strength training with longer rest periods is also very effective on low carb, as it, too, primarily targets the ATP-PC pathway and allows sufficient rest to replenish it. Higher-rep training will veer into glycogen-burning. Intensity matters, too. High reps with moderate weight will burn glycogen pretty quick. High reps with bodyweight give you more leeway.
Low-carb is fine for the program you describe.
You, half-starved, in a daze after slamming your head during the storm that destroyed your ship, stumble down a mysterious beach chasing a scent. It rises above the usual briny rankness, reminding you of that time at the 4 AM tuna auction in Tsukiji market, where you realized “fishy” wasn’t always a bad thing. You come upon a fisherman. He’s squatting in front of a bowl of rice and dried pork, and the sun is overhead. It must be lunchtime. You bring your fingers to your mouth, miming, trying to convey hunger. He looks you over, squints, takes a drag on his cigarette, then fishes out an old mason jar full of murky liquid—homemade fish sauce—from a plastic shopping bag and splashes it over his rice. He hands the bowl over. You dig in, and it’s the best thing you’ve ever tasted.
The way that fantasy fisherman made his fish sauce is the same way Red Boat does: fish, salt, and time.
That’s it for me, folks. Thanks for reading and be sure to give you input down below. Have a great rest of the week.
via Mark's Daily Apple http://ift.tt/zxCBD6
July 31, 2017 at 10:09AM
Huge Spike Seen In Fatal Crashes Linked To Opioids
By Steven Reinberg
MONDAY, July 31, 2017 (HealthDay News) -- In yet another sign of just how deadly the U.S. opioid epidemic has become, researchers report a sevenfold increase in the number of drivers killed in car crashes while under the influence of prescription painkillers.
Prescriptions for drugs such as oxycodone (OxyContin), hydrocodone (Vicoprofen) and morphine have quadrupled, from 76 million in 1991 to nearly 300 million in 2014, so it's no surprise these medications are playing a growing role in highway deaths, the Columbia University researchers said.
"The significant increase in proportion of drivers who test positive for prescription pain medications is an urgent public health concern," said lead researcher Stanford Chihuri.
Prescription drugs can cause drowsiness, impaired thinking and slowed reaction times, which can interfere with driving skills, Chihuri said.
"Prescription pain medications use and abuse may play a role in motor vehicle crashes," he said. "Additional research is urgently needed to assess its role."
Chihuri is a staff associate in the department of anesthesiology at the College of Physicians and Surgeons at Columbia University Medical Center in New York City.
He isn't the only one worried about the trend.
"MADD [Mothers Against Drunk Driving] is concerned about the rising use of opioids across the nation and the effect these drugs have on the safety of our roadways," said J.T. Griffin, chief government affairs officer at the nonprofit organization.
Unlike alcohol, there is no reliable test for impairment by other drugs, Griffin explained.
"MADD has always served victims of all substance-impaired driving and remains committed to eliminating drunk driving and fighting drugged driving," Griffin said.
For the report, Chihuri and co-author Dr. Guohua Li, a professor of epidemiology at Columbia's Mailman School of Public Health, studied two decades of data from the Fatality Analysis Reporting System, which was created by the National Highway Traffic Safety Administration.
Chihuri and Li focused on drivers who died within one hour of a motor vehicle crash in California, Hawaii, Illinois, New Hampshire, Rhode Island and West Virginia. These states routinely test for drugs in people who have died in car crashes.
Of the nearly 37,000 drivers in the analysis, 24 percent had drugs in their system, of which 3 percent were prescription narcotics, the researchers found.
Among the 3 percent of drivers who tested positive for prescription narcotics, 30 percent also had high levels of alcohol and 67 percent had traces of other drugs, Chihuri and Li said.
More women than men tested positive for prescription narcotics -- 4 percent versus 3 percent.
Among male drivers killed in car crashes, the prevalence of prescription narcotics increased from less than 1 percent between 1995 and 1999 to slightly over 5 percent between 2010 and 2015. Among women, the increase went from slightly over 1 percent to more than 7 percent within the same time frame, the researchers found.
The report was published online recently in the American Journal of Public Health.
"The opioid epidemic has been defined primarily by the counts of overdose fatalities," Li said in a statement. "Our study suggests that increases in opioid consumption may carry adverse health consequences far beyond overdose morbidity and mortality."
One travel safety expert said it's difficult to tell if the increased presence of prescription painkillers was due to increased testing for it over time.
Also, it isn't clear if the protocols used to test drivers who died in car crashes was the same from state to state, said Jim Hedlund, a spokesman for the Governors Highway Safety Association.
From these data, the extent to which narcotic painkillers were the cause of a car crash also isn't clear. "The presence of a drug doesn't imply impairment," Hedlund said.
"Despite that, I believe the conclusions of the study are correct. They are finding more opioids in dead drivers than they were 20 years ago," he added. "That goes along with the trend in society of more opioids being prescribed and more opioid deaths.
"It's up to doctors and pharmacists to tell their patients that these drugs can impair driving and not to take them when they drive," Hedlund said.
WebMD News from HealthDay
SOURCES: Stanford Chihuri, MPH, staff associate/data analyst, department of anesthesiology, College of Physicians and Surgeons, Columbia University Medical Center, New York City; J.T. Griffin, chief government affairs officer, Mothers Against Drunk Driving; Jim Hedlund, Ph.D., spokesman, Governors Highway Safety Association; July 27, 2017, American Journal of Public Health, onlineCopyright © 2013-2017 HealthDay. All rights reserved.
via WebMD Health http://www.webmd.com/
July 31, 2017 at 09:05AM
The New Health Care: When Children Lose Siblings, They Face an Increased Risk of Death
Another factor could be the emotional impact and its effects on mental health, especially in the short term. Children who lose their parents are more likely to engage in alcohol and substance abuse not long after, often because of greater functional impairment, or to experience depression or post-traumatic stress disorder.
A case control study of children in Scandinavia found that children who experience the death of a parent had twice the chance of committing suicide. That increased risk lasted at least 25 years.
The risk of suicide in children who had lost a parent was 4 in 1,000 for boys and 2 in 1,000 for girls.
Emotional damage can have a physical impact as well. In 2013, researchers published work in PLoS One that showed that both men and women who had lost a sibling in adulthood had an elevated risk of death from stroke, potentially stress related, in the 18 months after the sibling’s death. For women, that increased risk got worse over time, still increasing 18 years later. Sibling death from external causes (mostly accidents and suicides) was also associated with an increased risk of death from heart attacks in women years later.
Families who lose a child are more likely to show problems that already existed, like evidence of social deprivation and poor health. Health care professionals may want to consider that the death of a child can exacerbate problems, and signify long-term social, behavioral and environmental risks for the survivors.
These warning signs exist in other familial relationships. Research has shown that losing a child increases the mortality rate in mothers more than a decade later, both from natural and unnatural causes. It increases the mortality rate in fathers, too, but only from unnatural causes. Losing a parent does the same.
But death may be harder for children. As a parent, I can imagine nothing worse than the loss of a child. But as I watch my children grow up together, I’m struck by the fact that their bond is, at times, stronger than their bonds to my wife and me. They’re together at school. They’re together at camp. They’re together when they play. They have secrets and shared experiences as they grow and develop together. They also have known almost no life without each other.
They are also far less capable of handling a loss than I or my wife would be. A study in the late 1990s examined how children responded to the loss of a parent versus a sibling. Girls, in general, were more affected by the loss of a sibling — especially a sister. Preteens showed higher levels of depression and anxiety, and adolescents had more attention problems and anger.
Given all these data, it may be time for us to pay more attention to the long-term effects of a child’s death. We can take hope from research showing that most children do thrive and overcome adversity, even after such a loss. Too many do not, though. We ought to monitor those who lost siblings as children for possible health consequences for many years to come.Continue reading the main story
via NYT > Health http://ift.tt/2koaaw3
July 31, 2017 at 07:12AM
Is 'overfat' the new obesity?
BMI, which stands for body mass index, is determined based on a person's height and weight. You're considered overweight if your BMI is between 25 to 29.9 and you're obese if your BMI is 30 or above.
in the journal
Frontiers in Public Health suggests the number of people who meet the criteria for
overfat in the top 30 industrialized countries are more than all of
the obese and overweight people in the world. In fact, they estimate that 90% of the men and 50% of the children in the US, New Zealand, Greece and Iceland are overfat. In the top overfat countries, researchers found 80% of the women were overfat, too.
This adds to previous
research publishedin January
that first suggested "the term more accurately encapsulates the problem itself."
And if doctors rely only on the definitions we use to consider someone "obese," or "overweight," they may not be helping all the patients they should.
What is overfat?
Overfat is a term created to describe if you have a body fat level that can actually hurt your health. Even people who are considered "normal weight" or "non-obese" by traditional standards can fall into this category.
The authors of this new study
argue that BMI misses about 50% of the people who still have dangerous amounts of fat. Those are typically people who have theproverbial beer belly
, but are otherwise in decent shape.
"We shouldn't be as much worried about weight," said authorPaul Laursen
, an adjunct professor and performance physiologist at the Sports Performance Research Institute in New Zealand.
Your scale or that BMI calculator don't know that you could be an athlete and have a lot of muscle mass, or a growing teen. Or, you could have gone on a fad diet and lost 3 pounds, but that doesn't necessarily make you healthier -- that 3 pounds could merely have been water weight, he said. "What we should really be worried about is the fat part and where your fat is concentrated."
Why's belly fat so bad
Abdominal fat is one of the most dangerous kinds of fat you can have. The reason it's so bad is that unlike your love handles -- which are the pinchable fat right beneath your skin -- the fat that is in your stomach area grows deep inside your body and it wraps around your vital organs. Your liver borrows this fat and turns it into cholesterol that can sneak into your arteries and start collecting there. When it collects, your arteries start to harden, and when they get hard, this can lead you to having a heart attack or stroke.
This deep layer of belly fat is also what makes your body insulin-resistant, which can lead you to having type 2 diabetes. It can also cause inflammation, which scientists are finding at the root of many chronic diseases and even cancer and Alzheimer's. Excess belly fat can also raise your glucose levels and decrease your muscle mass. You need good muscle mass to help keep good heart health.
It's no wonder earlier studies have shown that excess belly fat, even if you are skinny elsewhere, may be even more deadly than being obese or overweight. And that's saying a lot, since good old fashioned obesity is related to all sorts of diseases and potentially life threatening problems like cancer, heart attacks, stroke, asthma, sleep apnea, high blood pressure and a handful of other problems.
If a doctor is relying on BMI to assess your potential danger from your fat, they miss the risk. Earlier studies have also shown that doctors that rely solely on BMI may miss other warning signs for people of different ethnicities put them at greater risk for heart problems and other health issues.
A better measure
What may be a better way to assess if you are overfat is for your doctor to look more like a tailor and take a tape measure to your waist, the authors argue. If you want to try this at home, measure your circumference at your belly button. If your waist circumference is half your height or less, you are at a healthy fat level. If you are over that number, your fat could put you at risk for ill health.
It's not as perfect a measure as if your doctor were to calculate your fat using an X-ray, but it's a good indicator, suggestsDr. Francisco Lopez-Jimenez
, a cardiologist and obesity expert at the Mayo Clinic in Minnesota.
Lopez-Jimenez, who is not connected to this study, finds overfat an interesting concept and thinks the author's suggestion of measuring waist circumference is a good one. He said you could even do something simpler and look at your hip to waist ratio -- something a doctor could eyeball quickly. "If the waist is bigger than the hips, it tells me that the risk carried with that weight is much higher for that person for premature death," Lopez-Jimenez said.
But he's not convinced we need the term "overfat," as he thinks it over-complicates matters.
"It basically adds a little more complexity to an already complicated subject," he said. He suggests scientists may want to broaden the term "obesity" to include people with normal weight BMIs that carry too much fat around the middle.
Laursen thinks adding "overfat" to the lexicon will give doctors one more important tool.
"We are so conditioned to walking up to the doctor's office to get a pill for every issue, but that is not working. When it comes to excess fat, the onus is really on the individual to figure out what works for themselves," said Laursen, who added he gets upset that the overfat epidemic has become such a large problem for so many. By giving doctors another term it helps them have an honest conversation with their patients.
"Dealing with excess fat needs to be a priority," he said, "as it truly can put someone's life in jeopardy."
via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF
July 31, 2017 at 06:29AM
Raising an optimistic child in a pessimistic world
Consider their world: Thesuicide rate is up
, cyberbullying is rampant, the United States is more divided than ever, and people are now live-streaming murder and suicide. So it's understandable if you don't feel like putting on a happy face every day and keeping your kids optimistic about the future.
But don't give up. Ironically, even though media and technology seem to be the cause of our collective pessimism, they're also essential for overcoming it, either by using them wisely or knowing when to put them away.
Here are six ways to find the silver lining in every cloud.
When tragedy strikes somewhere in the world,we relive it every time
we turn on the TV, open our social media, check our phone notifications, or walk by a supermarket newsstand trumpeting a sensationalistic headline. Parents understand that the media amplifies things for eyeballs and clicks. But kids don't necessarily get the relationships among sources, sponsors, and audience. How you respond to news makes a difference in how kids process it, too. Help your kids put things in perspective by explaining that the loudest voices capture the most listeners.
When you "right-size" things, it lessens kids' fears and restores hope.
Talk about what you're grateful for
Counter defeatist attitudes by nurturing your kid's character. Strong character grounds your kids when the world feels chaotic. Take the time to share what you're grateful for. Encourage them to persevere against obstacles and to have compassion for others.
Research shows that expressing gratitude actually makes people feel optimistic. Try these character-building movies to kick off the conversation.
Fight fake news
A lot of kidssay they can't tell the difference
between what's real and fake online. Confusion, doubt, lack of trust -- these things get in the way of being optimistic. But kids have the tools to fight fake news. They can useonline fact-checking tools
to discover the truth (or at least uncover the fraud). They can refuse to contribute to the spread of false information by not sharing stuff they can't verify. And they can call out dubious claims when they see them.
Taking fact-checking into your own hands is empowering.
Stand up to cyberbullies
Teach your kid
that the buck stops with them. When they see someone getting bullied -- and it happens all the time in texts, on social media, and in online games -- they shouldn't just stand by. While they should never do anything that would endanger themselves, they can do a lot to assert their support of others. They can call out cyberbullies, report them, stand up for the victim, or just private-message the victim and tell them someone cares. It's not tattling. It's truly everyone's responsibility to keep the internet a positive, productive place.
Standing up to cyberbullies shows you believe you can make a change.
Stamp out hate speech
Online anonymity can have some unintended consequences. For example, people think they can spew hateful language or share insulting images without fear of being discovered. That may be, but hate speech is not a victimless offense. Whileinstitutions are beginning to punish those
who spread abusive material, no one should wait until that happens. Hate speech hurts people, contributes to an overall negative environment, and is sometimes a cry for help from someone in crisis. Explain how to handle hate speech: Don't respond to it, block people who do it, report offenders, and don't share it.
If your kid can influence only one person to knock off the negative stuff, then they'll influence someone else, and they'll influence someone else, and they'll ...
Tune out the world for a while
Grab your kids, grab your spouse if you have one, and shut everything else down. If they're all there with you, you won't miss anything. Simply being together, whether it's to read, have adevice-free dinner
, or talk about an issue recharges you and sends your kids the message that family time takes precedence over everything else. Experts recommend this kind of self-care because the buildup of bad news can be overwhelming and even debilitating. And if that's how adults feel, imagine how kids are reacting to the constant barrage.
By managing your media and reclaiming your family time, you show your kids what's really important.
via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF
July 31, 2017 at 06:29AM
Doctors increasingly face charges for patient overdoses
While high-profile cases against doctors have brought yet another spotlight to the nation's ongoing opioid epidemic, experts say this is rare and overlooks the bigger picture.
"The well-meaning doctors and dentists are the bigger part of our problem," saidDr. Andrew Kolodny
, executive director ofPhysicians for Responsible Opioid Prescribing,
an advocacy and education group.
"They're inadvertently getting patients addicted, and they're also stocking homes with a highly addictive drugs."
Once a wonder drug
"In the late '80s, early '90s, we were all told that we were too cautious and we were not appropriately treating patients' pain," said Sur, a professor of family medicine at the University of California, Los Angeles.
At the same time, pharmaceutical companies aggressively marketed opioids to doctors, former Surgeon General Vivek Murthy wrote in anopen letter
last year. Doctors were taught that these medications were not addictive if patients were in "legitimate pain," he said. Multiple studies have shown thisto be false.
"That was a quote I heard regularly," said Sur, who has testified in cases in which doctors are accused of recklessly prescribing opioids.
More and more, Sur sees other doctors referring risky patients to pain specialists who might be better equipped to offer alternative treatments, screen for addiction and, when necessary, prescribe opioids safely.
The fear, she said, "is not just strictly about being sued; it's about harming somebody."
These doctors might be looking for pain specialists likeDr. Kimberly Curseen,
a palliative care doctor at Emory Healthcare who works largely with cancer patients. But even she is acutely aware of the legal precedent being set against doctors.
"Personally, it's very frightening ... when you're working with medications that are receiving this type of scrutiny," Curseen said.
But she said it's a risk that many doctors accept to help patients in need.
"This is the profession that we chose," she said.
Scope of the problem
In 2010, doctors wrote enough prescriptions for hydrocodone to give every American adult a one-month supply, according to areport
by the US Centers for Disease Control and Prevention.
In general, prescription opioid abusers tend to get pills from family and friends for free. Those at the greatest risk of overdosing, however, are more likely to get the drugs through their own doctor's prescription,according to the CDC.
last year found that 91% of overdose survivors were still able to get another prescription for opioids.
Some doctors may be more willing to write an opioid script than others.One study
found that some emergency physicians were three times more likely to do so than other doctors at the same hospital. And their patients were more likely to be long-term users, too.
But some researchers have pushed back against the idea that a small number of doctors are responsible for the opioid epidemic.
Last year, researchers at Stanford argued that"opioid prescribing is no more skewed than other prescribing."
On one hand, opioid prescriptions are concentrated among specialties like pain management and anesthesiology. These specialties have been well represented inDEA cases.
But looking more broadly, a greater number of opioid prescriptions were written by general practitioners, such as family doctors, who see far more patients overall.
Not all patients have access to pain specialists and comprehensive care in the first place, saidDr. Keith Humphreys
, one of the authors of that paper and a professor of psychiatry at Stanford School of Medicine.
"There's just not that many pain medicine specialists. They can't drive national prescribing patterns," said Humphreys, also a former White House drug policy adviser under Presidents Bush and Obama.
Humphreys described criminal cases against doctors as "rare." Many doctors see these cases as outliers, which may also involve allegations of fraud, poor record-keeping and other misconduct.
But a number of doctors claim to have been falsely accused, and some of their investigations have ended inacquittals, dismissals
or no charges at all.
on the DEA investigation of Dr. Lynn Webster -- a pain specialist who was considered an expert in safely prescribing opioids -- after a string of patient deaths. In 2010, a handful of DEA agents raided his clinic, occupying "every corner of every room," he told CNN.
The investigation lasted several years, but no charges were ever brought against him.
"It's kind of like a scarlet letter that I will always carry with me," Webster said. "An investigation can be life-altering, but it can be career-ending."
The DEA has been putting more resources into investigating doctors and addressing the opioid crisis in general, according to Melvin Patterson, a DEA spokesman and agent of more than 20 years. For example, in 2015 the agency started rolling out its"360 Strategy,"
a program that educates doctors as part of a larger effort to fight illicit drug use in various pilot cities.
Patterson, who has investigated opioid cases involving doctors, said the DEA has made the drug epidemic a priority in recent years. He said it is much easier to push these investigations forward than before.
"There was a reluctance to really prosecute doctors" early in his career, he said. "That's being prosecuted all over the country right now. That's how far we've come."
But Patterson said that doctors shouldn't fear prescribing opioids if they're checking all the boxes. These investigations, widespread as they might be, represent a "small percentage" of doctors, he said.
"When a doctor is acting responsibly ... opioids are one of the best things they could have to treat pain," he said. "But when it's irresponsible -- in other words, a doctor hasn't even examined the patients, and they're prescribing them -- that's what's killing people."
Webster believes that "this is simply an approach to try to address the opioid crisis through legal channels" and continues to research pain therapies. He is vice president of scientific affairs atPRA Health Sciences
, a company that conducts clinical research on a variety of therapeutic drugs, includingopioids and opioid alternatives to pain
Webster, who has spoken in defense of other doctors in criminal cases, said that colleagues were "stunned" that this could happen to him.
"He's respected in our field," said Dr. Steven Stanos, president of theAmerican Academy of Pain Medicine
, of which Webster was past president.
Beyond legal concerns, Stanos said, doctors are acutely aware of a rising opioid death toll and powerful synthetic drugs hitting the streets, like fentanyl. Stanos said doctors are becoming "more worried" about prescribing opioids -- but that worry, he said, is not necessarily a bad thing.
"They should be careful, and opioids aren't for every patient," Stanos said. "Opioids are just a small part of (pain) management."
Doctors have been coming up with ways to avoid being put under the microscope themselves: by documenting their appointments meticulously, by followingguidelines
and by checking statewide prescription drug databases before taking out their pens.
Many doctors even have formal "agreements" with their patients, Stanos said. This may involve taking occasional urine samples to check for other drugs.
But experts like Stanos have had to solve another looming question: What about all the patients who were put on high-dose opioids in the past?
In the aftermath of cases involving doctors, some patients might be drug-dependent and have nowhere to go. Many face severe withdrawal symptoms and a heightened sensitivity to pain, a condition called hyperalgesia, Kolodny said. If those patients get their hands on opioids later on, they are more likely to overdose, having lost their tolerance.
Stanos, who is also the medical director of Swedish Pain Services in Seattle, has absorbed patients when nearby clinics have closed.
"We took over a number of patients that were in clinics where ... I don't agree with what was done with them," Stanos said. "Those patients are at high risk."
Stanos said doctors who receive cases like these can learn a lot from the Veterans Health Administration, part of the Department of Veterans Affairs. Early on, the health care system heavily pushed opioid painkillers as part of its pain management approach. But over much of the past decade, the VArevamped its approach to pain
, offering a wider variety of pain services and addiction treatment programs.
The impact of these measures -- including the 2013 rollout of the VA's Opioid Safety Initiative -- was a majorcut in the number of opioids it prescribed.
"You could call it a U-turn," Kolodny said.
"The (VA) had one of the earliest and worst guidelines on opioid prescribing that I've ever seen," he added. "And in 2017, they put out the most conservative guideline that's ever been made to date -- which is, I think, a very good guideline."
But many veterans on high-dose painkillers suddenly had to cut down medications that their bodies were dependent on.
"If you are getting a patient who's been put on chronic opioids, even though they never should've been started on it, that doesn't mean you should force them to come off rapidly," Kolodny said.
Last week, aVA-funded study
found that tapering down painkillers improves quality of life for chronic pain patients. Experts say that research and guidelines on opioid use for chronic pain is otherwise lacking and that the evidence is much clearer for short-term uses -- for example, after a major surgery.
Stanos said that the VA's interdisciplinary approach to pain has changed the field but that many unaffiliated doctors aren't able to offer the same array of alternative treatments and programs.
The VA "had to deal with this even sooner than the commercial payors, Medicare and Medicaid." Stanos said. "Now, they have some of the strongest treatment centers."
It's not just doctors who have been facing legal action for the opioid epidemic. A number of stateshave filed suit
against pharmaceutical companies for their roles in the opioid epidemic.
Even some pharmacy chains -- likeWalmart, CVS and Walgreens
-- have been named in lawsuits and investigations.
Missouri Senator Claire McCaskillannounced on Thursday
that she was expanding heropioid investigation,
which focuses on the relationship between prescription drugs and the opioid epidemic. She is requesting documents from opioid distributors, which were not previously part of the investigation, and she has also added new pharmaceutical companies to the mix.
But many physicians and advocates want to focus on the doctor's office in order to protect patients at risk.
"If we're ever going to bring (the opioid epidemic) to an end ... we need these folks to prescribe much more cautiously," Kolodny said. "If you can get your patients off of opiates, that should be the goal."
via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF
July 31, 2017 at 06:29AM
Personal Health: No Crying Over Dry Eyes
Tears serve a variety of functions, which accounts for the kinds of complications their deficiency can cause. They lubricate the eye, supply it with nutrients and oxygen, and help to focus images and clear the eye of debris.
Untreated, severe dry eye disease can result in scarring, ulceration, infection and even perforation of the cornea, the clear outer layer of the eye that protects the iris, pupil and anterior chamber and accounts for much of the eye’s optical power.
But the current and evolving knowledge of the nature of tears and their production has led to a better understanding of the various causes of dry eye disease and major improvements in treating this all-too-common condition.
“We used to think that tears were like salty water — just add more liquid and you’ll be fine,” Dr. Bishop explained. “We now know that there are many hundreds of substances in tears, including 1,500 proteins, and three main components. We try to pinpoint why a particular person is experiencing dry eye and treat that person’s specific problem.”
Tears are now known to have layers: an outer fatty layer produced by the meibomian, or tarsal, glands at the rim of the eyelids; a middle watery layer from the lacrimal gland in the upper outer corner of each eye; and an inner protein-rich lubricating layer of mucin from the goblet cells of the conjunctiva that covers the whites of the eyes and lines the eyelids. A disruption of any one of these systems can result in dry eye.
The fatty layer keeps tears from evaporating too quickly and helps them cling to the surface of the eye. The watery layer continuously moistens the eye, nourishes the cornea and flushes away toxins and foreign bodies. And the mucin layer inhibits microbial growth and binds water.
Dry eye disease also turns out to have far more possible causes — and, as a result, various specific treatments — than was once thought. As the above description suggests, it is not just a matter of insufficient tears from the lacrimal glands.
Possible causes include defects in the parts of the eye that produce each of the layers in tears; an inflammatory disease like allergy or chronic blepharitis (an inflammation of the eyelids); environmental conditions like tobacco smoke or a dry climate; a hormonal imbalance (as occurs, for example, at menopause); the use of contact lenses; a vitamin deficiency; an underlying systemic disease like diabetes or rheumatoid arthritis; prolonged use of certain medications (diuretics, antihistamines, antidepressants and cholesterol-lowering drugs, among others); and damage to nerves in the eye, as can happen in LASIK eye surgery.
One of the more common chronic causes in older adults is Sjogren’s syndrome, an autoimmune condition that affects moisture-producing tissues throughout the body, including the lacrimal glands, Dr. Bishop said.
Among current possible treatments described by researchers at the Schepens Eye Research Institute and Massachusetts Eye and Ear Infirmary are topical applications of the immunosuppressant cyclosporin A; antibacterial and anti-inflammatory derivatives of the antibiotic tetracycline (like doxycycline); and high doses of essential fatty acids (the omega-3 fatty acids DHA and EPA in fish oil and flaxseed oil, used topically and orally) that inhibit inflammation and are now being tested in a major study funded by the National Eye Institute.
When conventional remedies fail, specialty eye drops can be made using the patient’s own blood serum diluted with saline.
Additional therapies are being tested. Results of an industry-sponsored study of a synthetic form of lacritin, a protein that stimulates tear production, are expected next year.
Meanwhile, there is much that dry eye sufferers can do for themselves. Dr. Reza Dana, professor of ophthalmology at Harvard Medical School, emphasizes that most cases “are not fully treated by one medication or one approach. You often need to do several things in combination.”
In an interview, he recommended sitting high up at a computer so that you are looking down at the screen, which reduces exposure of the eye surface; always wearing wraparound glasses outdoors; and adjusting the flow of air-conditioning in a car so that it doesn’t blow in your face.
In addition, he said, “A lot of evidence supports the benefits of vigorous exercise. It fosters blood flow, helps regenerate tissues and, by increasing heat, promotes the release of oils in the eyes.”
People taking tear-suppressing medications for a chronic illness might ask their doctors about trying an equally effective substitute that lacks this debilitating side effect. If blepharitis is a chronic problem, wet a washcloth with hot water and apply warm compresses to the eyes every morning. “This can be the cheapest and most effective remedy for some people,” Dr. Bishop said.Continue reading the main story
via NYT > Health http://ift.tt/2koaaw3
July 31, 2017 at 06:06AM
The Checkup: Binge Drinking Drops Among Teenagers
“The overall declines in frequent binge drinking indicate that national and state-level policies and programs targeted at underage drinking may have been effective, although I’m not sure to what extent each of the policies specifically contributes to the declines,” Dr. Jang said.
The differential effects on different populations, however, are worrying. “One of the crucial messages from our study is that the public efforts may not be reaching all adolescents equally,” Dr. Jang said. So the researchers would like to see more attention — from parents, from health care providers and from researchers — to the populations that are not being reached as successfully: black adolescents, young women and people from lower socioeconomic backgrounds.
“I think this is a real public health success that hasn’t actually been really celebrated,” said Dr. Scott Hadland, a pediatrician and adolescent addiction specialist at the Grayken Center for Addiction Medicine at Boston Medical Center, who was a co-author of a commentary on the study. And it’s not just alcohol use that has declined. “Rates of teen use and, for most substances, rates of teen heavy use have declined,” he said, steadily since about the 1990s. The exception, he said, is marijuana; daily use and near-daily use of that drug have increased, while perceptions of harm have decreased.
In the late ’90s, he said, about one in two high school seniors reported having used alcohol in the last 30 days, whereas in 2016, it was down to one in three.
Binge drinking, he said, has declined notably among all age groups. “More teens than ever are expressing disapproval around binge drinking, fewer teens than ever are reporting that alcohol is readily available, easy to get,” he said. But he agreed with other experts’ concerns about the ways that the improvements were more significant in some groups than in others. “The public health successes are not being equally shared by everybody.”
This is one of the first papers to really look carefully at drinking in this kind of detail, he said. And it’s important, even while we celebrate the public health success we think is connected to effective messaging and good preventive care, to think about whether there are adolescents cut off from the potential benefits of anti-drinking programs.
“Not all youth have the same access to high quality care and to high-quality screening and referral services,” Dr. Hadland said. “We need to think about whether our school systems have equal access to high-quality preventive messaging, whether our schools are managing this problem equally and across the board for all youth.”
How can parents best help their teenagers navigate this issue and keep an eye out for trouble?
“I’m also a parent, and I have been asked a lot of those kinds of questions by my friends and my co-workers,” Dr. Jang said. She pointed to the important role of screening at health care visits.
“We have to talk with the practitioners at the regular checkup because there are these short checkup guidelines so practitioners can see whether the child has any problems or not,” she said. The National Institute on Alcohol Abuse and Alcoholism publishes a guide for practitioners on how to screen young people relatively quickly for alcohol problems and intervene when necessary.
Dr. Hadland acknowledged that parents can feel that they are being asked to give contradictory messages.
“What I say to teens and what I recommend that parents reinforce with teens,” he said, “is first and foremost, for your health it’s best not to drink or to use any substances. We have data underlying that.” But then there has to be a second message, particularly for young people who are drinking: “I say, for your health, I recommend that you reduce the amount that you drink and you drink less often to reduce the harms of drinking.”
In addition, of course, there are other essential messages about how to take care of yourself if you are drinking, especially regarding safe rides home, protected sex practices and mental health.
“I do think it is really important in these conversations with teens to help reset their understanding of what is excessive drinking,” he said. Adolescents may not be measuring their alcohol intake by the same standards as researchers.
“Many of the teens I care for are not measuring alcohol as we would,” Dr. Hadland said. “They’ll tell me oh, just one or two drinks, but if you drill down you realize each of those may have four or five ounces of hard liquor.” Researchers define a drink as containing 12 ounces of beer, five ounces of wine or one-and-a-half ounces of hard liquor.
Dr. Hadland also uses hist conversations with young patients to talk about the consequences of heavy drinking. The top three causes of death in adolescence are motor vehicle crashes, homicide and suicide, and he said alcohol can be a contributing factor in all three.
The long-term dangers of heavy drinking may be harder for adolescents to grasp, he said, though starting to drink young puts you at risk for long-term addiction. Over the long haul, heavy drinking is linked to many other kinds of illness, from liver disease and heart disease to cancer.
“I say, I’m really having this conversation because I’m worried about you and I want to keep you safe with this drinking.”Continue reading the main story
via NYT > Health http://ift.tt/2koaaw3
July 31, 2017 at 06:06AM