Methylated Spirits Revisited

On Sunday my site got 155 views. On Monday  121. That is a lot more views than I usually get. Most of them were to read my post on methylated spirits which is almost seven years old. I don’t really get it since when you google “methylated spirits” my post doesn’t come up.

I was going to tweet about this, but since Twitter still won’t let me tweet my URL, I decided to write a short post about it instead. The problem with Twitter is over 2 years old. I don’t think it will ever get fixed.

I am little afraid that the sudden increase in views  was some kind of hack, but everything seems okay. If anyone knows why there would suddenly be so much interest in methylated spirits, please let me know.

Denatured alcohol

Social Drinking

Can you be a social drinker? I recently read an article in The New York Times that would suggest the answer was no. The article itself was interesting and the comments were even more interesting. The vociferousness of the comments that defended drinking indicates that drinking in America has been normalized. The recent Atlantic article that asked why there is no anti-alcohol movement explored some of the reasons for that normalization. When I was at my writing retreat this fall, one of the other attendees was a woman who has recently stopped drinking and has a blog about it.

Prior to Prohibition, the temperance movement saw drinking as being both a moral and societal issue. They sought a civil response to the problems of drinking. Although prohibitionists counseled individuals to have the moral and individual strength to stop drinking, the movement sought to remove drinking from society through political and legislative means.

Since Prohibition, the liquor industry has been very successful in framing drinking and the serious issues it can cause as an individual disease. There have been some moments where the public health analysis of alcohol and the society-wide problems it causes, have been in ascendance. Both the movement to decrease drunk driving and the 1991 tax increase on alcohol had public health components.

Today the liquor industry is completely in control and health information detailing problems with liquor go nowhere. On television you see public service announcements on tobacco and vaping. There are none about drinking.

Here is a picture of a cirrhotic liver as one example of the damage excessive drinking can do to your body and health.

Cirrohotic Liver

Second time around

Looking over my last few posts I thought I would revisit some of the topics. In Summer I outlined what I was doing during this season. The Take Back the House (TBTH) opening was a huge success. You can see a video about it here. I am still working there and I feel, now more than ever, it is critical to turn the house Democratic.

Skating Camp, which I talked about in Summer and Off to Camp, was terrific. There were only nine of us and the coaches and assistant coaches were so helpful and supportive. It really improved my skating, making me more adventuresome and less fearful. I plan to start some off ice work which should further strengthen my skating.

I am still having trouble sleeping. At least once a week I have a bout of insomnia. My latest thought is to try hypnosis to change my sleeping habits. If anybody has tried that, please me know.

It has been two weeks and I  have watched two  Youtube videos that were on Feedly. I am also reducing my watching of Reality TV since it feels very connected to the rise of Donald Trump, something I fervently wish had never happened. I do not want to be complicit with his fascism in any way,

Several of the posts reference how hard it has been to do weekly posts. That remains true. I put all of the potential changes to my website which I discussed in Half Year Update out of my mind but  it is probably time to start thinking about them again.

Finally in the last month my most viewed post was the one on Methylated Spirits which I wrote five years ago. It had 229 views in 30 days. I average about 20 reads a day. The day I post is not always the day with the most readership which is a bit of a puzzle to me. I am  still thinking about ways to increase readership. If you have any ideas, let me know.

If these more personal posts are not your taste, let me know that as well.

 

I got rid of YouTube

Wednesday, I removed YouTube from my phone, blocked it on my computer using LeechBlock, and removed the app from my Vizio Smart TV. Why, you might ask.

In general most of the internet and the world-wide web is a total time sink. Most people probably find social media like Facebook, Twitter, and Instagram the most egregious but recently YouTube – particularly makeup videos has taken over my life.

YouTube makeup videos function in exactly the same way as all forms of advertisements. Generate anxiety about a physical characteristic, a social or economic status or the lack of some possession and then provide the solution to the problem the video created in the first place.

As a women of a certain age, YouTube videos about “makeup for mature skin” have sucked me in. Many of the women producing these videos are in their 30s and 40s. The fact that the skin of women of this relatively young age is “mature” seems inherently misogynistic.

For most of my life I was thin and wore little to no makeup. To be honest, menopause changed all that so I was a ripe candidate for the anxiety and advice of YouTube videos.

Ironically many of the women who are in their 60s and even 70 who are making these videos seem to be sincere about helping other women but makeup videos on YouTube is big business and these women are part of it. The production values of the video with professional lighting and filters that remove all wrinkles are the same techniques that television advertisers use.

Makeup videos on YouTube and Instagram  have changed the makeup industry. There are now a set of people, mostly women and mostly makeup artists, who are “influencers”. Makeup companies send them products to review; the subsequent videos are part of the company’s marketing campaign. Thus, your average YouTube makeup video, even if it is a women in her 60s, presents as unreal and unattainable a vision as any Revlon or Maybelline commercial on TV does.

The degree of anxiety and self-dissatisfaction that watching a lot of these videos generate is immense, deeply distracting and even addicting. I therefore did a self-intervention and am going cold turkey. I’ll let you know whether I stay on the wagon or not.

Cirrhosis

Cirrhosis of the liver is on the rise, according to the New York Times. From 1999 to 2016, deaths increased 65%. The largest increase in deaths was in the population group aged 25 to 34. From 199 to 2008, in some groups including Native Americans and African Americans cirrhosis rates stayed steady or decreased. After 2008 both groups saw increase in  cirrhosis deaths.

The author of the study cited in the newspaper article hypothesizes that the increase can be attributed to the Great Recession and economic despair among young men.  He does acknowledge, however, that “almost every one of these deaths, particularly in the young, is completely preventable.”

Cirrhosis deaths are usually preventable because alcoholic abuse is the major cause of the illness. I have written about this in a previous post which you can read here.

This is the picture from that post.

Addiction Treatment

Yesterday I listened to Preet Bharara’s podcast, Stay Tuned with Preet. The topic was the opioid crisis. The guests were Susan Salomone, a parent advocate and Dr. Abigail Herron, a psychiatrist who works with addicts.

Part of the discussion was on treatment and what is available to help addicts. Salomone believes that currently there are not enough days for treatments. When I worked in an inpatient detox unit, the addicts were only there for 5 days and then placed in outpatient care.

Dr. Herron discussed the medical treatments that are available. There are three.

Methadone is the oldest treatment available. It is dispensed in licensed clinics and the clients usually attend every day. After a certain number of clean random drug screens, some people can get take-home privileges and reduce the number of days they have to attend the clinic.

Because methadone is an opioid and can be abused, methadone as treatment for addiction is controversial. If a person wants to stop taking methadone they will suffer withdrawal symptoms just like heroin. However, when I worked at a methadone clinic I saw many people whose lives were saved by being on methadone

Naltrexone is an opioid inhibitor. It can be used for alcohol addiction as well as opioid addiction. It reduces cravings. Unlike methadone which stays in the body for a long time, naltrexone only works if you take it. There are no withdrawal symptoms. It is available as a pill or inject-able. The injection, which is very expensive, is supposed to last for thirty days but often wears off before that period is up.

50 mg is the usual dosage for the oral medication. Low dose naltrexone, approximately 4.5 mg, is used for a variety of illness including ALS, urinary issues and Crohn’s disease.

Buprenorphine is an opioid but only partially attaches to opioid receptors. With this drug there is supposedly no euphoria. Physicians are required to take a special course before prescribing buprenorphine. Because it is an opioid, stopping the drug does cause withdrawal symptoms.

All three of these treatments have some negative aspects. It is clear that a drug alone will not prevent a relapse. I think you would have to also be under the care of a therapist and attend support groups regularly. Many people believe that addiction causes brain changes that are difficult to undo. Addiction is a disease of relapse. Just ask anyone who has tried to stop smoking.

Opioid Epidemic

In January, Blue Cross Blue Shield of Massachusetts surveyed 601 Massachusetts adults about the opioid crisis. A majority know someone who has been addicted to opioids and three in ten know someone who has died from drug addiction.

The respondents felt that this was the most important issue to then and that it wasn’t getting better. A clear majority think it is a public health issue rather than one of law enforcement. There is large support for increased treatment. However a majority also think the addicted person shares some of the blame.

Over half of the respondents think that prescription drugs are too easy to get and legal drugs are seen as more of a problem than illegal.  22 % of the people had themselves taken a prescription pain killer in the past two years.

Rural areas appear to be the most affected by the problem. 16 percent of the sample came from rural areas  and 77 percent of them thought opioids was a very serious problem.

81 percent of the same was white while 7 percent was black.  As the opioid crisis has become more pronounced it is clear that people are paying attention because it is affecting white rural or suburban areas. Heroin has been a problem in urban minority neighborhoods for a long time but has not received the same focus.

The fact that most of the respondents saw prescription drugs as the problem is also a change. Although President Trump thinks that gangs are the major source of drugs the current crisis has been fueled by d0ctors with prescription pads.

The other major culprit in the current crisis is the pharmaceutical industry which aggressively marketed opioids as a appropriate response to pain. In nursing school I learned that pain was the fifth vital sign and had to be adequately addressed.

Of course chronic pain sufferers are the other side of the coin. In clamping down on misuse of prescription drugs we may inadvertently be limiting access to pain relief for this population.

Drinking Responsibly

Someone recently wrote a letter to the editor of The Roanoke Times complaining about the ubiquity of beer related stories in the paper. Writing from a public health perspective, Mr. Klein found it bewildering that a women’s health event that a local clinic was sponsoring was being held at a brewery. He wrote, “Have we really gotten to the point as a society where alcohol is so pervasive that it has to be used to entice people to every social event even those designed to promote a healthy lifestyle.”

Klein finds the integration and normalization of alcohol throughout society troubling. This was a big point of contention for the public health activists on the Massachusetts Alcohol Tax Force sub-committee that I served on. They were all people who were working to prevent underage drinking. They also felt that the presence of alcohol at so many community events sends mixed messages. This is something Klein also pointed out.

Klein reminded readers that alcohol consumption can lead to addiction; something that is overlooked in the promotion of events. He apparently lives in Blacksburg, Virginia which is a college town. I also live in a college town where students periodically drink to excess.

There were seven comments in response to Klein’s letter. One pointed out that college students are probably not drinking craft beer which has a higher price point. Most of the other comments focused on the economic benefits of beer to the local economy This is the perennial tension between the public health movement and officials seeking economic development.

Understanding Addiction

Last Thursday I attended a seminar on “Understanding addiction.” The Institute for Natural Resources sponsored the one day seminar which was a way for nurses and other medical professionals to collect continuing education credits.

Much of the material was familiar to me and I don’t think I learned that much that was new. One interesting thing is that alcohol, tobacco, and even caffeine are now seen as drugs with psychoactive properties similar to the illegal drugs such as opioids or cocaine. In fact the legal drugs cause more societal problems than the illegal drugs. The seminar handout states that alcohol and tobacco costs the United States over $400 billion a year  due to crime, lost work productivity, and healthcare. Costs associated with Illegal drugs are about $181 billion a year.

There is an opioid crisis but the speaker did not spend that much time on it. He made the point that at different times different drugs are in fashion. Unfortunately heroin seems to be in vogue right now. It is clear that the War on Drugs has failed and we need to invest much more money on treatment. We also need to find a balance between maintaining pain medicines for people with chronic pain while reducing the more casual prescribing of opioids.

 

 

Cirrhosis and Liver Cancer

Several times a year I listen to CancerCare telephone workshops on different aspects of cancer research and treatment.  Today’s workshop was an “Update on the Treatment of Liver Cancer.” One of the speakers discussed the various risk factors for liver cancer. Cirrhosis underlies 50 to 60 percent of all the liver cancer cases in the United States. Hepatitis C and alcohol abuse are the most frequent causes of cirrhosis. According to the speaker, one can never ignore the degree of underlying damage to the liver when considering treatment for liver cancer. A patient would have the symptoms from the cirrhosis, such as ascites and varices, as well as the cancer symptoms. A few years ago, I wrote a post, “Your Liver on Drugs” which looked at some of the issues connected to maintaining good liver health. I am linking to it again because it still seems relevant.