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February 26 2014

08:40
08:40

February 19 2014

05:31

February 17 2014

15:01

February 13 2014

08:01

Stress And Consequences For American Teens

American teens are stressed. They may not outgrow it in adulthood says a new report. We’ll look at troubling new findings, and solutions.

Students enter MS88, a New York City public middle school in the Brooklyn borough of New York on Wednesday, Aug. 7, 2013. A new AMA study suggests stress habits formed as young adults will follow teens throughout their lives. (AP)

Students enter MS88, a New York City public middle school in the Brooklyn borough of New York on Wednesday, Aug. 7, 2013. A new AMA study suggests stress habits formed as young adults will follow teens throughout their lives. (AP)

Guests

Dr . David Palmiter, professor of psychology and director of the psychological services center at Marywood University. Consultant physiologist on the American Psychological Association’s “Stress in America” survey. Author of “Working Parents, Thriving Families: 10 Strategies That Make A Difference.” (@helpingparents)

Michael Bradley, psychologist. Author of “Yes Your Teen Is Crazy,” “Yes, Your Parents Are Crazy,” “The Heart & Soul of the Next Generation: Extraordinary Stories of Ordinary Teens” and “When Things Get Crazy With Your Teen.”

Dr. Kristen Race, expert in child, family and school psychology. Author of “Mindful Parenting.” (@KristenRacePHD)

From Tom’s Reading List

USA Today: Teens feeling stressed, and many not managing it well — “As a result of stress, 40% of teens report feeling irritable or angry; 36% nervous or anxious. A third say stress makes them feel overwhelmed, depressed or sad. Teen girls are more stressed than boys, just as women nationally are more stressed than men.”

American Psychological Association:  Are Teens Adopting Adults’ Stress Habits? – “While the news about American stress levels is not new, what’s troubling is the stress outlook for teens in the United States. In many cases, American teens report experiences with stress that follow a similar pattern to those of adults.”

Boston Globe: Forum, fund planned in Newton after deaths of two teens –”Katie Stack, 15, also struggled with depression, her mother said, and was in treatment. The Newton South High School sophomore took her own life Wednesday. Stack’s death came less than two weeks after Newton North High School student Karen Douglas, 18, also took her own life.”

February 11 2014

02:07

Kelly McGonigal: How to make stress your friend | Talk Video | TED

Stress. It makes your heart pound, your breathing quicken and your forehead sweat. But while stress has been made into a public health enemy, new research suggests that stress may only be bad for you if you believe that to be the case. Psychologist Kelly McGonigal urges us to see stress as a positive, and introduces us to an unsung mechanism for stress reduction: reaching out to others." name="description http://new.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend

February 06 2014

07:31

Selling Testosterone

Testosterone ads for men are all over TV. Now come the warnings of health dangers. We’ll investigate.

An ad for the testosterone-boosting Fortesta Gel. ( Endo Pharmaceuticals)

An ad for the testosterone-boosting Fortesta Gel. ( Endo Pharmaceuticals)

Guests

Melinda BeckHealth Journal columnist for The Wall Street Journal.

Lisa M. Schwartz, professor of medicine and community and family medicine at the Dartmouth Institute at Dartmouth university.

Brad Anawaltprofessor and chief of medicine at the University of Washington Medical Center.

Michael Kimmel, distinguished professor of sociology at SUNY at Stony Brook. Author of “Guyland: The Perilous World Where Boys Become Men,” “The Politics of Manhood,” “The Gendered Society,” “Misframing Men,” “Manhood in America” and “The Guy’s Guide to Feminism.”

From Tom’s Reading List

New York Times: Weighing Testosterone’s Benefits and Risks – “Officials at the Food and Drug Administration said on Friday that they were reassessing the safety of testosterone products in light of the recent studies, and will investigate rates of stroke, heart attack and death in men using the drugs.”

Live Science: Low T: Real Illness or Pharma Windfall? — “Because low T can be treated with prescription medication, it has become the health problemdu jour for aggressive pharmaceutical marketing: The airwaves are now flooded with ads showing doughy, middle-age men turning into vigorous athletes and confident lovers.”

The Dartmouth Institute: ‘Low T’: How To Sell Disease — “By lowering the bar, pharmaceutical companies target people in the ‘big grey zone’ between being clearly well or clearly sick. ‘There are a lot of American men. Some are grumpy. Some are tired. Some may not be interested in sex at the moment. And all of them are aging,’ say Schwartz and Woloshin. ‘This is the intended target of the campaign.’”

February 05 2014

20:23

Immer mehr Krebserkrankungen

Sind die Krankenkassen gut vorbereitet? Heute ist der "Weltkrebstag". Seit dem Jahr 2007 wird dieser von der "Union for International Cancer Control" am 4. Februar begangen. Immer mehr Menschen erkranken an verschiedensten Krebsarten. Weil sie nicht zur Früherkennung gehen?
Tags: health

January 28 2014

20:28

Greatist Podcast: Primal Living with Mark Sisson | Greatist

Author, speaker, and healthy living advocate Mark Sisson has built an online empire promoting the primal lifestyle. In this episode, Greatist talks with the creator of Mark's Daily Apple about everything from dropping grains to beating the fad mentality. Listen right here on Greatist! http://greatist.com/health/podcast-mark-sisson-primal-living

January 27 2014

19:35

The Realities And Requirements Of A Living Will: A Guide

Our Monday, Jan. 27 hour looked at the case of Marlise Muñoz , a 33-year-old paramedic and mother kept alive on life support against her family’s wishes  for more than two months, due to her pregnancy.  The state of Texas used a law which states that even a person with a living will which says they do not wish to kept alive in such a condition cannot be taken off life support if they are pregnant.

Muñoz did not have a written living will, but her husband, Erick had said his wife had expressed a desire to be removed from life support in such a case, but the vague qualities of the situation lead to the lengthy and controversial stand-off.

Meredith Beers (Courtesy Holland & Knight)

Meredith Beers, partner at the law firm Holland & Knight (Courtesy Holland & Knight)

In preparing for the hour, we realized we had a lot of questions on living wills (also known as advance directives). On Point’s Emily Alfin Johnson spoke with Meredeth Beers – a partner at the law firm Holland & Knight in Boston — and Dr. Paul Mueller – Professor of Medicine and Biomedical Ethics at the Mayo Clinic College of Medicine — to get some answers.

Dr. Paul Mueller, Chair, Division of General Internal Medicine, Mayo Clinic, Rochester. (Courtesy Paul Mueller)

Dr. Paul Mueller, Chair, Division of General Internal Medicine, Mayo Clinic, Rochester. (Courtesy Paul Mueller)

It is of course  important to check on the rules and regulations regarding living wills in your state before you get too far along in the planing process. The rules and regulations vary from state to state, and what is sufficient to convey your wishes in court in one state may not be in another. You can find your state’s guidelines at the state Attorney General’s website, or at the National Healthcare Decisions Day site.

What is a living will?

A living will “allow a person to provide specific healthcare-related instructions and preferences and healthcare-related values and goals,” Mueller explained.

Often, a living will is part of a larger document — an advanced directive used “in the event that person loses decision-making capacity,” Mueller said. The other piece of an advanced directive (AD) is your healthcare proxy or medical power of attorney.

Living wills can come in all forms, with all different kinds of information.

“They can get into specifics with checklists and lists of illness while others are very vague,” Beers said. “Doctors in states where living wills are legal documents want them to be specific as possible. “ Both are valuable, Beers said. “But legally, if you sit someone down with a list of horrible things, it can be a very hard process for people to handle,” Beers said. “Often the more general the living will, the easier it is for someone to swallow.” 

A living will should not be confused with a DNR – or “do not resuscitate” order, which informs people that, should you collapse, you do not want anything done to bring you back. to consciousness. “DNR’s are only given to patients on the edge – terminally ill or close to death,” Beers said. “They’re not appropriate for perfectly healthy people to sign.”

Why do a living will?

Living wills allow you to guarantee that the person you want to be making your decisions is empowered to make those choices in the event that you are incapacitated.

In the absence of an AD, state law determines the hierarchy of who makes decisions for patients,” Doctor Mueller said. Often that will be defined as your next of kin. Should you be unmarried, without close family, it’s wise to define who you want in that decision making role – so that it’s not up to the hospital to have to make the decisions.

Taking the time to specify can make life easier for love ones, as Doctor Mueller explained.

“Some of the unfortunate cases that have received national press coverage have involved patients who did not have ADs, and there was lack of clarity regarding values, preferences and so on,” Mueller said.

Why does it matter what state I live in?

A living will is not considered a “legal” document (meaning it doesn’t hold up in court,) in every state. That does not mean they do not serve a valuable purpose for your family and doctors should you be unable to convey your wishes.

In some states, such as Massachusetts, you must designate someone as your healthcare proxy (or Medical Power of Attorney), Beers said..  In states like these, your healthcare proxy is responsible for voicing your decisions – not your living will.  However, “the person who has to make those decisions is in an awful place,” Beers said. “No one wants to pull the plug on a loved one.  A living will makes your wishes clear and provides comfort for those who do have to make the choice.”

Even if your state does not consider a living will a legal document, making your wishes known can keep an already difficult time from getting harder for the ones you love.

When should you get a living will?

“Any time once you’re over 18, when you can legally sign a document, it’s a good idea to have a legal will,” Beers said.

“Although it can be difficult for people to anticipate what might happen in the future, most people can determine who they trust and would like to make decisions for them,” Mueller said.

But it’s not enough to have one done and forget about it.

“The classic example is Ted Williams,” Beers said. “He signed a living will years before died, and in it he had mentioned wanting to be cremated. When he died about ten years later, his son said he had actually wanted to be frozen.  Not only is it good idea to have a living will, it’s a good idea to update it every few years, to avoid an equally confusing situation.”

What should I do with my living will? Does it need to be witnessed and notarized?

First, your physician should have a copy, Beers and Mueller stressed.It doesn’t hurt to make sure your healthcare proxy has one, or at least knows where you keep your copy, too.  It’s also a good idea to talk it through with your healthcare proxy, your doctor and your family, Mueller said.  Make sure to store your copy somewhere it is easily accessible – placing one in a safety deposit box or hidden away somewhere secret doesn’t help if you’re not around to get to it.

In states where it’s not a legal document, your living will does not need to be notarized. If it is a legal document it generally must be notarized or signed by two witnesses. Double check with your state to find out exactly what they require.

You can find more resources and information on living wills, healthcare proxies and other key documents herehere and here.

16:00

Texas ‘Right-To-Die’ Drama

Life, death, mother, fetus and the state of Texas.

Erick Muñoz's wife, Marlise, is said to be brain dead. The Fort Worth, Tx. hospital where Marlise is under observation will not permit her family to remove the pregnant woman from life support until her child is born. (AP)

Erick Muñoz’s wife, Marlise, is said to be brain dead. The Fort Worth, Tx. hospital where Marlise is under observation will not permit her family to remove the pregnant woman from life support until her child is born. (AP)

The story of Marlise Muñoz lying brain dead and pregnant in Texas, kept alive by machines for a damaged fetus, sounds ghoulish enough for Edgar Allen Poe.  Her body decomposing in a hospital bed.  The life within deeply damaged.  Her family begging she be let go.  The hospital citing Texas law and saying no for long weeks.  On Friday, a Texas judge said enough.  No more life support.  The remains of Marlise Muñoz have been released to her family.  But the story of what happened in that hospital in Texas is still stirring controversy.  This hour On Point:  a woman and a fetus, life and death, and the law in Texas.

– Tom Ashbrook

Guests

Diane Jennings, reporter for The Dallas Morning News. (@djennings)

Tom MayoAltshuler University Distinguished Teaching Professor and associate professor of law at Southern Methodist University. (@tangowhiskymike)

Joe Pojman, executive director, Texas Alliance For Life (@joepojman)

Andrea Grimes, senior political reporter at RH Reality Check. (@andreagrimes)

Emily Bazelon, senior editor at Slate. Contributing writer at The New York Times Magazine. Fellow for creative writing and law at Yale Law School. (@emilybazelon)

From Tom’s Reading List

Dallas Morning News: Fight to take pregnant Tarrant woman off life support goes to judge Friday — “In court documents, Erick Muñoz said that doctors told him his wife was brain-dead and that he asked that she not be kept on life support. Both husband and wife had worked as paramedics and knew of each other’s end-of-life wishes, court filings say. Marlise Muñoz’s parents agreed with their son-in-law’s request. But officials at John Peter Smith refused to turn off life-support equipment, citing Texas law prohibiting removal if a patient is pregnant.”

ABC News: Why Texas Fetus Might Have Had ‘Abnormalities’ Before Mother Was Brain Dead — “The family of Marlise Munoz, a 33-year-old paramedic who was 14 weeks pregnant when a suspected pulmonary embolism left her brain dead two months ago, is suing John Peter Smith Hospital in Fort Worth because doctors there told the family a Texas law forbade it from withdrawing life support until the fetus’s birth or a miscarriage occurs. The fetus has hydrocephalus, or water on the brain, a possible heart condition, and ‘lower extremities that deformed to the extent that the gender cannot be determined,’ lawyers representing Munoz’s husband announced Wednesday evening.”

Slate: Brain-Dead Marlise Munoz’s Fetus Is ‘Distinctly Abnormal.’ Please, Texas, Let This Nightmare End — “How can the state supersede the wishes of Erick in this scenario? The answer is that it can’t. Hospitals cannot provide ‘life-sustaining treatment’ to a person who is dead, and that’s what brain dead means: death. This is not the same as being in a vegetative state, where you can breathe without a respirator. In all 50 states, brain dead means you are legally dead.”

15:00

California Drought And The U.S. Food Supply

The drought emergency in California, and what it may mean for the nation’s food supply.

With the edge of Folsom Lake, Calif., more than 100 yards away, Gina, 8, left, and Sydney, 9, Gerety walk on rocks that are usually at the waters edge, Thursday Jan. 9, 2014. Gov. Jerry Brown said he would meet Thursday with his recently formed drought task force to determine if an emergency declaration is necessary as California faces a serious water shortage. Reservoirs in the state have dipped to historic lows after one of the driest calendar years on record. (AP)

With the edge of Folsom Lake, Calif., more than 100 yards away, Gina, 8, left, and Sydney, 9, Gerety walk on rocks that are usually at the waters edge, Thursday Jan. 9, 2014. Gov. Jerry Brown said he would meet Thursday with his recently formed drought task force to determine if an emergency declaration is necessary as California faces a serious water shortage. Reservoirs in the state have dipped to historic lows after one of the driest calendar years on record. (AP)

They are praying for rain in California.  And facing drought.  A drought emergency, Governor Jerry Brown declared last week.  Worst in years.  Winter weather so warm you’ve got a confused bear wandering through skiers on the slopes last week.  So dry that farmers are thinning herds and letting fields go fallow.  Wondering which crops to lose.  Up in the Sierra Nevada, only 20 percent of the normal snow pack.  Less to melt, less to drink.  It’s just dry.  This hour On Point:  fire, food, climate and the drought emergency in California.

– Tom Ashbrook

Guests

Bettina Boxall, water and environmental issues reporter for The Los Angeles Times. (@boxall)

Jeanie Jones, deputy drought manager and interstate resources manager for the California Department of Water Resources.

Heather Cooley, co-director of the water program at the Pacific Institute. Co-author of “The World’s Water,” “A Twenty-First Century U.S. Water Policy” and “The Water-Energy Nexus In the American West.”

Daniel A. Sumner, director at the University of California Agricultural Issues Center and Frank H. Buck, Jr. Professor, Department of Agricultural and Resource Economics at the University of California, Davis.

From Tom’s Reading List

Los Angeles Times: California declares drought emergency — “Brown’s drought proclamation follows California’s driest year on record and comes amid dropping reservoir levels and no sign of relief in the near future. Some Northern California communities dependent on shrinking local supplies have already imposed rationing and others are asking residents to eliminate outdoor watering. Many Central Valley irrigation districts are warning growers to expect severe delivery cuts this spring and summer.”

Significant Figures: What Californians Can Expect from the Drought – “It is not too late for some big storms off the Pacific Ocean to bring relief. But the odds are against it andcurrent meteorological conditions are not encouraging. If the rest of the winter months are dry, or even of average wetness, the state will have much less water than normal, and much less than water users want – from cities to farms to our natural ecosystems.”

TIME: Hundred Years of Dry: How California’s Drought Could Get Much, Much Worse — “Californians need to be ready, because if some scientists are right, this drought could be worse than anything the state has experienced in centuries. B. Lynn Ingram, a paleoclimatologist at the University of California, Berkeley, has looked at rings of old trees in the state, which helps scientists gauge precipitation levels going back hundreds of years. (Wide tree rings indicate years of substantial growth and therefore healthy rainfall, while narrow rings indicate years of little growth and very dry weather.) She believes that California hasn’t been this dry since 1580, around the time the English privateer Sir Francis Drake first visited the state’s coast.”

January 23 2014

05:30

An Obamacare Report Card

After a rough rollout, we’ll look at who is and who is not signing up for the Affordable Care Act.

House Minority Leader Nancy Pelosi of Calif. meets with reporters on Capitol Hill in Washington, Thursday, Jan. 9, 2014. The top Democrat in the Republican-controlled House focused on the Affordable Care Act and the fight to pass immigration reform. (AP)

House Minority Leader Nancy Pelosi of Calif. meets with reporters on Capitol Hill in Washington, Thursday, Jan. 9, 2014. The top Democrat in the Republican-controlled House focused on the Affordable Care Act and the fight to pass immigration reform. (AP)

Guests

Jenny Gold, healthcare reporter for Kaiser Health News. (@JennyAGold).

Dan Mangan, CNBC health care reporter. (@_DanMangan)

Carl Gibson, journalist and activist. Founder of U.S. Uncut. Wrote a piece in December called ‘Why I’m Choosing to Pay $300 to Stay Uninsured.” (@uncutcg)

From The Reading List

CNBC: Employers face tax hit in states with no Medicaid expansion — “The decision by 25 states not to expand Medicaid coverage under Obamacare could cost some employers more than $1.5 billion in new taxes starting next year, a new analysis reveals. That tax hit might come as a shock to many of those businesses unaware of their exposure to the penalty—which will kick in if their employer-offered health plan is deemed too expensive and workers then buy private, subsidized Obamacare insurance.”

Wall Street Journal: Target Cuts Health Coverage for Part-Time Workers — “Target will stop covering part-time employees on April 1, the company said in a corporate blog post quoting human resources chief Jodee Kozlak. Less than 10% of Target’s roughly 360,000 employees take part in the plan being discontinued. Those employees will be given $500 due to the coverage being ended.”

MarketWatch: California’s Obamacare program is close to meeting enrollment goal — “California has, by far, exceeded any other state in the union for Obamacare signups. Figures released last week from the Department of Health and Human Services showed California accounted for roughly one-fourth of all enrollment in the nation during the last three months of the year. The state also got 584,000 applicants into Medi-Cal programs, bringing its total enlistment figure to more than 1 million for the October-December period.”

January 22 2014

11:25

Carl Zimmer: Unlocking Secrets of the Human Brain

In his new cover article for National Geographic magazine, science writer Carl Zimmer explores the inner workings of the human mind, and delves into the latest technologies on mapping the brain and finding out what specific neurons do - including one neuron that's only triggered by pictures of Jennifer Aniston. We talk with Zimmer about how far the science of the mind has come - and how far it still needs to go before we can answer questions about consciousness and free will. Host: Michael Krasny Guests: Christof Koch, chief science officer, Allen Institute for Brain Science Carl Zimmer, science writer who contributes frequently to National Geographic and The New York Times and three-time winner of the American Association for the Advancement of Science's Journalism Award

January 17 2014

09:01

Week In The News: Bad Water, School Shooting, Net Neutrality

Poisoned water in West Virginia. Net neutrality takes a hit. Another school shooting – New Mexico. Our weekly news roundtable goes behind the headlines.

Water buffaloes are made available to local residents in South Charleston, W.V. to fill coolers and other containers at the GeStamp Stamping Plant-South Charleston Sunday morning, Jan. 12, 2014. The ban on using water for drinking, washing and cleaning remains in effect following the chemical spill Thursday in the Elk River that has contaminated the public water supply in nine counties. (AP)

Water buffaloes are made available to local residents in South Charleston, W.V. to fill coolers and other containers at the GeStamp Stamping Plant-South Charleston Sunday morning, Jan. 12, 2014. The ban on using water for drinking, washing and cleaning remains in effect following the chemical spill Thursday in the Elk River that has contaminated the public water supply in nine counties. (AP)

Guests

John Heilemann, national affairs editor at New York Magazine and MSNBC political analyst. Co-author with Mark Halperin of “Double Down: Game Change 2012” and “Game Change: Obama and the Clintons, McCain and Palin and the Race of a Lifetime.” (@jheil)

Nancy Cordes, Congressional correspondent for CBS News.  (@nancycordes)

Jack Beatty, On Point news analyst.

From Tom’s Reading List

CNN: ’Pay to play’ on the Web?: Net neutrality explained — “How would you like to have to pay a fee to be able to stream YouTube videos at full speed? What if you liked downloading music from, say, Last.fm or Soundcloud, but those sites suddenly became infinitely slower than bigger sites like Amazon or iTunes? Those are the kind of major changes to the Internet some folks are envisioning after a federal court ruling this week on what’s come to be called ‘net neutrality.’”

Politico: House approves bipartisan spending bill — “The House approved and sent to the Senate a landmark $1.1 trillion spending bill that fills in the blanks of December’s budget agreement and sets a new template for appropriations for the remainder of President Barack Obama’s second term. Adopted 359-67, the giant measure literally touches every corner of government. And more than any single document to date, it defines the new budget reality that faces the president and his activist agenda.”

Reuters: Pregnant women warned off West Virginia water in cleared areas — “One week after the spill into the Elk River prompted authorities to order some 300,000 people not to drink or wash with their tap water, officials have cleared more than 200,000 of them to start drinking the water again after tests showed levels below the 1 part per million level safety standard set by the federal Centers for Disease Control and Prevention. But pregnant women should continue to steer clear of the water in an ‘abundance of caution’ until the chemical is completely undetectable, West Virginia American Water said.”

January 13 2014

21:14

Vermont’s Gov. Peter Shumlin: ‘We’re Losing The Battle’

On Monday, Jan. 13, Vermont Gov. Peter Shumlin (D) joined us to explain just why he spent his entire state of the state speech this month focused on what he called a crisis “of great concern to [his] state’s future” — the abuse of opiates and heroin. It was a moving and remarkable speech that sent many national observers spinning.

During our hour, Gov. Shumlin also stressed how opiate and heroin addiction is more than just a Vermont problem. You can listen to and read the text of Gov. Shumlin’s On Point comments below.

You can also turn to some resources from our guest Caleb Banta-Green, a research scientist and epidemiologist at the Alcohol & Drug Abuse Institute at the University of Washington, for abuse counselling, advice and treatment.

 - National Institute Of Drug Abuse: Medication-Assisted Treatment for Opioid Addiction

- PresecribeToPrevent.org

- StopOverdose.org

“Well really the challenge with this disease is we won’t talk about. Families won’t talk about it, those obviously who are addicted are scared about talking about it, and politicians certainly don’t want to talk about it. And you know, Vermont is a place where we have the most extraordinary quality of life int eh country. We trust each other, we take care of each other, we know each other. And I just felt that it was time for me to use my role as Governor to talk about an issue that does threaten our quality of life and that has solutions if we’re willing to have the courage to address them.

“Like so many other states obviously we’ve seen a huge increase in the number of folks being convicted of dealing heroin and other opiates, we have sen a huge increase in the number of folks who are actually ready for treatment but for whom we don’t even have treatment capacity because their numbers are growing so large. And we’ve seen an increase in crime as a result of people’s need to steal their addiction and stealing to do it.

“Really when you see the story of those who are addicted, and you listen to them it breaks your heart. And you know, these are folks, I’ve got young kids I pointed out in the speech one example of an incredibly brave young man, grew up on his dairy farm, we’ve got a lot of farms in Vermont. Very loving family, very hard working family. Got offered Oxycontin during exams at  10th grade in high school. Became an addict hard and fast. Turned into a full-blown heroin crisis as it so often does. And you know these are lovable, extraordinary people who have a health care addiction, an addiction that is a health crisis now. And I just felt that when you hear the stories, and you realize that these are our kids, these are our neighbors, you gotta address it.

“If we think that there’s not a link between F.D.A- approved opiates like Oxycontin and our heroin challenge in America, you know we’re fooling ourselves. The fact of the matter is, over a decade ago we approved Oxycontin, we hand it out with great exuberance, and once you become addicted to that now, the economics are such that the pills, the Oxycontin on the street, is more expensive than heroin on the streets. My economic challenge, forgetting our hearts for a minute and just thinking with our heads, is that you can buy a bag of heroin in cities south for six, five, four bucks a bag and it sells here for $30 bucks a bag. So you can do the math — there’s a huge economic incentive for dealers to come into our state and other rural states around us, to sell this stuff at a great profit, get folks hooked and build up a clientele. So, we’re fighting a battle that is certainly related to our approval of F.D.A. approved opiates, then leads to cheaper options like heroin once you get addicted. I know we’re talking about the most extraordinary beautiful state in the country, but we’re kidding ourselves if we think that this isn’t happening in all the other 49 states. We’re losing the battle, and my point is, we have to come up with a better way of dealing with it. We can’t arrest our way out of this challenge. We’ve got law enforcement here in Vermont that’s better than anywhere, extraordinary United States’ attorneys, prosecutors and the rest. If we continue to think that we’re can just solve this with just law enforcement alone, we’re gonna lose the battle.

“Tom, it’s really important to remember that this affects all income categorizes, and all families, regardless of income. Now obviously, a lack of hope and a lack of opportunity is more likely to drive you to this kind of addiction. But listen, I’ve got this problem in my areas where we’ve got low incomes folks living, and where we’ve got this problem in areas where I’ve got high income folks living. It can affect anyone. And the interesting thing is, since I’ve raised this issue across the state, I just left my local Chamber of Commerce, Champlain Chamber here in Burlington. You know every time now I go into a crowd of 60-70 people, I have at least three or four that come up to me and say, ‘Thank you, my son’s addicted, my daughter’s addicted. This is our problem, these are our kids, and it affects all incomes.’”

“I have no doubt in my mind that when we chose to legalize opiates in pill form as we see in Oxycontin and in other pain killers, we made a decision to make opiates available in ways that we hadn’t in the past. And if we think that’s there’s not a link between F.D.A.-approved and what people are buying on the streets, then we aren’t looking at reality.

“We all know that there are a lot of reasons that drive addictions. And we’ve always had addiction challenges, whether it’s with alcohol or anything else. I think what’s changed is, that we really do treat opiates through F.D.A. approved drugs as if it’s an option that should be made available for almost any pain or discomfort. And if we’re gonna do that, we have to accept the fact that opiates are extremely addictive. It’s apparently a high that is like no other. And I believe that this epidemic is being drive by a government approach to pain killers.

“It doesn’t work. We continue to lose the ‘War on Drugs’ and at some point you gotta pause and say, ‘What are we doing wrong?’ Here’s what I think we’re doing wrong. With opiates, you have a very small window to convince people that treatment is a better option that addiction. You know, folks are addicted to opiates are the best deniers and the best liars that you’ll ever meet. And the bottom line is, it’s when the blue lights are flashing , when you’ve been busted, when you’re down and out, that you’re most likely to go to treatment. And in Vermont, and the most other 49 states if they’re like Vermont, our court system is not set up to deal with that moment of opportunity. So what we’re gonna try do here is move our judicial system so that our prosecutors have a third-party independent assessment that figures out whether you’re an addict — someone that we should be disappointed in perhaps,  angry at perhaps, but not fearful of — or whether you’re someone we should fear. If you’re someone we should fear, we’re gonna put you through the old court system and lock you up. If you’re someone that we might be mad at or disappointed in but think you can be treated, we’ll offer you treatment right there. And if you agree with it, and then you comply with it, we’re gonna spend the money to follow you closely and give you the services just like heart disease, kidney disease, any other health care challenge, then you’ll never go through the court system.

“You know this is not a cheery subject to talk about. So no one’s saying ‘Hey thanks for being so cheery, Governor!’ But this is what they are saying, they’re saying ‘Listen, we recognize that we have this problem in our community, probably in every area of the country, but I’m pleased that we have the commitment from all of us to work together to come up with a solution to what is a health care crisis and stop the denial.’”

Do Gov. Shumlin’s comments on opiate and heroin addiction ring true in your community? Have you seen what addiction can do? Let us know in the comments below, or on Facebook, Tumblr and @OnPointRadio.

 

06:31

A Heroin Scourge In Idyllic Vermont

Vermont Governor Peter Shumlin just devoted his entire State of the State speech to the scourge of heroin. We’ll look at the heroin tide in pastoral Vermont and across the nation.

Vermont Gov. Peter Shumlin, right, departs the Statehouse House Chamber after the Governor's State of the State Address in Montpelier, Vt., on Wednesday, Jan. 8, 2014. (AP)

Vermont Gov. Peter Shumlin, right, departs the Statehouse House Chamber after the Governor’s State of the State Address in Montpelier, Vt., on Wednesday, Jan. 8, 2014. (AP)

Guests

Gov. Peter Shumlin (D-VT), governor of the state of Vermont. (@GovPeterShumlin)

Tristram Coffin, U.S. District Attorney for the District of Vermont.

Caleb Banta-Green, research scientist and epidemiologist at the Alcohol & Drug Abuse Institute at the University of Washington. Representative to the National Institute on Drug Abuse’s ‘Drug Trends Work Group.’

From Tom’s Reading List

State of Vermont: Gov. Shumlin’s 2014 State of the State Address — “In every corner of our state, heroin and opiate drug addiction threatens us. It threatens the safety that has always blessed our state. It is a crisis bubbling just beneath the surface that may be invisible to many, but is already highly visible to law enforcement, medical personnel, social service and addiction treatment providers, and too many Vermont families. It requires all of us to take action before the quality of life that we cherish so much is compromised.”

ABC News: Scourge of Heroin Abuse in Vermont Mirrors National Epidemic –”The governor of Vermont devoted his entire State of the State speech on Wednesday to address the scourge of heroin abuse, a problem he described as a ‘full blown… crisis’ in his state, but which is also spreading across the country. Gov. Peter Shumlin, a Democrat, described an epidemic that ‘may be invisible to many,’ but which has increased in his state by 770 percent since 2000.”

Here & Now: Vt. Governor Confronts State’s Opiate Addiction Crisis — “Vermont, like most of New England, has become an epicenter for heroin and prescription opiate trafficking. Since last year, deaths from opiate overdoses have doubled in Vermont, and the number of Vermonters seeking treatment has increased 771 percent since 2000. Crimes related to opiates has also increased. Now, 80 percent of Vermont’s inmates are locked up for drug-related crimes.”

Watch A Trailer For “The Hungry Heart”

January 09 2014

22:37

Updates On Vaccination Rates In Colorado; Anti-Vaccine Advocates Speak Out

There are few topics in public health that are as controversial or attention-grabbing as the ongoing debate over vaccination rates and vaccine policy. When our Jan. 9 hour looking at a growing state-by-state pushback against the anti-vaccine movement  hit the airwaves, our phones lit up with people on both sides of the debate.

Parents, pediatricians and registered nurses alike called in to tell us their own experiences with vaccination, while our Facebook, Twitter and comment feeds burst open with heated debate as to whether or not state governments have the right to require families to vaccinate their children.

In Colorado,  proposed new state regulations have required just that. The state, with one of the higher rates of voluntary immunization opt-out, is exploring possible enforcement mechanisms to increase public participation in vaccine campaigns, especially among students in the public school system.

Reporter Michael Booth of The Denver Post gave us a great run through of the state’s domestic politics around immunization.

“Colorado has gone at this on a couple of fronts right now. We did this about a year and a half ago, two years ago. Where they saw that flu obviously is a big problem every year in every state. And they went after it by saying that up to in this following year 90 percent of people who came in contact with people at health facilities — whether it’s a hosptial or a nursing home, — across the board have to be immunized.

There was some controversy about that. Some nurses and other people ho work in those studies did not like being told what they had to do in order to keep their job, but Colorado was pushing ahead on that and saying that it’s clear that people who are vaccinated against flu viruses every year are much better protection for public health, and that in public heath situations in medical situations, those are the very people who should understand that and those employees should be immunized.

Now since then we have continued to have outbreaks of pertussis-whooping cough in Colorado and many other states major spikes in that in the last couple years and now as you’ve seen and as you mentioned, measles outbreaks that are very worrisome to people because measles was really one that was supposed to have been conquered a long time ago.

So now in Colorado and some other states there is talk of tightening up this form that people have that they can, when their kids go to school, say that they don’t want vaccinations, and their kids are exempt from it. This is a very simple process in Colorado — you just sign a form that says you have some personal objection — can be religious, it can really just say ‘Personally I disagree with it or I don’t like it.’ And your kids can still go to public school.

And the way that Colorado and other states are going about it is talking about, ‘What can we do to make that system more difficult?’ If five or six percent of kids are showing up at school without proper vaccinations and getting exemptions, that’s when you start getting to this problem; that’s not whole herd immunity, that’s not enough people to protect us from future outbreaks. So how can we make it, inform those parents and make it more difficult for them to just opt-out. And one of the ways to do that is to make it,  my phrase has been informed dissent.  So that before you make that dissent from what the customary practice is, you have to go through an education process. So that a doctor a public health official person, a nurse would sit down and explain to you why public health officials believe that vaccination is important, how it protects the general public and protects your own child,. And then you could sign the form but you would have to go through that education process first.”

Booth also explained how having a seemingly overwhelming but not universal number of vaccinated citizens can still affect public health.

“That’s the map that you don’t want to stand out on, but we do in Colorado. Depending on which study you’re looking at, somewhere between about five and six percent of students are coming with the exemption, without the vaccinations or at least without proper proof that they on the schedule that public health officials want them to be on.

Now  five or six percent may not sound like that much, you might say ninety five percent of anything must be some kind of public policy success. But the way it works in epidemiology and in medicine is that people come in contact with so many other people that that one person or that small group of people makes a big difference in things like vaccinations in these kind of highly communicable illnesses.”

Booth told us about how diverse the groups of people pushing against vaccination schedules truly can be in practice.

“So we talked to many people and talked to many doctors and nurses who talk to a lot of people, they’re the ones meeting the parents on the front lines coming in and hearing what their objections are or what their thinking is. It’s not just one group of people or one political or social ideology that we’re talking about. I think that people often assume that it’s people who are very distrustful of the government, maybe from a conservative point of view, more Libertarian who might consider homeschooling their kids, do not want to be involved in all of the public schedules of things that they feel is required of them. And there certainly is that group of people in Colorado, and in some of the other states. But there also is in Colorado, a significant group of people who might have a more left-leaning ideology who are very well informed, who have thought about things like genetically-modified foods and what they’re putting into their bodies in other way and they have decided that they feel that that they are risks to vaccinations, that it’s better to expose their children to the diseases that are out there and have them build up their own immunities.

What drives doctors and nurses crazy is they are often latching on to old and very discredited information about dangers of the vaccines themselves and the immunization process themselves. There was a study that was done that claimed there might be a link between the increase of reports in autism in kids to vaccination. And that has been thoroughly discredited over and over again since then, but doctors tell us many times that what they hear very frequently as parents come in us that particular study, it sticks in people’s heads and they’re trying to figure out how to change that dialogue.

It happens in Boulder, CO, also an affluent area, a highly-educated area. I’m sure you would find that reflected in other areas that might not be your first candidate in the other states that are highlighted on this map. So I don’t think that there is just the one pattern. Economically another aspect of this is there really shouldn’t be much of an economic reason in terms of whether it’s affordable or not to avoid vaccinations. We’ve pushed now school clinics so deep into the process of medicine and health care in America, both through things like private health care foundations in Colorado and in other states.  Obamacare put a lot of money into bolstering school clinics. And now there are a lot of communities where not just the students but their families are getting a significant amount of their health care through the school. And that’s a great way for public health officials to make contact and give out free or reduced prized vaccinations and try to figure out if the people they’re seeing having the full schedule. There is an infrastructure available to make sure that his push can happen. Now you gotta deal with the laws and rules in place that make it too easy for people to back out.”

And despite the public health infrastructure and rules, there will always be public pushback against this kind of government instruction, Booth noted.

“There will always be pushback on this, when the government comes through and says, ‘We think this it’s important that you do something and now we’re going to make it even more of a requirement  or we’re going to make it a higher penalty if you font do it.’ There will always be the pushback that it’s government arrogance, they shouldn’t have the right to tell me what to do. They are assuming they know better than I do when it’s my children. And that’s certainly understandable. But I think on the other hand that some public health officials are feeling their muscles a bit more in terms  of dealing with these problems. They’re not just gonna sit back and let the problem get worse. They’re taking steps like requiring the health workers to get flu vaccines and now they’re’re considering this step in Colorado and other states, saying ‘We understand, but the whole point of  public health is to protect the public when the public doesn’t always understand the situation or have time to deal with it.’ They sometimes have to follow mandates when the mandates have been proven to improve the overall health of the population.”

What’s your take on the public health arguments in the ongoing vaccine debate? Have you seen the return of forgotten illneses in your community as more and more people opt out of mistrusted vaccine campaigns?

Let us know in the comments below, or on Facebook, Tumblr and @OnPointRadio.

Your Tweets From The Hour

07:11

A Pill For ‘Brain Youth’?

Imagine a pill that could rewire your brain. Would make your brain young again. Able to learn and absorb like a five-year old. Music. Languages. Would you take it?

An imagine of the human brain. New research into brain plasticity suggests that a generic pill could change the brain's ability to absorb and retain new skills, like language, music and more. (Creative Commons / FlamePhoenix1991)

An imagine of the human brain. New research into brain plasticity suggests that a generic pill could change the brain’s ability to absorb and retain new skills, like language, music and more. (Creative Commons / FlamePhoenix1991)

Guest

Takao Hensch, professor of molecular and cellular biology and professor of neurology in Harvard University’s Department of Molecular and Cellular Biology.

From Tom’s Reading List

Frontiers in Systems Neuroscience: Valproate reopens critical-period learning of absolute pitch — “Absolute pitch, the ability to identify or produce the pitch of a sound without a reference point, has a critical period, i.e., it can only be acquired early in life. However, research has shown that histone-deacetylase inhibitors (HDAC inhibitors) enable adult mice to establish perceptual preferences that are otherwise impossible to acquire after youth. In humans, we found that adult men who took valproate (VPA) (a HDAC inhibitor) learned to identify pitch significantly better than those taking placebo—evidence that VPA facilitated critical-period learning in the adult human brain.”

New Scientist: Learning drugs reawaken grown-up brain’s inner child –”From bilingualism to sporting prowess, many abilities rely on neural circuits that are laid down by our early experiences. Until the age of 7 or so, the brain goes through several “critical periods” during which it can be radically changed by the environment. During these times, the brain is said to have increased plasticity.”

Discover: ”Plasticity Pill” Could Rewire Brain to Treat Autism and Schizophrenia – “Today, a growing number of researchers are examining the complex ways in which immune molecules affect the brain and nervous system. Manipulating such molecules, these scientists believe, may be key to treating many devastating neurological ailments, from autism and schizophrenia to Alzheimer’s and ALS. Shatz even dreams of a ‘plasticity pill’ to restore the neural suppleness of stroke victims — and her latest experiments offer hope that it could someday come to pass. ”

07:11

With Outbreaks, States Push Back On Anti-Vaccine Movement

Outbreaks of measles, whooping cough and more are growing, spreading because of the anti-vaccine movement. Now there’s pushback. We’ll check in.

In this Thursday, May 3, 2012 file photo, Nurses Fatima Guillen, left, and Fran Wendt, right, give Kimberly Magdeleno, 4, a whooping cough booster shot, as she is held by her mother, Claudia Solorio, at a health clinic in Tacoma, Wash. A government study offers a new theory on why the whooping cough vaccine doesn't seem to prevent outbreaks that well. In research involving baboons, researchers found that while the vaccine may keep people from getting sick, it fails to prevent the germ from spreading, said one of the researchers, Tod Merkel of the U.S. Food and Drug Administration. (AP)

In this Thursday, May 3, 2012 file photo, Nurses Fatima Guillen, left, and Fran Wendt, right, give Kimberly Magdeleno, 4, a whooping cough booster shot, as she is held by her mother, Claudia Solorio, at a health clinic in Tacoma, Wash. A government study offers a new theory on why the whooping cough vaccine doesn’t seem to prevent outbreaks that well. In research involving baboons, researchers found that while the vaccine may keep people from getting sick, it fails to prevent the germ from spreading, said one of the researchers, Tod Merkel of the U.S. Food and Drug Administration. (AP)

Guests

Michael Booth, health and medical reporter for The Denver Post. (@mboothDP)

Steven Salzberg, professor of medicine and bio-statistics at Johns Hopkins University. Blogs about pseudo-science and “bad medicine” for Forbes Magazine.

Paul Offit, chief of the division of infectious diseases and the director of the vaccine education center at the Children’s Hospital of Philadelphia. Professor of vaccinology and pediatrics at the University of Pennsylvania’s School of Medicine. Author of “Do You Believe in Magic?: The Sense and Nonsense of Alternative Medicine,” ”Deadly Choices: How The Anti-Vaccine Movement Threatens Us All,” “Vaccines and Your Child: Separating Fact From Fiction,” “Austism’s False Prophets: Bad Science, Risky Medicine and the Search For A Cure” and “Vaccinated: One Man’s Quest to Eradicate the World’s Deadliest Diseases.” (@DrPaulOffit)

From Tom’s Reading List

The Wall Street Journal: A Booster Shot For Vaccines – “Amid national outbreaks of measles, whooping cough and other preventable diseases, Colorado officials might make it harder for parents to exempt children from vaccinations for school and day care. Colorado is one of 48 states that allow such exemptions for reasons of personal belief or religion—often requiring little more than a parental signature on a form. In the 2012-2013 school year, about 4.3%, or 2,900 children, were excused from required vaccinations, one of the highest percentages of kindergartners in the nation.”

Slate: Growing Up Unvaccinated — “I find myself wondering about the claim that complications from childhood illnesses are extremely rare but that “vaccine injuries” are rampant. If this is the case, I struggle to understand why I know far more people who have experienced complications from preventable childhood illnesses than I have ever met with complications from vaccines. I have friends who became deaf from measles. I have a partially sighted friend who contracted rubella in the womb. My ex got pneumonia from chickenpox. A friend’s brother died from meningitis.”

The Denver Post: Colorado vaccination policy needs a booster shot — “By law, kids who go to day care or public schools in Colorado are supposed to be vaccinated against serious diseases. But in practice, many of them aren’t. Too many. And that needs to change.”

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