We’ve been hearing about the rise of opioid abuse and prescription pain reliever overdose deaths. Now this deadly behavior is resulting in an unintended consequence: HIV outbreak
For the 20 somethings that are now the heaviest users of opioids and heroin, they haven’t heard the same lessons that older generations have learned about the dangers of sharing needles.
Recently, the Indiana Department of Public Health announced an HIV outbreak in Southeastern Indiana linked to injection of the prescription painkiller Opana. Since mid-December, 142 have tested positive for HIV, with 136 confirmed cases and six more with preliminary positive test results. While the majority of cases were found among injectors, some are attributed to sexual transmission. This is a huge number of cases for an area in rural Indiana that has a population of only a few thousand people.
Rural areas in Indiana, Kentucky, Ohio and West Virginia are among the highest at risk. Many family members, across generations, live in the same house and will use the drugs together which has led to more needle sharing, which spreads infection.
This is the first documented HIV outbreak in the United States associated with injection of a prescription painkiller. Over the past 20 years, HIV rates associated with injection drug use have declined and so has hepatitis C infections. However, both are now on the rise again in Indiana. Health advocates have been sounding the alarm that if hepatitis C is spreading among injectors, HIV won’t be far behind. Unfortunately we’re now seeing that prediction come true.
Some now say that we are in phase two of America’s opioid epidemic. “The first phase, from the late ‘90s up through a few years ago, was characterized by a dramatic rise in the use and misuse of prescription painkillers. These drugs were heavily marketed, heavily prescribed, and readily available — resulting in skyrocketing rates of opioid dependence and overdose. But heroin use was largely stable, and injection of opioids was uncommon”, says Daniel Raymond, Policy Director, Harm Reduction Coalition.
Raymond goes on to report that “in this second phase, the prescription opioid overdose epidemic has morphed into a full-fledged opioid epidemic, with rising drug injection and heroin use. As more opioid users transitioned to injection, hepatitis C spread quickly through syringes and injection equipment shared within social networks. CDC estimates that between 2010 and 2012, new hepatitis C infections rose 75%, to about 23,000 new cases a year. Like HIV, hepatitis C is a blood-borne virus, but tends to spread more quickly among social networks of drug injectors through shared syringes and injection equipment.”
Opioid overdoses have leveled off in recent years due in part to controlling the supply of prescription opioids by developing prescribing guidelines, establishing monitoring programs and setting up “take-back days” where people bring their unused prescriptions back to the pharmacy for disposal.
However, demand of opioids is on the rise. According to the CDC, there has been a 150% increase in hepatitis C between 2010 and 2013 – the majority of the increase believed to be from injection drug abusers.
Another reason that HIV and Hepatitis C have spread so rapidly is the nature of the drug itself. “Opana, as the prescription opioid is known, needs to be injected more than once a day. Users have reported injecting it four to 10 times a day to stay under its influence. When people start to feel the drug wear off after about four hours, they begin to feel sick and go into withdrawal. Often they’ll turn to an injecting partner in the same house who will share their needle and their drug to give the person relief from these symptoms”, says Dr. Joan Duwve, chief medical consultant with the Indiana State Department of Health.
Opana also requires a larger-gauge needle that exposes users to more blood, which increases the risk of infection.
“The situation in Indiana should serve as a warning not to let our guard down. This is a powerful reminder that HIV and other infectious diseases can gain ground at any time, unless you remain vigilant,” say Jonathan Mermin, MD, MPH, and the Director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP)
Sources: CDC, CNN, and Harm Reduction.org
Water is the second most popular beverage in the U.S. after soft drinks, which is a scary statistic when you stop and think about it. Sugary soda increases risk of obesity, stroke, and other heart problems . However, these dangers can be avoided if people choose to drink water, which doesn’t have negative side effects.
The amount of water people need per day is up for debate, but studies suggest adults need nine to 16 cups of water. However this number varies depending on activity level, age, and how much water people are consuming in coffee, tea, or water-rich veggies and fruit.
The benefits of drinking water is is not up for debate. Here are the many reason that drinking water is good for your entire body:
Roughly 60% of the body is made of water. Drinking enough water maintains the body’s fluid balance, which helps transport nutrients in the body, regulate body temperature, digest food, and more. Water-rich fruits and vegetables like cucumber, watermelon, and strawberries contain minerals, salts, and natural sugars the body needs for optimum hydration levels, so eating them can sometimes rehydrate us more effectively than water alone.
Drinking water could also help with weight loss. Studies have found that when participants drink water before a meal, they lose weight faster than those who did not drink water . Extra H2O helps us eat less by making us feel full, and it may also boost metabolism. CamelBak hydration advisor Kate Geagan, RD says it’s not uncommon to put on weight by mistaking thirst for hunger, and she offers this pro tip: Next time you feel fatigued or sluggish, “drinking water may be just what [you] need to perk up.”
Sweating during a workout causes muscles to lose water. And when the muscles don’t have enough water, they get tired. As we get closer to summer with temperatures rising, staying hydrated is one of the most important things you can do. The hotter the workout, the sweatier we tend to get, so it’s extra important to replace those lost fluids. So for extra energy, try drinking water to push through that final set of squats.
Certain toxins in the body can cause the skin to inflame, which results in clogged pores and acne . Water flushes out these toxins and can reduce the risk of pimples.
In order to really focus, a glass of water could help people concentrate and stay refreshed and alert. If you’re going to need to concentrate for long periods of time, keep water handy to help you stay refreshed, hydrated, and focused: Dehydration can impair your attention span, memory, and motor skills. One study even found a link between students bringing water into an exam room and better grades. While it’s unclear if drinking the water had anything to do with a better score, it doesn’t hurt to try it out!
Water can help fight tired eyes too . One of the most common symptoms of dehydration is fatigue. Next time you’re feeling tired, try drinking a couple glasses of water. Feeling tired is one of the first signs of dehydration and filling back up on H2O could give you the boost you need.
Drinking water makes us feel so refreshed that it actually improves our state of mind. You don’t even have to be severely in need of it to benefit: Even mild dehydration has been shown to negatively impact moods.
Drinking alcohol causes dehydration, which can lead to hangovers. Using seltzer water and fresh fruit instead of sugary mixers makes for a delicious, better-for-you drink (that can also help prevent dehydration). Having a glass of water with each alcoholic drink you sip is another way to help hydrate the body and stop that pounding headache the next morning.
A little water can really go a long way. Aching joints and muscle cramps and strains can all occur if the body is dehydrated. Water keeps the cartilage around our joints hydrated and flexible, ensuring that our joints stay lubricated. It also protects our spinal cord and tissues, keeping us healthy from the inside out.
Going without water for too long causes headaches for some people, and has been identified as a migraine trigger. Studies have shown that drinking an average of two cups of water will relieve a headache within 30 minutes. Staying hydrated throughout the day can help prevent headaches caused by dehydration.
Keep things flowing
Drinking enough water prevents constipation and also reduces the burden on the kidneys and liver by helping to flush waste products. “In the large intestine, water binds with fiber to increase the bulk of the stools, reduce transit time and make elimination easier. When you don’t drink enough water and fluids, the colon pulls water from stools, increasing your risk of constipation,” says Geagan. Our kidneys process 200 quarts of blood daily, sifting out waste and transporting urine to the bladder. Kidneys also need enough fluids to clear away what we don’t need in the body.
Water may help with decongestion and dehydration, helping the body bounce back when feeling under the weather with a cold or flu. But did you know that research has found that the greater the fluid intake, the lower the incidence of bladder cancer, with more significant results when the fluid is water? One possible reason could be that urinating more frequently prevents the buildup of bladder carcinogens. Staying hydrated may also reduce the risk of colon cancer and breast cancer.
Studies show a link between the risk of death from coronary heart disease and water intake. Consuming more water means a lower risk of death from coronary heart disease and that risk of death rises when intake of “high-energy fluids” (like soda and juice) increases.
We had to include this one… A study shows that good health is more prevalent the closer one lives to the coast . Whether it’s the proximity to sea air, greenery, or opportunities to soak up sunshine on the beach, spending time near the water makes us healthier.
So get in the habit of drinking a glass of water as soon as you wake up, and 30 minutes before eating any big meal. Keep a water bottle on hand at all times. And if the taste beings to bore, liven it up with a squeeze of citrus or slices of fresh fruit in the glass.
Drug abuse isn’t just about street drugs. Besides marijuana, legal medicines are the most commonly abused drugs in the U.S. Over-the-counter and prescription drugs can help and heal us. But some can be addictive and dangerous if they’re used the wrong way. Educate yourself with the information below so you can be aware of the dangers of some of these medicines:
These are sedatives like phenobarbital, pentobarbital (Nembutal), and secobarbital (Seconal). They help with anxiety, sleep problems, and some seizures. But if you take more than prescribed, you can get addicted. High doses can cause trouble breathing, especially if you use them when you drink alcohol. If you can’t function without barbiturates, get help. Going into withdrawal can be dangerous.
Valium (diazepam) and Xanax (alprazolam) are two examples of benzodiazepines — another type of sedative that can help with anxiety, panic attacks, and sleep problems. They work well and they’re safer than barbiturates. But overused, they can also lead to physical dependence and addiction. Prescription drugs shouldn’t be shared. They are only for the person with the prescription.
If you have trouble sleeping, drugs like zolpidem (Ambien) , eszopiclone (Lunesta), and zaleplon (Sonata) can help you get the rest you need. But if you use them longer than your doctor suggests, you may start to believe you need them to sleep. Although they’re not as addictive as some sleeping pills, doctors are concerned about abuse if they’re not taken as prescribed.
Codeine and Morphine
Some of the most commonly abused prescriptions are painkillers — specifically, opioids. These drugs dull pain, but in large doses they can also cause a euphoric high — and dangerous side effects. Doctors usually prescribe morphine for severe pain and codeine for milder pain or coughing. Brands of morphine include Avinza, Kadian, and MS Contin.
Another opioid painkiller is oxycodone. It’s in drugs like OxyContin, Percocet, Percodan, and Roxicodone. People who abuse oxycodone sometimes crush it and snort it or inject it — greatly raising the risk of overdose. Street names include “oxy,” “O.C.,” and “oxycotton” for OxyContin and “percs” for Percocet or Percodan
Vicodin, Lortab, Lorcet
These drugs contain the opioid hydrocodone plus acetaminophen. Opioids cause drowsiness and constipation. High doses can cause dangerous breathing problems. Vicodin’s street names include “vike” and “Watson-387.”
When prescribed, stimulants like the amphetamines Adderall and Dexedrine can help people with ADHD. But some people use amphetamines to get high, to boost energy and alertness, or to keep their weight down. You can get addicted to stimulants. High doses can cause a dangerous rise in body temperature, irregular heartbeat, and even cardiac arrest. Nicknames for amphetamines include “bennies,” “black beauties,” and “speed.”
This is a stimulant in ADHD drugs like Concerta, Metadate, Methylin, and Ritalin. Its nicknames include “MPH,” “R-ball,” “Skippy,” “the smart drug,” and “vitamin R.” If you take stimulants, combining them with common decongestants can cause dangerously high blood pressure or an irregular heartbeat.
It’s not just prescription drugs that are a problem. Dextromethorphan is a common ingredient in over-the-counter cold and cough medicines — it helps stop the cough. But large doses can get you high and cause hallucinations. It’s popular among teens, since cough syrup is so easy to find in medicine cabinets. High doses also cause vomiting, rapid heart rate, and — rarely — brain damage.
This is a decongestant in lots of non-prescription cold medicines. While it helps clear up a stuffy nose, it’s also an ingredient in illegal methamphetamine (“meth”). To curb meth abuse, U.S. laws now control how you buy pseudoephedrine products. That’s why some cold medicines are located behind the counter and why you may have to sign for some.
Spotting a Suspicious Pill
Found a random pill around the house or in your teen’s jacket? Want to know what it is? WebMD’s Pill Identification Tool may help. But because there are hundreds of drugs and thousands of pills and tablets of all shapes, colors, and sizes, you may need a pharmacist to identify it.
Drug Abuse: What to Do
Worried that someone you love might be abusing drugs? The best thing to do is ask directly. Keep an eye out for signs of abuse, like behavior changes or missing medicines.
Many kids assume that common household drugs or even prescription medicines are safer than street drugs because they’re legal. Explain the risks. Head off problems — and clean out your medicine cabinet. Get rid of the drugs you don’t need, and keep track of the ones you do.