Cannabidiol, or CBD, is a component of the cannabis plant lacking the “high” associated with marijuana, and right now products claiming to contain CBD are everywhere — from gummies to cocktails, ice cream to hand cream, and more. An estimated 64 million consumers, according to a January 2019 Consumer Reports survey, have tried products containing CBD in the past two years alone. But do you know what you are buying - and taking?
(BPT) - Before you reach into that jar of CBD gummies, or add some CBD oil to your bath, proceed carefully. Do you really know what’s in that “miracle cure” that you purchased online or at the health store for anxiety or your aching back?
Cannabidiol, or CBD, is a component of the cannabis plant lacking the “high” associated with marijuana, and right now products claiming to contain CBD are everywhere — from gummies to cocktails, ice cream to hand cream, and more. An estimated 64 million consumers, according to a January 2019 Consumer Reports survey, have tried products containing CBD in the past two years alone.
With widespread marketing that is largely unregulated, CBD purchased online or at stores is often promoted as a one-stop product for a range of potential health benefits, such as relieving stress, soothing aches and pains, reducing inflammation or improving sleep.
Interest in — and access to — CBD increased with the passage of the Farm Bill which removed CBD derived from hemp (a variety of cannabis that contains very low levels of tetrahydrocannabinol or THC) from the list of controlled substances. Although CBD products are now available online or in many stores, health or medical claims made by the product manufacturers are still subject to regulation by the FDA to ensure consumer safety. Through all the current interest surrounding CBD one critical question remains: Are widely available CBD products safe and effective?
Separating fact from fiction
The contents and dosage of CBD products sold in retail stores or online are often unknown and not consistently, if at all, regulated. To navigate the current environment, consumers first need to understand that not all CBD products are equal:
So, what’s the bottom line for the millions of people currently using CBD products? As the saying goes, the smart consumer is the wise consumer. The FDA approval process is considered by many to be the gold standard in the medical field and was put in place to protect patients. Taking unregulated CBD products that lack scientific evidence can pose health risks, particularly for very sick patients who may be looking for hope in these products, in part, because of unproven health claims.
You deserve to know what you’re taking
It can be difficult to know if CBD products actually contain what they claim. A 2017 study published in the Journal of the American Medical Association found that almost 70% of all CBD products sold online did not contain the amount of CBD stated on the label — 42% contained a higher concentration of CBD than the label claimed, and 26% of the products contained less. Twenty percent included enough unlabeled THC to cause intoxication, especially in children. The FDA also evaluated some of these products and found that they did not contain the levels of CBD that they claimed. More studies and regulations are needed to ensure these products are safe for consumer use.
An important moment in the evolution of CBD occurred in June 2018 when the FDA approved Epidiolex® (cannabidiol) oral solution CV, the first prescription CBD medicine. Because it is a prescription, available in pharmacies just like any other FDA-approved medicine, it is legal throughout the entire U.S. when prescribed by a licensed health care professional. It is the only FDA-approved CBD product currently available.
“The approval of Epidiolex is historic not only for the long-awaited relief it provides patients with Lennox-Gastaut syndrome and Dravet syndrome, two very difficult-to-treat epilepsies, but also for the parameters it has put in place for how a CBD medicine should be studied to understand its safety profile and efficacy,” said Justin Gover, CEO of GW Pharmaceuticals, plc, the company responsible for Epidiolex. “We hope that this opens the door for further well-controlled clinical studies of CBD in other medical conditions to achieve FDA approval and ensure patients are getting the medicines they deserve.”
This sponsored article is presented by Brandpoint.
Every day nearly 200 people die from an overdose of drugs or from alcohol poisoning, with opioids responsible for the majority. Recognizing the signs and knowing how to respond to medical emergencies, including carrying and administering naloxone in cases of opioid overdose, can literally save lives. Here are tips from the American Society of Anesthesiologists (ASA) on what to do in case of a suspected overdose.
(BPT) - Every day nearly 200 people die from an overdose of drugs or from alcohol poisoning, with opioids responsible for the majority. Recognizing the signs and knowing how to respond to medical emergencies, including carrying and administering naloxone in cases of opioid overdose, can save lives, says the American Society of Anesthesiologists (ASA).
“The tragic increase in overdose deaths is an alarming and devastating issue that touches so many of us,” said ASA President Mary Dale Peterson, M.D., MSHCA, FACHE, FASA. “If you can identify an overdose or alcohol poisoning, you are more likely to react quickly, making the difference between life and death for a family member, friend or stranger.”
Physician anesthesiologists have a critical role in fighting against overdoses, starting with managing patients’ pain after surgery or chronic pain in responsible ways. During Physician Anesthesiologists Week, Jan. 26-Feb. 1, ASA is joining forces with U.S. Surgeon General VADM, Jerome Adams, M.D., M.P.H., to empower everyone to recognize the following signs of an overdose or alcohol poisoning:
Any one of these signs should prompt a call to 911 for emergency medical care. Never leave an unconscious person alone, as they may be at risk of dying, including by choking on his or her own vomit. If an opioid overdose is suspected, naloxone should be administered immediately, if available. Naloxone is administered by injection or nasal spray and access to it is expanding on a state-by-state basis. It can be prescribed by a physician and often is carried by police officers and emergency medical responders. Additionally, it’s increasingly available over the counter at some pharmacies.
“To stem the tide of the opioid overdose epidemic, we need everyone to consider themselves a first responder. We need to encourage everyone in our communities to carry naloxone and know how to use it,” said U.S. Surgeon General, VADM, Jerome M. Adams, M.D., M.P.H., a physician anesthesiologist who issued a Surgeon’s General’s advisory in 2018 calling for increased awareness and use of the medication. “When on hand, naloxone may mean the difference between life and death, and can be a first step to getting someone onto the pathway of recovery.”
Anyone who takes opioids to manage their pain may be at-risk for an overdose. In recent years, opioids were the go-to pain reliever for everything from backaches and injuries to post-surgical and chronic pain. In 2017, more than 190 million prescriptions were written for opioids. While they can be effective for short-term pain, chronic use can lead to abuse. Every day 130 people die from opioid overdoses, according to the Centers for Disease Control and Prevention.
“ASA strongly agrees with the Surgeon General and supports policies that promote access to naloxone and safe and effective pain management care,” said Dr. Peterson. “All of our members have a significant interest in reducing misuse, abuse and diversion of opioids that have led to unintended deaths.”
To learn more about the critical role physician anesthesiologists play before, during and after surgery, visit asahq.org/WhenSecondsCount. ASA also offers an opioid overdose resuscitation guide that provides guidance on symptoms of an overdose and how to help.
Migraine headaches are literally life-altering, chronic health concerns for millions of Americans. In this article, we examine the latest medical research and examine the most common reasons why you may be getting constant migraines.
Migraines are not an easy thing to deal with. For most people, the onset of a migraine calls for a dark room and resting in bed. Although migraines seem to happen out of nowhere, there are usually some reasons why they even appear in the first place. Therefore, the following list includes some of the most common reasons why you may be getting constant migraines.
Recent studies have concluded that stress is the number one factor when it comes to the reason why people are getting migraines. In fact, over 50 percent of people associate their migraines with stressing. Look back to your past few weeks at work or school. Figure out what things are causing you great stress and how you can reduce those triggers. You can then add additional preventive measures, such as getting relaxation therapy, setting aside time for exercise and making sure you get enough sleep each night.
Although rarer than most reasons, vision problems such as nearsighted, farsighted, or astigmatism can be the reason behind your migraines. Often, it is the pressure to work on our computers for long hours, or your eyes are simply losing their strength as you age. You should have a regular eye exam to test for common eye disorders. This will provide you with some treatment options; however, reducing the amount of computer/phone time should also be practiced as well.
One of the most overlooked reasons for migraines is medication overuse. As the old saying goes, too much of something good can be bad. This is essentially the reasoning behind this theory. Medication that is continuously used and in heavy doses may cause you to experience those constant migraines. Therefore, people are recommended to cycle off their medication in order to remove any harmful toxins that may reside within them. Often, people need to get special help from a doctor to withdraw from these medications that put them at risk for rebound pain or dependency. Note that you should first consult with your physician about this theory and work together to reduce your medication enough to where migraines are either entirely gone or significantly reduced.
Although the information above describes the most common triggers for migraines, there are plenty of more reasons to go around. Also, people can suffer migraines depending on certain situations and conditions that are unique to them. Therefore, it is always recommended that you research some of the reasons behind your migraines and speak with a medical professional in order to receive a proper diagnosis and treatment plan.
Ear pain can be a source of significant discomfort. Due to the many nerves that are clustered in the area, ear pain can sometimes persist for days and be beyond the aid of common over-the-counter painkillers. Some causes of ear pain may require the assistance of medical professionals; others can be solved by yourself. Here are three of the most common causes of ear pain.
Some of the most common causes of ear pain are dental issues. According to Alpine Dental, cavities, impacted molars, abscesses, infections and jaw problems can lead to earaches that seemingly don't go away. Persistent jaw pain may be a sign that you should pay a visit to the dentist. Even if you don't believe you have any cavities, the pain may be coming from a source that is not visible to you, such as a wisdom tooth that is pushing against its neighboring teeth at an abnormal angle. Only a dentist capable of taking an X-ray of your mouth can show you what is happening under the gums.
Earwax is a natural substance produced by your ear to keep out bacteria, dirt, and water. Earwax is normally created in the ear canal and gradually pushed into the outer ear by the hair inside your ear. However, sometimes too much earwax is produced. One of the most common ways people deal with earwax is to clean it with a cotton swab. Unfortunately, this method will only push your earwax deeper into the canal, and can even be dangerous, according to ENT Orlando. Cotton swabs should only be used lightly around your outer ear to brush off dead skin and loosen ear wax. You can use hydrogen peroxide, diluted vinegar or mineral oil to loosen the buildup of wax in the ear and let it drift out normally.
Normally, the air pressure inside your inner ear is roughly the same as the pressure in the outer ear. However, according to Virtua Health, rapid acceleration can quickly destabilize that equilibrium. For example, if you're on a roller coaster, you may feel increasing pressure inside your ear until your ear pops and the pressure recedes. However, there are some instances where you might need to take a more active approach to relieve air pressure. Frequent air travelers often experience ear pain while travelling by plane. The rapid acceleration at takeoff can create a painful buildup of air pressure inside your ear that your body cannot adjust to quickly. In this case, a common remedy is to force your ear to pop by swallowing or chewing gum in order to stimulate frequent swallowing to keep your ear tubes open and air available to your inner ear.
Other causes of ear pain may be a lot more serious than the ones described above. If your ear pain comes with signs of infection, such as a fever, rash or sore throat, and it doesn't go away within a few days of home treatment, you should seek medical attention.
Read about more health IDEAS: 3 Home “Remedies” That Just Don't Work
Anyone who suffers from migraines knows how debilitating they can be. Beyond the throbbing headache, they're often accompanied by nausea. Sometimes even light and sound become unbearable. If you are looking for ways to manage your migraines, then read on to learn three tips for living with them.
Keep a Journal
Journals are a smart way of managing your migraines. Using a daily journal to track variables such as food, environmental factors and stress can help identify patterns and triggers. Create a migraine tracking system that works for you. It can be a diary, a spreadsheet, or an app. There are also phone apps that cater to migraine management, and some of them include digital trackers. You can effortlessly track your physiology patterns by using a smartwatch that integrates with your app. Be sure to bring your journal to your doctor so they can extrapolate data to help figure out which treatment is best for you. Keep in mind that you need to be consistent for this tool to be effective.
Consider Applying for Disability
Migraines can severely affect your quality of life. They can interfere with both job performance and maintaining healthy relationships. They can even inhibit your ability to take care of yourself and your children. If a migraine prevents you from being able to perform your basic duties at home or work, you might need to seek financial assistance. Surprisingly, migraines may qualify as a disability. Applying for disability can lead you toward broader medical options such as different doctors and more affordable insurance. Information is available on a federal government website, and resources may exist locally.
Learn Self-Care Techniques
Western doctors are becoming more accepting of alternative therapies. Research shows that there are healing benefits to alternative treatments such as essential oils, massage and acupuncture. Remain conscious of the fact that stress can trigger migraines. Consider creating a daily ritual to help you relax at home. Insurance plans do not always cover alternative therapies, so relaxing at home can be an affordable option worth exploring. Create a nighttime routine that includes deep breathing and baths with healing salts. Essential oils may also be effective for you if you use those that are appropriate for your health condition. Always speak to your doctor if you are unsure about any of your choices.
Managing migraines is time-consuming, and asking for help can be difficult. However, there are many tools to assist you along your way. Remember to always consult with your doctor before experimenting with alternative therapies.
While all of us have experienced the dull pain of a headache and some know the recurrent pulse and throbbing of migraine, few people can understand the severity of pain associated with cluster headache, also known as “suicide headache.”
(BPT) - While all of us have experienced the dull pain of a headache and some know the recurrent pulse and throbbing of migraine, few people can understand the severity of pain associated with cluster headache, also known as “suicide headache.”
What is cluster headache?
Cluster headache is an extremely painful primary headache disorder characterized by recurring unilateral attacks, or attacks that occur on one side of the head. It is called “cluster” headache because headaches typically occur in bouts (or “clusters”) for 6 to 12 weeks, often at the same time each year or day, and are more frequent at night. It begins as sharp pain centered at the eye, temple or forehead, and can be as brief as 15 minutes or as long as several hours. Attacks can strike up to 8 times a day.
The condition, which affects about one to two people in every 1,000, predominantly occurs in males, with symptoms typically manifesting by the age of 30. Those at greater risk of cluster headache include heavy smokers and individuals with a family history of the condition.
“Cluster headache is one of the most painful conditions an individual can experience, known for being potentially more excruciating and debilitating than migraine,” said Stephen Silberstein, M.D., from the Jefferson Headache Center at Thomas Jefferson University in Philadelphia, Pennsylvania. “Sadly, patients diagnosed with cluster headache commit suicide twenty times more than the national average as the pain can be described as unbearable.”
Diagnosis and treatment
Unfortunately, diagnosis of cluster headache may be delayed significantly due to patients and physicians mistaking the end of a bout for resolution of a separate, standalone condition.
Historically, even after the proper diagnosis is made, there have been very few viable therapies for cluster headache, making prevention and treatment strategies a challenge. While the exact cause of cluster headache is unknown, it is typically treated with injectable sumatriptan, a combination of oxygen and various drugs and/or nerve blocks. These methods are associated with barriers to use including a myriad of pharmaceutical side effects. Not surprisingly, 79 percent of patients have been dissatisfied with available treatment options.
Today, patients now have a novel treatment option called gammaCore®(nVNS). gammaCore, the first non-invasive vagus nerve stimulation therapy applied at the neck for the acute treatment of pain associated with migraine and episodic cluster headaches in adult patients, offers a way to treat symptoms without many of the side effects and dose limitations observed with commonly prescribed treatments or the need for invasive and costly procedures. Patients prescribed gammaCore can have reliable access to treatment for up to four cluster attacks per day for 30 days.
“gammaCore has shifted the paradigm by allowing patients to self-administer non-invasive vagus nerve stimulation therapy for acute treatment of cluster headache, resulting in the reduction of pain,” notes Dr. Silberstein. “gammaCore’s efficacy and safety profiles, along with its self-administered mode of delivery, have the potential to not only reduce the side-effect burden associated with other medications but also bring much needed relief to patients.”
For more information on cluster headache and treatment with gammaCore (non-invasive vagus nerve stimulator), please visit http://gammacore.com/.
Important Safety Information
gammaCore (non-invasive vagus nerve stimulator) is indicated for the acute treatment of pain associated with episodic cluster headache and migraine in adult patients.
gammaCore is available by prescription only. U.S. Federal Law restricts this device to sale by or on the order of a licensed healthcare provider.
 *Survey conducted in October 2016 to assess the impressions and perspectives on current treatments and interest in new acute treatment options. A total of 291 subjects participated in the survey, with 177 of them suffering from episodic cluster headaches and 111 suffering from chronic cluster headaches, and 3 patients refrained from answering this question.
To help shed light on the growing national problem with opioid drugs, Dr. W. Michael Hooten, a Mayo Clinic anesthesiologist and Pain Clinic specialist, lends his expert insight on what people need to know about opioids.
(BPT) - While a decade ago you may not have heard much about opioids, today they make headlines daily. The nationwide epidemic crosses generations and socioeconomic lines, and it's affecting your family, friends and neighbors.
"Opioids have long been used clinically to treat pain, but prior to the 1990s they were primarily reserved for patients with a limited life expectancy, such as for someone with cancer or in a hospice setting," says Dr. W. Michael Hooten, a Mayo Clinic anesthesiologist and Pain Clinic specialist. "The potential problems associated with long-term use were secondary considerations."
To help shed light on this growing national problem, Dr. Hooten lends his expert insight on what people need to know about opioids.
Opioids are prescribed for various reasons
Opioids are used to treat a variety of pain disorders. While they are commonly prescribed after an operation, opioids are also used to treat a host of chronic pain conditions including musculoskeletal, abdominal, pelvic, and neuropathic pain.
Length of use varies
"Following surgery, up to one in four patients may use opioids longer than anticipated," says Dr. Hooten. "How long, exactly, depends on several clinical factors."
He notes that after an operation, a patient might use opioids to manage acute pain for three to five days.
"When opioids are used for acute postoperative pain, patients should try to use the lowest possible dose." After this short time period, opioids should be replaced with non-opioid pain medicines including Tylenol scheduled to be taken every six hours."
There are alternatives for pain management
There are many alternative options for chronic pain. Dr. Hooten suggests talking with your doctor about:
* Non-opioid analgesics (non-opioid pain medications).
* Interventional treatments such as image-guided spine injections or nerve blocks. * Acupuncture.
* Low-impact exercise such as walking, yoga, Pilates. Consider working with a physical therapist to develop a structured exercise program.
* For advanced pain treatment, spinal-cord stimulation can disrupt the pain stimuli and provide sustained pain relief.
* Work with a pain psychologist who can help teach individuals how to use specialized behavioral and cognitive techniques that could lead to improvements in daily functioning and quality of life.
Opioids can be deadly if misused
"Approximately 90 people per day die in the U.S. from a prescription opioid and/or an illicit opiate overdose," says Dr. Hooten. Many of those are accidental overdoses. “People who take prescription opioids will inadvertently mix them with benzodiazepines (e.g., Valium and Xanax). Dr. Hooten warns that these two drug classes should never be taken together, as the combination can suppress the central nervous system and put the individual at risk of an accidental overdose.
Addiction can happen to anyone
As Dr. Hooten notes, “No one plans to get addicted, but it happens. Using opioids requires a high level of vigilance for the signs and symptoms of addiction."
There are many signs of over-reliance or misuse that families should be aware of. These include an increased preoccupation with the drug, concern about the timing of the next dose or refill, hiding use of the drug, and signs of intoxication like slurred speech and excessive sleep.
If you notice these warning signs, alert your loved one about your concerns. "This might be enough to prompt a change," says Dr. Hooten. "Otherwise relay this information to the prescriber and tell them what’s going on. They can take the correct next steps."
For more information on pain medication and alternatives, or to make an appointment, visit www.mayoclinic.org.
(BPT) - Opioids often are the go-to pain killer for everything from back aches and injuries to post-surgical pain, as evidenced by the more than 300 million prescriptions written each year. While they can help with moderate to severe short-term pain, opioids are not without risk. Because they have significant side effects, including an increased risk of addiction and overdose, the American Society of Anesthesiologists suggests those who take opioids ask some tough questions — including if it is time to consider alternatives.
Kathleen Callahan understands the dilemma. She suffers from a condition that causes painful cysts that required multiple surgeries resulting in post-surgical and chronic pain for which she took opioids for years. Despite being on a high dose of opioids, she still had chronic pain. So she turned to Anita Gupta, D.O., Pharm.D., a physician anesthesiologist who specializes in pain medicine.
“When I was on opioids long-term I couldn’t function, couldn’t be involved in my children’s lives and my work was suffering,” said Kathleen. “Dr. Gupta helped me manage my pain so life is livable. Now I exercise, go out with friends and go to my kids’ activities.”
“Kathleen and I had some difficult discussions. I didn’t think the medications were helping her anymore and I was truthful with her,” said Dr. Gupta. “She asked some hard questions, and I helped her move forward and cope with her pain. Since she’s been opioid-free Kathleen is vibrant and energetic. She has her life back.”
If you are taking opioids or your physician has prescribed them, the American Society of Anesthesiologists suggests asking yourself (and your physician) some tough questions:
* Are opioids affecting my quality of life? Opioids have many side effects, ranging from severe constipation, mental fogginess and nausea to depression. Kathleen said she was “exhausted, cranky, depressed, constipated and gaining weight.” She realized the side effects of opioids were worse than the pain itself, motivating her to seek other options.
* What are my concerns about taking opioids — or stopping them? With the media attention surrounding opioid risks, many people worry they:
- are being judged by others
- may become addicted or overdose
- won’t be able to control their pain if they stop taking opioids
Ask your physician about obtaining naloxone, a drug that can reverse an overdose. If you take opioids when you don’t have pain or use more than directed, you may develop a dependence. Talk to your physicians about alternatives to manage your pain.
* Is it time to consider other methods of pain management? Opioids are most effective in the short term. If they are taken for chronic pain, they should be part of a “multimodal” plan that includes other methods of pain management, including:
- Injections or nerve blocks, which can short circuit muscle and nerve pain.
- Electrical stimulation and spinal cord stimulation devices that send electrical impulses to block pain.
- Physical therapy, which strengthens muscles to improve function and decrease pain. Whirlpools, ultrasound and massage can help, too.
- Alternative therapies, such as acupuncture, biofeedback, meditation, deep breathing and relaxation, which help you learn how to ease muscle tension.
* What type of physician can best help manage my pain? If you have severe or ongoing pain, be sure to see a physician who specializes in pain management, such as a physician anesthesiologist. These specialists have received four years of medical school and additional training in a medical specialty, followed by an additional year of training to become an expert in treating pain. They have the expertise to best help you manage your pain.
“If I was still on opioids I would be overweight, inactive, not involved in my children’s lives and depressed,” said Kathleen. “When you have a physician like Dr. Gupta who you trust and who shows you there’s another way, it’s just amazing. It’s night and day.”
For more information, download ASA’s Asking the Hard Questions About Opioids. To learn more about the critical role physician anesthesiologists play before, during and after surgery, visit www.asahq.org/WhenSecondsCount.
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