Opioids on the Quad
http://ift.tt/2iNEC4l Once at college, she replaced pills with bags of cheap heroin. Her roommate moved out. The drug rendered her friendless. “It was one of the most lonely times of my life,” she recalled. She grew thin and pale. She would sit in the cafeteria alone, barely eating, occasionally nodding off. The workers would ask, “Are you O.K.?” She still managed to get decent grades and to keep her addiction hidden at her job. By the end of the semester, Ms. Linneman’s father knew something was wrong. Over winter break, he gathered her sister and brother for an uncomfortable intervention. She wasn’t ready to seek help and went back to school. She began skipping classes and eventually dropped out. Then she was ready. Nasty withdrawal symptoms make stopping doubly hard. She spent four and a half months in a New Jersey rehabilitation center before joining the Haven, first as a resident, now as a frequent visitor. She has been clean for a year and a half. The opioid epidemic has ravaged communities around the nation — deaths from overdoses now outnumber deaths from car crashes — prompting President Trump to establish a federal task force and, on Thursday, to declare a public health emergency, allowing some grant money to be released to combat the problem and some laws and regulations to be eased. The task force is to issue a plan of action this week. Already on campuses, recovery programs are expanding and multiplying, populated by students who have struggled with dependence on Percocet (oxycodone) and Vicodin (hydrocodone), as well as those who have moved on to fentanyl and heroin, which are far cheaper on the street than prescription pills. Little data exist on the extent of the problem among college students. But according to a 2016 national survey of them by the University of Michigan, 7 percent of 870 respondents said they had misused opioid painkillers; 4 percent had done so in the previous year. For 19- to 22-year-olds who hadn’t gone to college or had dropped out, which is common when struggling with addiction, close to 13 percent said they had misused painkillers. Sean Esteban McCabe, a Michigan researcher who has studied student addiction for close to 20 years, said misuse is most prevalent on competitive campuses, where students are more affluent and have better access to prescribed pills. Studies have indicated that athletes in high-contact sports like ice hockey and wrestling, who are often prescribed painkillers, are particularly vulnerable. Campus users, Dr. McCabe said, tend to be white, live in fraternity or sorority houses, and have lower grade-point averages. Thanks to better prevention education and treatment, heroin use among college students has flattened out, and abuse of painkillers seems to be dropping. A decade ago, 9 percent in the Michigan survey said they had misused within the previous year. This news has not heartened advocates, though, largely because the number of deaths has actually risen. Public health officials blame a black market flooded with more dangerous options like fentanyl, a highly addictive synthetic that is 100 times more potent than morphine. It is the opioid that killed Prince. Opioid-related deaths among Americans age 24 and under almost doubled from 2005 to 2015, when 3,165 were reported, according to the Kaiser Family Foundation, based on data from the Centers for Disease Control and Prevention. The number of opioid-related emergency room visits by young people also nearly doubled over five years, from 52 per 100,000 patients to 97 in 2014, according to the United States Department of Health and Human Services. Last May, four students at Johns Hopkins University were hospitalized after overdosing on opioids during a late-night fraternity party. Furman University in Greenville, S.C., lost a student a day before his graduation last spring when he overdosed on fentanyl. A sophomore at the University of North Carolina at Chapel Hill, who had just spent the weekend with his mother at a Tar Heel football game, was found dead in his bedroom. In his system were traces of the opioids he had tried desperately to kick. States have urged colleges to take action. New York and Colorado are earmarking millions of dollars to their public colleges for prevention education and research. Maryland now requires colleges and universities to offer arriving students a drug-prevention class that focuses on the risks of opioid use. Gov. Chris Christie of New Jersey, who heads the federal addiction task force, announced this year a $1 million increase for recovery dorms on public campuses in his state. It is not uncommon for stores near campuses, health centers and dorms to stock free overdose reversal kits of naloxone. And the return to school now includes a bustle of overdose-prevention training sessions for residence hall assistants, campus police officers and health care workers. Last year, West Virginia University, in a state that leads the nation in fatal drug overdoses, started a parent support group. Mothers and fathers of young users gather monthly, some calling in remotely, to tell stories of spoons going missing from kitchen cutlery drawers and students calling home, desperate for money, dropping out of classes or getting arrested. Sometimes the parents cry uncontrollably. Photo Credit Mark Makela for The New York Times• Prescription pills are part of the party mix. Xanax, a highly addictive anxiety drug, has become a popular accompaniment to beer and vodka shots. Adderall is crushed for snorting. And Vicodin is ingested as a relaxant, available from students with prescriptions or on an online black market. Dr. Joseph Lee, medical director for youth services at the Hazelden Betty Ford Foundation, says that students act as mixologists, creating dangerous drug and alcohol cocktails for themselves and friends. “They are alarmingly familiar with what they can do to get high, but not the danger,” he said, “and they don’t know where to get help.” Students in recovery confirm this. Many of them say that in high school and college they were purposeful about their drug use, smoking pot to calm down and taking stimulants to speed up. The technique worked well, until overuse and mixed use began to alter the impact. Drugs that were supposed to do one thing did another. Bart Arconti, a junior at the University of North Carolina at Chapel Hill, got hooked on prescription painkillers in the basement of his best friend’s townhouse in a Baltimore suburb. He was 17. His friend had bought hydrocodone from a neighbor. They crushed a pill on the washing machine lid and snorted it. It became his favorite high. Mr. Arconti hopes his story might inspire others to get help. He stopped taking opioids four and a half years ago after several stints in rehabilitation. He says users destined to become addicts generally experiment until they find the drug they want. “There is a lot to choose from,” he said. It should not be a surprise that today’s 20-somethings have developed a taste for prescription pill cocktails. Pills are ubiquitous in homes, schools and offices. The National Survey on Drug Use and Health in 2015 found that 119 million Americans, 12 and older, take prescription painkillers, tranquilizers, sedatives or, increasingly among children and young adults, stimulants like Adderall. That’s nearly half the population. Painkillers in particular have surged. The sale of opioids quadrupled between 1999 and 2010, according to the American Society of Addiction Medicine. By 2012, doctors were writing 259 million opioid prescriptions a year, enough for every American adult to have his or her own bottle. The National Institute on Drug Abuse has been encouraging doctors to reduce the number of addictive pills they hand out. Parents are being told to dispose of unused painkillers, and drug companies are producing opioids in gel forms, so they can’t be crushed to snort. Dr. Andrew Kolodny, the co-director of Opioid Policy Research at Brandeis University’s Heller School for Social Policy and Management, describes the drug surge as “a pill-for-everything culture,” which he says has significantly affected how young people feel about prescription pills when they go off to college. Multiple studies have shown that the more available pills are to young people, the more likely they are to use them. “Today, if you grow up in a home where pills are used for every little problem,” he said, “you are likely to leave for college with a lot less fear about them.” • Throughout October, a wall of painted sneakers has greeted visitors to the University of North Carolina’s student union. It’s part of an exhibit entitled “Step Into the Soles of Recovery,” sponsored by the university’s four-year-old recovery program. Alongside the shoes are the personal accounts of the students who decorated them. The laces of one sneaker are wrapped tightly around it. On a piece of paper nearby, the student wrote: “For me, addiction always felt suffocating.” Frank Allison used heroin and drank heavily until he was 40; now 51, he heads the U.N.C. recovery program. He said the exhibit was a way for some of the four-dozen students in his program to talk candidly with the campus about their struggles, part of a push to destigmatize addiction and shift attitudes about treatment. Mr. Allison wants to see a move away from a “moral model” that treats students with substance issues like failures with no self-control instead of like people with a chronic illness, which is how the American Society of Addiction Medicine defines it. Physicians believe that this viewpoint will help frame the opioid problem for parents and educators, and help funnel recovery and prevention funds onto campuses. U.N.C. offers a cadre of services that largely depend on where students are in their recovery — six months substance-free or 60 months substance-free. Two years ago, Mr. Allison persuaded administrators to offer beds on a drug- and alcohol-free dorm floor. Three of his students currently live there. Some choose to be closely monitored, through breathalyzers and urine tests. The university helps them find therapists and coaches who accompany them to multiple recovery meetings a week. Others have chosen more autonomy but attend Mr. Allison’s workshops on meditation, mindfulness and balanced living. Like others in the movement, he refers to addiction as a “substance use disorder” and refuses to use the word “failure” when referring to relapses. Photo Credit Travis Dove for The New York Times“People don’t misuse substances because they are bad people,” he said. “I wasn’t a bad person. I was a sick person. Having a substance use disorder is like having diabetes or a heart condition.” Mr. Arconti, now 26 and pursuing a degree in Asian studies, says that Mr. Allison’s vision is reflected in the recovery community. The group, mostly male, consists of former frat boys, rock climbers and hip-hop fans, many not yet of legal drinking age. While some arrived in the program after too much dorm-room pot smoking, Mr. Arconti’s addiction lasted years. At the height of it, he made frequent “runs” to a drug-infested neighborhood in West Baltimore. Some of his friends have since died. Others are in jail. That was before he woke up one morning in a seedy hotel room and decided his body was spent. He committed to stopping. When there are U.N.C. basketball games Mr. Arconti watches with his recovery friends. Together, they go to Durham Bulls games and amusement parks. But it is at weekly meetings where the recovery ethos shines. Students talk about sober dating, relapse temptations and struggles to make time for studying and recovery. When they speak specifically about their addictions, they are quick to play down the drugs they gravitated toward. Instead, they focus on the illness they share, and the future. During a recent meeting, when it was his turn to talk, Mr. Arconti said: “I’m happy to be here. I’m mentally and spiritually feeling well.” Nationally, more students are seeking treatment. Last year, about one in two patients at the Minnesota youth treatment center of the Hazelden Betty Ford Foundation were being treated for opioid addiction. In 2010, one in six were. And the number of opioid-related claims for coverage by Blue Cross Blue Shield has almost doubled since 2010 for college-age patients. The Haven at Drexel is part of a network called the Haven at College, which started in 2012 with one residence, at the University of Southern California, where young people could bond over a common struggle. Now there are five — four on or near California campuses and the one at Drexel — housing more than 50 young adults. The umbrella organization is run by two former users — alcohol and heroin were their drugs of choice. The cost is $1,900 to $3,800 a month, which can be defrayed by financial aid, alumni funds earmarked for recovery and Haven work-study. Students who live in the houses receive meals, coaching from a licensed clinician and support from a house manager who monitors their whereabouts. There are curfews for newcomers, penalties for missing them and chores for everyone. But mostly, students say, there is camaraderie. Most of the houses are near dorms or fraternity houses, in what Holly Sherman, a founder and the executive director, calls the “war zone of party central.” Still, or perhaps because of this, it is not uncommon to have dozens of people show up for the Saturday night meeting. Ms. Sherman says students arrive on campus and wonder: “‘How am I going to stay sober if I can’t find a sober community?’ What we do is work with the university to establish that community for them.” Matthew, a 24-year-old former varsity athlete, sometimes attends the meetings. A May graduate of Albright College in Reading, Pa., he asked that his last name not be used because he wants to work as a financial adviser or analyst at a Fortune 500 company. But the opioid obsession he developed in college is getting in the way. He hopes the experiences of other students, many of whom know well the allure of opioids but have managed to kick the habit, will rub off on him. He was handed a “Perc” freshman year by an older teammate he looked up to. At the time, he was at a small Catholic college in a Philadelphia suburb. “I’m in college,” he recalled thinking. “Let’s experiment, let’s party. He’s cool. I want to be cool.” Soon after, a dealer introduced him to heroin. He began snorting before class, while doing homework and instead of going to parties and drinking. The heroin made all the drudgeries — homework, dining hall food, boring classes — seem manageable. “During Accounting 101, I’m in the bathroom snorting heroin, thinking: ‘I’ve got to get back to class.’” When he transferred to Albright College, he dialed back on the heroin and returned to Percocet. Last summer, shortly after graduating, he went to a rehabilitation center in Florida. “I’m not ready to just throw my life away for a stupid blue pill,” he said, perched on a weathered coach in the recovery center living room. Still, he acknowledged, he struggles to kick the habit. “I don’t want to do this for the rest of my life. I’ve got really big goals.” Kyle Spencer writes frequently for The Times on education. A version of this article appears in print on November 5, 2017, on Page ED23 of Education Life with the headline: Opioids on the Quad. Order Reprints| Today's Paper|Subscribe Health via NYT > Health http://ift.tt/2koaaw3 October 30, 2017 at 05:00AM
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Myths about baby sleep and SIDS debunked
http://ift.tt/2zR4Jur Dr. Harvey Karp, author of "The Happiest Baby on the Block," will be taking your baby and parenthood questions on the CNN Parenting Facebook page live at 11 a.m. ET Monday, October 30. When it comes to baby sleep, bad advice can be dangerous. October is Safe Sleep Awareness month, an opportunity to learn more about sudden unexpected infant death and debunk the myths about what is sabotaging your sleep and highlight habits that potentially risk your baby's safety. Not true. In fact, total silence can make it hard for your baby to doze off. Remember, the womb is noisy: louder than a vacuum cleaner and running 24 hours a day. For nine months, your little one's been lulled to sleep by the rhythmic whooshing of the blood flowing through the placenta. To her, the quiet of the average home is jarring. Plus, in a silent room, she's more likely to wake up when a loud truck on the street or any other bump in the night breaks that silence. The truth is, your baby will sleep best if you play loud, rumbly white noise during all naps and nights. Nope. You should always wake your sleeping baby using a little technique called " wake and sleep." It gently teaches your child the important skill of self-soothing. Here's briefly how it works: Starting as early as the first day of life, wake him up the tiniest bit after sliding him into bed. Just tickle his neck or feet until his eyes drowsily open. Very soon after, he'll drift right back into slumberland. In those few semi-awake seconds, he's just soothed himself back to sleep -- the first step toward sleeping through the night. Myth 3: Some babies sleep worse when swaddled because they want to be free.Not really. Your baby may fuss and resist swaddling at first, so it may look like she hates it. But babies don't need freedom, they need the feeling of security they had in the womb. Without wrapping, your infant will flail her arms, whack herself in the face and startle easily throughout the night. That's a recipe for poor sleep. Swaddling is the first step to calming, and it's important you don't stop there, especially if your infant's been fighting it. To help her settle, you'll want to layer in other womb-mimicking steps: "shushing," side/stomach position, swinging and sucking, which, along with swaddling, make up the 5 S's of setting up a baby for sleep success. And once the S's become part of your sleep routine, she'll give up her battle! (Note: Side/stomach position is for calming only, never for sleep.) Myth 4: We should teach babies to sleep in their own rooms.Having our babies grow up to be independent takes a long time. There's no need to rush it. In fact, having your new child sleep in another room is inconvenient (for feedings and diaper changes) and possibly dangerous. The American Academy of Pediatrics recommends that babies sleep in the parent's room for at least six months (always on their back, in their own bed). The simple practice has shown to significantly reduce the rate of sudden infant death syndrome. Myth 5: Swaddling should be stopped after two months.Swaddling reduces crying and increases sleep. But new research shows that swaddled babies who roll to the stomach have double the risk of SIDS compared with an unswaddled baby rolling over. As a result, the pediatrics academy is now recommending that parents stop baby-wrapping at 2 months. On the face of it, the group's new advice seems to make sense, but it completely ignores the risks of not swaddling. In an eight-year review of datacollected by the Consumer Product Safety Commission, only 22 sudden unexplained infant deaths related to swaddling were reported; almost 50% were in sleep sacks (a wearable blanket), and 90% were found on the stomach and/or with bulky bedding. (Note: Fatalities categorized as sudden unexplained infant death include sleep deaths from accidental suffocation, strangulation and SIDS.) During those eight years, hundreds of thousands -- if not millions -- of babies were swaddled. Since sudden unexplained infant death strikes one in 1,200 babies, one would have expected hundreds or perhaps thousands of swaddle-related deaths over this period if wrapping caused these deaths. Of note, during the same eight years, 1,026 deaths related to sofa sleeping were reported to the safety commission. The point is, though swaddling may introduce a theoretical risk, there is not a lot of proof it is causing a true increase in sudden unexplained infant death. On the other hand, swaddling has been shown to reduce infant crying and boost sleep. That is of critical importance because the stress provoked by persistent fussing and parental exhaustion is a potent trigger for postpartum depression, child abuse, car accidents and even risky sleeping practices, which are associated with up to 70% of all infant sleep fatalities. We don't want babies rolling over swaddled, but we also don't want them rolling over unswaddled during the 2- to 4-month-old peak period for SIDS. An unswaddled baby can roll to an unsafe position more easily than one whose movement is restricted by snug swaddling. And, since swaddling improves sleep, unwrapped babies wake more often and are more likely to tempt their tired parents to fall asleep with them in their beds. To solve this tricky problem, I assembled a team of MIT-trained engineers and renowned industrial designer Yves Behar to invent a type of swaddle that keeps sleeping babies safely on the back. In October 2016, my company Happiest Baby debuted Snoo, the world's first responsive bassinet that employs this special swaddle, which clips to the base of the bed to prevent rolling. This innovation allows parents to reap the substantial benefits of swaddling for a full six months without any of the risks. Myth 6: Putting babies to sleep on the back has solved SIDS.The National Institute of Health-led Back to Sleepcampaign quickly reduced sleep deaths from 5,500 in 1994 to 3,500 in 1999. However, for the past 17 years, progress has completely stalled. The tragic truth is that 3,500 infants die during their sleep each and ever year. Although more babies are sleeping on the back, the rate of accidental suffocation and strangulation infant deaths has quadrupledsince the mid-1990s. What's behind this alarming trend? Unsafe sleeping practices. Seventy percent of all sudden unexplained infant death victims are found in adult beds, sofas and other risky locations. A recent study revealed that while most parents fully plan to follow the ABCs of safe sleep (Alone, on the Back, in a Crib), less than half actually doit. And by the end of the night, about 60% of babies have migratedfrom their bassinet to their parents' bed, according to a study in the Journal of Clinical Lactation. The terrible, unintended consequence of the Back to Sleep campaign is that it has worsened infant sleep. Babies just don't sleep well on their backs in still, quiet cribs. And as discussed in myth 5, when babies don't sleep well, parents resort to bed-sharing, which leads to many more infant suffocation deaths. It is very important that parents continue to place their babies to sleep on the back, but they also need to start using more tools to improve their child's sleep. The good news is that there are three effective ways to boost slumber for back-sleeping babies: sound, swaddling and rocking. Rumbly white noise is inexpensive and very effective for improving a baby's sleep. Snug swaddling is too, but as explained above, pediatricians now recommend that parents stop wrapping at 2 months old. Motion, or swinging, is also great, but the American Academy of Pediatrics has found that sleeping in sitting devices, such as rockers and swings, may allow a baby's head to roll forward and cause accidental suffocation and death. These are issues we sought to address with the Snoo bed. It allows for safe swinging (it is totally flat), safe swaddling (the baby can't roll over) and safe sound, as the sound increases when a baby cries but then immediately softens -- after the baby calms -- for all-night sleep promotion. We designed it to deliver the right level of womb-like stimulation that is right for any particular baby to calm his or her fussing and boost sleep. For nearly 20 years, despite enormous public health educational programs, we have failed to reduce infant sleep death. But, by focusing on sleep efficacy (boosting a baby's sleep), we now have a very exciting means to prevent many -- if not most -- of these deaths. And as a health bonus, improving sleep efficacy may also allow us to reduce other serious and unsolved health problems triggered by exhaustion and crying, such as postpartum depression (with about a half million cases diagnosed a year) and shaken-baby syndrome (1,300 incidents a year). Please join me in October -- and all year long -- by telling new parents about exhaustion's role in sudden unexplained infant death and by sharing the sleep-boosting tips mentioned here. I am confident that we will dramatically improve the health of American parents and babies as we put more energy and emphasis on helping parents promote better infant sleep. Health via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF October 30, 2017 at 04:34AM
Drugmaker set to profit from opioid it said was unsafe
http://ift.tt/2ziuHKL As the opioid epidemic grew, Endo Pharmaceuticals took the extraordinary step in 2012 of pulling a version of one of its best-selling painkillers off the market, saying that the narcotic was susceptible to abuse. Endo even unsuccessfully sued the US Food and Drug Administration that year to prevent the approval of any generic version of its drug, called Opana ER. The drugmaker argued that given a chance, drug abusers would crush and snort the generic pills, just as they had with the brand-name drug. Snorting intensifies the high but heightens the chance of overdosing. It seemed as though a drug maker was taking selfless action to try to curb the growing opioid epidemic. But some industry observers say the story of Opana ER may better illustrate the lengths a drug company would go to in order to protect its profits. Endo introduced a new formulation of Opana ER before phasing out the old one. Both drugs had the same active ingredient, oxymorphone. Both were extended-release pills for long-lasting effects. Both were called Opana ER. The difference was a few inactive ingredients, including a hard coating that made the pills harder to pulverize. Even so, addicts quickly learned how to cook the new painkiller and inject the liquid with a syringe. Endo contended that the new Opana ER and its hard coating deterred abuse, but this summer, the FDA disagreed. In June, the regulatory agency concluded that the risks of new crush-resistant Opana ER outweighed its benefits and pressured Endo to stop selling it. It was the first time the FDA had taken steps to stop sales of a currently marketed opioid because of the consequences of abuse. President Trump allude to the drug last week when declaring the opioid epidemic a public health emergency. "We're requiring that a specific opioid, which is truly evil, be taken off the market immediately," he said. Endo agreed to halt shipments of Opana ER starting September 1. But that's not the end of the drug's story. Endo still has the patent on the original version of the drug, the one it fought to keep off the market. The FDA's action this summer didn't impact the crushable version Endo stopped selling in 2012. So on August 8, Endo cut a deal with Impax Laboratories to split the profits of a generic version of its original drug. Endo is now poised to make money from a drug that it said shouldn't be on the market. 'It just doesn't seem right'Endo's efforts to profit from a drug that it said was susceptible to abuse raises ethical questions, in the opinion of one member of the FDA advisory committee that recently reviewed Opana ER. "They're the ones who called it dangerous and unsafe," said Suzanne Robotti, who is also the founder of the MedShadow Foundation, a patient advocacy group. "It just doesn't seem right." Dr. Michael Carome, director of health research for the consumer group Public Citizen, was harsher in his criticism. "The pharmaceutical industry is solely driven by its desire to make profits and boost its bottom line," Carome said. "Here's a situation where the company is talking out of both sides of its mouth, depending on what will make them money." Endo defended its decision to cut the deal with Impax. "The FDA is charged with -- and makes -- the sole determination of whether pharmaceutical products are safe and effective," the company told CNN. "In June 2017, the FDA requested that Endo voluntarily withdraw the formulation of Opana ER that is designed to be crush resistant due to unintended use and misuse. ... In July 2017 the Company, after careful consideration, decided to voluntarily withdraw it from the market. In the case of the prior formulation of Opana ER, the FDA determined that the product should remain on the market." The FDA declined to comment on why it left the generic version on the market but told CNN it is assessing the abuse patterns for that drug. History of keeping generics off the marketEndo Pharmaceuticals has a long history of trying to keep generic versions of Opana ER off the market. Because generic drugs are so similar to their brand-name counterparts, a generic drug's maker can piggyback off the FDA approval of the brand-name drug. The FDA approved oxymorphone as a painkiller in 1959, but the pill form was voluntarily taken off the market in 1982. Endo decided 15 years later to revive the drug as an extended-release pill. In 2006, the FDA approved Opana ER. The extended-release pill comes in higher doses that are slowly released in the body for up to 12 hours. Opana ER is more potent than its two competitors, morphine and oxycodone, and was intended for use for moderate to severe pain for patients who needed 24-hour relief. In 2007, Impax sought FDA approval to sell a generic version of Opana ER, but Endo immediately suedfor patent infringement. The drugmakers settled in 2010, with Impax agreeing to wait until 2013 to launch its generic. But as that date drew near, Endo tried again to keep Impax from selling a generic version of Opana ER. That's when Endo decided to pull the original formulation of Opana ER off the market, saying the drug was susceptible to abuse. Endo petitionedand later suedthe FDA to force the agency to declare formally that the original formulation was withdrawn for safety reasons. Doing so would keep generic drugmakers from piggybacking off the drug's FDA approval. Endo filed the FDA lawsuit only about a month before Impax was scheduled to sell the generic drug. The drugmaker urgently sought a decision by the end of the year. But the FDA persuaded the court to dismiss the lawsuit, telling it "Endo's self-inflicted December 31 deadline is a thinly-veiled attempt to maintain its market-share and block generic competition from Impax." Opana ER was one of Endo's best-selling brand-name drugs. In 2012, net sales of the narcotic amounted to nearly $300 million, or 10% of Endo's total revenues. Endo justified withdrawing the original version of Opana ER by telling the FDA that it saw misuse of Opana ER soar after Purdue Pharma introduced a crush-resistant version of its top-selling Oxycontin in 2010. The company cited researchshowing that abuse of Opana ER rose 111% from August 2010 through March 2012. Endo said it introduced a crush-resistant version of Opana ER "in recognition of increased reports of the potential for abuse and misuse" of the original formulation. However, the FDA says Endo never told it about these safety concerns until months after it began selling the crush-resistant pill and phasing out the original one. Even when Endo announcedthe FDA's approval of crush-resistant Opana ER in December 2011, the company said, "It has not been established that this new formulation of Opana ER is less subject to misuse, abuse, diversion, overdose, or addiction." In the lawsuit, the FDA asked why Endo continued to sell original Opana ER if it thought the drug was unsafe. Allowed to join the lawsuit, Impax put it more bluntly: "Contrary to its insincere concern about public safety, Endo distributed the allegedly 'dangerous' Opana ER for years, and then apparently continued distributing it for up to nine months even after obtaining approval to market (crush-resistent) Opana ER." In 2013, the FDA ruledon Endo's petition, saying that Opana ER "was not withdrawn from sale for reasons of safety and effectiveness." The ruling was based on the company's failure to present sufficient evidencethat the crush-resistant version of Opana ER was less likely to be abused than the crushable version. The decision allowed Impax to sell a generic version of Opana ER. Last year, the Federal Trade Commission suedEndo and Impax, alleging that their 2010 agreement to delay the launch of a cheaper generic until 2013 violated federal consumer laws. The FTC alleged that Endo paid Impax more than $110 million for the delay. The federal lawsuit also alleged that Endo launched its crush-resistant pill "to protect and extend its Opana ER franchise in the face of potential generic entry." Endo settledthe FTC lawsuit in January, promising not to cut any deals intended to keep generic drugs off the market. Impax is still contesting an administrative complaint from the FTC on the same allegations. Abuse of new drug goes upMeanwhile, the FDA decided to take a closer look at Opana ER. Over time, datafrom drug rehabilitation centers showed that as users learned to inject the reformulated drug, the rate of overall abuse actually increased. Opana ER is not the only opioid being abused, but medical researchers were linking its misuse to outbreaks of hepatitis C as well as a rare but deadly blood disorder affecting at least 30 people in Tennesseeand North Carolinaand an HIV epidemic affecting more than 200 people in southern Indiana. Opana can be bought illegally for a hefty price on the street, where the drug is sometimes called "biscuits," "O bomb" and "stop signs." Because it is so potent, addicts often split the dose with others. The high is over quickly, so addicts shoot up several times a day. This year, an FDA advisory committee said these factorsmay have encouraged needle sharing and the spread of disease. Vice President Mike Pence, then governor of Indiana, reluctantly gave into calls in 2015 for a needle exchange -- replacing used needles with sterile ones -- to stop the spread of HIV in his state linked to Opana ER abuse. In March of this year, an FDA advisory committee held two days of hearings on crush-resistant Opana ER. The group concluded by a vote of 18-8 that the risks of the newer version of the drug outweighed its benefits. But before pulling the drug, the Pennsylvania-based drugmaker went into negotiations with Impax to settle ongoing litigation. The deal announcedin August was to split the profits on generic extended-release oxymorphone for the next 11 years, starting January 1, 2018. Endo told CNN that the deal "allows Endo to be fairly compensated for Impax's license to use Endo's valuable intellectual property in offering the product for use as intended." Last year, Impax made $72.7 million from sales of the generic drug. Endo's sales of Opana ER amounted to about $159 million last year. During a recent conference call with investors, Paul Bisaro, president and chief executive officer of Impax, said, "I think our challenge will be to make sure that patients and caregivers understand that if their patients are on oxymorphone extended-release product because they prefer that, that that product remains available." Asked by CNN about the safety of the generic, Impax issued a statement: "Patient safety is very important to us. We believe that our product is an effective therapy for patients with chronic pain when used as directed by a physician and in accordance with the label/package instructions." The future of oxymorphone is not entirely certain, however. In March, the FDA advisory committee was shown data that generic extended-release oxymorphone had the highest rate of abuseof all opioid pills, even among users who are snorting or injecting the drugs. The FDA told CNN it is reviewing the safety of all oxymorphone drugs. CNN's Caitlin Ostroff contributed to this report. Health via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF October 30, 2017 at 04:34AM
How #MeToo could move from social campaign to social change
http://ift.tt/2hmN7zJ But can a hashtag, a meme or any viral moment -- no matter how widespread -- really turn into a lasting movement that that will create social change and reduce sexual abuse of women? Maybe. But experts say it's going to take a coordinated effort between antiviolence organizations, the media and Hollywood as well as concrete actions from each and every one of us, especially men. "I am really tired of talking about women," said Toni Van Pelt, president of the National Association of Women. "We must focus on the men. We must be demanding that the men step forward and take responsibility, whether they think they are the good guy or not. They are not the good guy if they are not speaking out against this, if they are allowing the bullying to continue." It's the men's turnA Call to Men, a violence prevention and male socialization group, is hoping the launch of its new campaign, #IWillSpeakUp, will help the cause. "We felt like we really needed to respond because it's out of control," A Call to Men co-founder Ted Bunch said. "And it's not just Hollywood. Viewing women as objects, property and having less value than men is something that all males have been taught, even by 'well-meaning men,' and we pass that on to our boys. So this has to become a men's issue, because men won't stop unless other men say so." Launching Monday in conjunction with the Joyful Heart Foundation, founded by "Law and Order: SVU" star Mariska Hargitay, the campaign includes an op-ed and public service announcement featuring male celebrities such as Danny Pino, Blair Underwood, Christopher Meloni, Anthony Edwards, Sway Calloway and Tim Gunn, who all encourage men to pledge better behavior toward women under the hashtags #IWillSpeakUp and #SupportSurvivors. The theme of the PSA is "I'll say something next time," Bunch explained. "It finishes with a line that we frequently use when we train men on healthy, respectful manhood: 'Most men are not abusive. But they are far too often silent about the abuse committed by other men. Their silence is as much of the problem as the abuse.' " A viral graveyardSocial media is littered with the digital bones of once-vibrant hashtags and memes, so getting the momentum behind #MeToo to translate into literal action could be an uphill battle. Last year, Canadian-born writer Kelly Oxford shared her storyof being groped at age 12 on the bus; the response from women to her #ItsNotOkaywas unprecedented. But it soon faded. Other hashtags expressing social outrage over sexual abuse have suffered similar fates: #YesAllWomen, #WhyIStayed, #YouOKSis, #EverydaySexism, #ToTheGirlsand #BrockTurner, to name a few. #MeToo was created over a decade ago by female activist Tarana Burke, who works with Girls for Gender Equity and founded Just Be Inc., organizations focused on empowering women of color. She launched the hashtag after her own experience with abuse kept her from helping a traumatized young girl. "I could not find the strength to say out loud the words that were ringing in my head over and over again as she tried to tell me what she had endured," Burke wrote on her website. "I couldn't even bring myself to whisper...'me too.' " Though Burke sees #MeToo as a movement, she admits that the hashtag's popularity ebbs and flows. "I've seen it happen over and over again in small waves, but to see it happen en masse has been pretty amazing," she told CNN. Some social activists blame the media for the public's short attention span, believing that online interest is driven by the amount of time and attention the press gives to any given subject. Just look to #Charlottesville, #Fergusonand #BringBackOurGirls. Others point to "slacktivism," a portmanteau of "slacker" and "activism," as part of the problem. It's a pejorative term coined by sociologists to describe keyboard activists who react to an online movement so they can feel good about themselves, but these social "slackers" are thought to stop short of taking offline action. "Saturday Night Live" poked fun at armchair activism this year with a skit called "Thank you, Scott," starring comedian Louis C.K. as a well-meaning man who shares a few articles with his Facebook friends. But it's no laughing matter. A University of British Columbia studyfound that public displays of support, such as "liking" a charity online or wearing a lapel pin, hurt that charity's fundraising efforts, as people failed to follow through with their wallets or volunteer their time. Private displays of activism, such as signing a door-to-door petition, fared better. Keyboard apathy is such a problem in fundraising that in 2013, UNICEF Sweden tackled it with a hard-hitting poster and video campaign: "Like us on Facebook and we will vaccinate zero children against polio. We have nothing against likes, but vaccines cost money." There have been successes, most notably the 2014 ALS #IceBucketChallenge, which raised more than $115 millionfor causes related to amyotrophic lateral sclerosis, also known as Lou Gehrig's disease. According to the ALS Association, more than $77 million of that went to research, which recently scored by uncovering a key gene, NEK1, that contributes to more than 3% of ALS cases. Another hashtag to make the leap from online social activism to the street was #BlackLivesMatter.It burst onto the scene after the 2012 killing of African-American teenager Trayvon Martin by George Zimmerman, a white Hispanic man. #BlackLivesMatter gained national prominence during violent protests in Ferguson, Missouri, following the killing of 18-year-old African-American Michael Brown by a white police officer and has since grown to 40 chapters, including Canada and Britain. This summer, the group won the 2017 Sydney Peace Prize.Though much has been written on the demise of the hashtag and what that means for the movement,co-founder Patrisse Cullors disagrees. "It's not a hashtag that built the movement," she said in an interviewwith the Los Angeles Times. "It was organizers, activists, educators, artists -- people who built an actual infrastructure so that a movement can exist and have life." From meme to movementThat's exactly what is needed to solidify #MeToo's viral legacy, according to sociologist Jen Schradie, who studies digital activism for the Institute for Advanced Study in Toulouse, France. "Based on my research, the movements that are most successful are those who have an organizational infrastructure in place: a network, a coalition, a united front of a group of celebrities or established organizations," she said. She points to the civil rights movement as the ultimate example of success. "The energy we see in the #MeToo movement is very similar to that of the civil rights movement," Schradie said, "but the difference is, the civil rights movement was able to connect people who just heard about it with actual organizations who were coordinating resistance. "I've found that the groups that can sustain high levels of online participation are those which are more structured and have volunteers and staff dedicated to keeping that online effort in place." "People want concrete ways to be part of a solution, and that's where the #MeToo movement needs to go," said Kristen Houser, chief public affairs officer at the National Sexual Violence Resource Center. "Talking about victimization doesn't end victimization," she said. "We need people to intervene. We need whistle-blowers. Parents need to be great role models. Ask your school, church, civic organizations and youth sports clubs to be proactive. Walk the walk in your own home." Many of these men's and women's rights organizations say that all anyone has to do to get involved is reach out to the many local, state and national organizations that have been fighting for equality for women for decades. Volunteer. Donate time and money. Do more than lift your finger to "like." "Funding for prevention work is hard to get, yet investment in this space is critical," Bunch said. "We are trying to go upstream and prevent things before they start. It's not in a man's DNA. It's not who we are. We are socialized to behave this way. That has to stop." "This could be a watershed moment if this connects the dots," Van Pelt said. "Connect the dots from a culture of male authority and patriarchy to the fact that women do not get equal pay; connect the dots to birth control and abortion that is being kept from women. "Because if women are in position of authority, they will help stop the submission of other women," she continued. "So that men can't corner them, can't force them into sexual acts, because women won't need the financial stability. The economic security." Health via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF October 30, 2017 at 04:34AM
Study links acetaminophen in pregnancy to ADHD
http://ift.tt/2gNcDNU The lead author of the new study, Eivind Ystrøm, a senior researcher at the Norwegian Institute of Public Health, said pregnant women who need medicine for fever or pain relief "should not refrain from short-term acetaminophen use." However, pregnant women who require "continuous acetaminophen for a longer period" should consult with their physicians, he wrote in an email. The study defines a longer period as 29 days or more. The makers of Tylenol, McNeil Consumer Healthcare (a Johnson & Johnson company), did not respond to a request for comment on the study. Association, not cause and effectThe Norwegian Mother and Child Cohort Study provided data for the new research. Women were invited to participate after routine ultrasound examinations around week 18 of their pregnancies. Information was gathered from 95,242 mothers, 75,217 fathers and 112,973 children born between 1999 and 2009 -- including 2,246 children diagnosed with ADHD. Nearly 47% of the women used acetaminophen during their pregnancies: 27% in one trimester, 16% in two trimesters and less than 4% in all three. "We found that using acetaminophen for 29 days or more during pregnancy gave a 220% increase in risk for ADHD in the child," Ystrøm wrote -- more than twice the expected risk. "This was after taking medical conditions and risk for ADHD in the family into account." Use of acetaminophen by pregnant women for less than seven days was associated with a decreased risk of ADHD in offspring, the researchers say, based on their analysis. Fathers who used the pain reliever for 29 or more days prior to conception also had twice the number of children with ADHD. Unsure how to interpret this finding, Ystrøm suggested that "it could be that fathers who use a lot of acetaminophen have a higher genetic risk for ADHD" or that long-term use of the medicine might lead to changes in sperm. No evidence of a cause-effect relationship between the drug and ADHD was found, Ystrøm and his colleagues concluded. Still, they believe further study is needed. Dr. Alison G. Cahill, a member of the American College of Obstetricians and Gynecologists' Committee on Obstetric Practice, said the study "doesn't add anything to our medical knowledge." Cahill was not involved in the research. She applauds the researchers for their efforts -- in particular the high number of participants -- but says the study simply cannot "overcome" certain challenges and design flaws. Chief among these is the way in which a diagnosis of ADHD is assessed, she said. Ideally, the same careful and measured approach would be used with all the children in the study. Instead, the researchers calculated the number of children diagnosed with ADHD by codes in their medical records. "As you can imagine, there can be some disconnect between the making of that diagnosis and how it's actually coded," Cahill said. Also, variability between providers and how they make that assessment means it is possible a child didn't have ADHD but instead had a related disorder. Dr. Max Wiznitzer, co-chairman of the professional advisory board for the nonprofit Children and Adults with Attention-Deficit/Hyperactivity Disorder, agreed. Doesn't make 'biological sense'Wiznitzer, who also did not participate in the new research, noted that the codes the researchers used to calculate the total number of ADHD diagnoses may have merged in learning and language disorders. "They also did not confirm the diagnoses," he said. And past telephone surveys conducted in the US have asked parents whether their child was ever diagnosed with ADHD and then whether the child still has that diagnosis. "It's a smaller percentage," Wiznitzer said. "Just because a kid gets labeled with having this diagnosis doesn't mean it's accurate." For expected rates of ADHD in children, the researchers used an estimate of 4%, yet in the United States, most people would use between 8% and 11% based on CDC estimations, Wiznitzer said. This lowball estimate would explain the twofold increase in risk the researchers found. Ystrøm explained that Norway and other nations rely on the World Health Organization's International Statistical Classification of Diseases and Related Health Problems to diagnose ADHD. By that standard, children must show symptoms, both inattention and hyperactivity, before age 7. It is a more rigorous standard than the one commonly used in the US, he said. Cahill said that when linking a prenatal exposure to a certain outcome, scientists would expect to see certain things if the "association is actually true." One of those things would be seeing the same result repeated across many studies. Previous studies have shown an association at times, and at other times, they've shown none, she explained. "The other thing we expect to see is a dose-response relationship, where an increasing dose would relate to a worsening risk or worsening severity of that disease," Cahill said. This too was not seen in the new study. At low doses, acetaminophen reduces risk of ADHD in offspring, while at high doses, the reverse is true. "And that doesn't make any biological sense," she said. The researchers also didn't measure the amount of acetaminophen taken or levels of biomarkers; they used a survey in which patients self-reported the number of days. That is "not informative from a scientific perspective," she said. Finally, the numbers don't add up to a statistical significance as the authors imply, she said. Wiznitzer agreed that "the numbers here don't support the conclusion." However, Ystrøm maintains that the lower estimates uphold the statistical significance and that the sensitivity analysis further supports the study's conclusions. Wiznitzer also noted that, since the study began at 18 weeks into each pregnancy, mothers and partners had to recall their use of acetaminophen from months earlier. "You have to be careful about distance recall," he said, noting that people often have distorted recollections of their behavior from even a week ago. Animal modelsAcetaminophen is usually prescribed for only short periods during pregnancy, so Wiznitzer wondered, "Who during pregnancy would have all these pain complaints that they would be taking pain medicine regularly? I can make an argument that perhaps there's something special about that group." The special reason -- probably some underlying condition -- may be associated with ADHD in the children, rather than the use of acetaminophen. In their conclusion, the authors speculate about the association, and according to Wiznitzer, they quote "all this animal research. I'll guarantee these rodents are not getting the type of dose like you would take if you're pregnant." "It's good to use the animal models as a first step, but you cannot automatically assume because it happens to the animal, it happens to humans," said Wiznitzer, who is also a professor of pediatrics and neurology at Case Western Reserve University. An example of this is thalidomide, a sedative prescribed in the 1960s for morning sickness; later, it was found to cause birth defects. "It was tested in animals, and it was safe for the animals," Wiznitzer said. Cahill, who is also chief of maternal fetal medicine at Washington University in St. Louis, said some untreated symptoms during pregnancy can have "negative impacts" on the unborn baby. Doctors are trained to read medical studies and decide whether the results need to be followed when treating patients. "A board-certified provider is really the best person to advise them on medications during pregnancy," Cahill said. Wiznitzer said "acetaminophen serves a practical purpose in pregnancy." "Women should not be afraid of using acetaminophen, especially if it's their doctor's recommendation," he said. "The data here is not strong enough to support the conclusion." Health via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF October 30, 2017 at 04:34AM
Childhood friends die on same day, half a mile apart
http://ift.tt/2ieEoPu His devastated parents, Greg and Lisa Manning, said the toxicology report found he had taken a toxic mix of heroin and fentanyl, a synthetic opioid so powerful it's often fatal. "The amount of fentanyl in his body was the equivalent to three grains of salt. That's all it took to kill a 180-pound guy," said Greg Manning. Dustin died on Friday, May 26, in Lawrenceville, a suburb on the outskirts of Atlanta. At 6:09 a.m., paramedics were called to a home with reports of an unresponsive teenager. Dustin was dead. "I had told him I'd get him up early for work, and I came up around 5:45 to wake him up, and when I opened the door, he looked like he was tying his shoes. Very quickly I realized, grabbed him and he was cold," said Greg Manning. Lisa Manning was at the gym when she got the call from her husband. "He said, 'Oh my God, oh my God, call 911.' I didn't ask any questions. I knew." Less than an hour later, at 6:53 a.m., another phone call was placed to 911. Half a mile down the road, 18-year-old Joseph Abraham was found slumped on the floor by his parents, Dave and Kathi Abraham. He had no pulse. "I started yelling and yelling and yelling, 'Joe, Joe -- wake up, man!' And then I realized there was something really wrong," said Dave Abraham. "As soon as I saw him, I knew and I just ran and I just started holding him and I could tell he was cold," said Kathi Abraham. "Dave was on the phone to 911 and I said, 'It's too late. We can't fix this,'" she added, as tears welled in her eyes. Childhood friendsDustin Manning and Joseph Abraham were childhood friends. They played on the same Little League team. For two years, Joseph's father coached them. But in middle school, both began to dabble in drugs. The Abrahams believe their son had his first dose of opioids when he had his wisdom teeth removed. He was prescribed the drugs again when he broke his ankle -- and later, his hand -- playing sports. "When you're given a prescription from a doctor, we often just trust that," Kathi Abraham said. She believes Joseph turned to drugs after dealing with two major tragedies at a young age. "He lost two of his really good friends in eighth grade -- one to cancer and one to a drowning. He really had a hard time. He struggled with that," she said. At the age of 12, Dustin told his parents he felt like he was suffering depression. He soon started drinking beer and taking drugs. "He told us the drugs are what gave him 'the out' and made him feel good," Lisa Manning said. Both parents sought help from treatment centers, not once, but time and time again. Lisa Manning even began working at one of the centers to keep an eye on her son and better understand addiction. But Dave Abraham says the treatments weren't enough to fight his son's battle. "Once they take (opioids), there's a switch in their brain that gets flipped on -- and to get that switched flipped back could take up to five years, and most treatments are 35 days and they're back out," he said. According to both sets of parents, Dustin and Joe hadn't been in touch in recent years, yet it appears they may have bought the drug that killed them from the same dealer. According to police records, some of the pill wrappings were almost identical. There were fears in the community that other kids may have bought the same drugs. Lost potentialAs the parents started to gain insight into the world of opioid addiction, they realized that getting the drug is fast and easy. Like most parents, they had high hopes for their beloved sons and their great potential. Walking through her son's bedroom, Lisa Manning pointed at a US flag on the wall. "This flag was a symbolic thing for him. He always wanted to go in the service. He always wanted to be a Marine. He would have made a great Marine," she said, breathing a deep sigh. "Joe was a sensitive young man, he was funny, he had a big heart", Kathi Abraham recalled. "He loved to fish, he loved to be outside and hike. He could have done anything he wanted. He was very smart, in advanced classes." Dave Abraham added: "He could watch a video on YouTube and go and play it on the piano. ... Most dads teach their kids how to fish. Joe taught me how to fish." Community in shockHopes for their children's futures were dashed in an instant. "This happened within 18 houses of each other to two young men on the same morning. The community was in total shock," said Kathi Abraham. The parents now attend a support group for people who have lost children to opioids. And in a sign of the times, the support group grows in size each month.
Last year, about 64,000 Americans died from opioids
, according to the first government account of nationwide drug deaths. That is more than the number of Americans killed in car accidents or by guns, combined. Fentanyl, which is 50 to 100 times more powerful than morphine, was devised to treat chronic pain. A tiny amount can be fatal. The number of people killed by fentanyl has risen from 3,000 to more than 20,000 in just three years -- a 540% increase. President Trump has declared opioid addiction a public health emergency, which officials say will allow the federal government to waive some regulations and give states more flexibility in how they use federal funds. It does not provide any additional funding to deal with the crisis. Like many critics, the Manning and Abraham families say it doesn't go far enough. "This is a just a step, a small step," said Greg Manning. "The problem with treatment right now is there is a very low percentage of success. The longer they stay in treatment, that success rate goes up," said Dave Abraham. They also want tougher punishment for dealers. "These drugs are killing people and there's a lot of drug dealers around," Kathi Abraham said. "To me it's poison or murder -- anyone who sells fentanyl should have a life sentence," her husband added. These parents believe prevention is key and education needs to start as early as fifth grade. They have started spreading awareness in their community in the hope it will save another family from suffering the loss of a child. As they tried to hold back tears, Lisa Manning and Kathi Abraham conceded their lives are forever changed. "You change. You're never going be the same. I'll never be the person I was. It's like a knife deep in your heart," said Lisa Manning. "We wanted to have two children because we wanted them to have each other," said Kathi Abraham as she cried. "Now (our son) Matthew is an only child." Health via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF October 30, 2017 at 04:34AM
Weekend Link Love — Edition 475
http://ift.tt/2zhlB18 Research of the WeekMuscle strength predicts health outcomes in older folks. Women who are too skinny may risk early menopause. A daily cold shower is good for your psychological health. We intuitively know how many lay opinions it takes to outweigh an expert’s opinion. Contrary to previous results, a new study finds no evidence that women’s preference for facial masculinity changes with their hormonal status. Type 2 diabetics who restrict carbs and walk after meals see improved glucose tolerance and endothelial function. Mild cold exposure lowers insulin. A rosemary polyphenol increases muscle glucose uptake and activates AMPK. New Primal Blueprint Podcasts
Each week, select Mark’s Daily Apple blog posts are prepared as Primal Blueprint Podcasts. Need to catch up on reading, but don’t have the time? Prefer to listen to articles while on the go? Check out the new blog post podcasts below, and subscribe to the Primal Blueprint Podcast here so you never miss an episode. Interesting Blog PostsIs there consciousness after death? Lyme disease may trigger celiac. Media, SchmediaRecipe writers often lie about how long it takes to caramelize onions. Why? Some NBA players are going vegan and vegetarian. Curious to see how it goes for them. Everything ElseAmazon drones to deliver statins directly to gaping mouths. CRISPR 2.0 is here, and it’s apparently better than ever. Migraines may be a self-defense mechanism against oxidative stress. 42% of American kids under the age of 8 have tablets. The US wastes about 50% of its healthcare spending. See? Sprinting can save your life. Things I’m Up to and Interested InPodcast I dug doing: The one with Thor Conklin where I discussed achieving mental clarity. Podcast I dug listening to: Krista Tipett interviews physician Atul Gawande about what makes life worth living (and ending). Study that didn’t surprise me: Patients who used statins were more likely to develop diabetes over ten years, even after controlling for baseline diabetic markers. Article I’m reading: “How evolution designed your fear” News I did not enjoy: Roundup is showing up in people’s blood. Recipe CornerTime CapsuleOne year ago (Oct 29 – Nov 4) Comment of the Week
Post navigationSubscribe to the NewsletterIf you'd like to add an avatar to all of your comments click here! Health via Mark's Daily Apple http://ift.tt/2hDpYfl October 29, 2017 at 08:50AM
Vanilla Coconut Collagen Bites
http://ift.tt/2yRT55B Today’s delicious guest recipe is offered up by Registered Dietitian, Certified Personal Trainer, and Health and Wellness Blogger Rachael Devaux. You can find her awesome insights and amazing recipes at Rachael’s Good Eats. Rachael’s taken Primal Kitchen® Vanilla Collagen Fuel and turned it into an easy and tempting bite-sized snack you can have ready and stored for whenever hunger calls. With the sweet tastes of vanilla and coconut and the crunch of a variety of nuts and seeds, I find it’s perfect with some morning coffee or as an after dinner treat. And if you’re someone who’s always looking for fast and easy options in the kitchen, this is the ticket! Vanilla Coconut Collagen BitesServings: 14-16 balls Time in the Kitchen: 10 minutes Ingredients
Directions Combine cashews and almonds in food processor to pulse until coarsely chopped. Add remaining ingredients, excluding 1 Tbsp shredded coconut and pulse until a thick dough forms. Form into 1-inch balls then roll in remaining coconut flakes. Store in airtight container in the fridge for up to 5 days, or freezer for up to 2-3 weeks. Rachael Devaux is Registered Dietitian, a Certified Personal Trainer, and a lover of all things health and wellness. Her goal is to give people the tools they need in order to build healthy habits and to ultimately build a balanced lifestyle. Creating a positive environment around food, learning to think about ingredients and where they come from, and being mindful of what your body needs are just a few of the topics she shares about on her popular website and social media channels: Facebook, Instagram, Pinterest, and Twitter. The post Vanilla Coconut Collagen Bites appeared first on Mark's Daily Apple. Health via Mark's Daily Apple http://ift.tt/2hDpYfl October 28, 2017 at 10:10AM
Drop Off Your Unused Meds Saturday on 'Take Back Day'
http://ift.tt/2zctlBB On Saturday, Oct. 28, you can safely dispose of unwanted medicines at sites across the country as part of the next "Take Back Day," sponsored by the U.S. Drug Enforcement Administration (DEA) and state and local partners. Health via WebMD Health https://www.webmd.com/ October 27, 2017 at 09:59AM
With Severe Flu Season Lurking, Shots a Must
http://ift.tt/2iEzPli Early signs suggest that the United States will see a severe flu season, so it's especially important for Americans to get their shots, health experts say. Health via WebMD Health https://www.webmd.com/ October 27, 2017 at 09:59AM |
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