Opioids: Too Many Prescriptions And Lots of Unused Medications, Too

A HealthDataBuzz series: Our Daily Lives – Things That Impact Our Everyday Health

While there is an opioid crisis in this country, there is an almost stunningly routine part of the massive problem: too often medications prescribed for patients after surgeries, for instance, aren’t used after they picked them up. The pills are left in the house, and may be taken accidentally — or not – by someone else. And that someone else may be a child.

Not only do many people take only some or none of the prescribed pills, but more than 90 percent fail to dispose of the leftovers in the recommended way, which may be potentially hazardous to others, never mind hurting the environment.

That was found in an extensive Johns Hopkins Medicine study also showed that physicians were prescribing too many opioids, which has become well-known. The researchers said they highlighted in the report the need for more personalized pain management to avoid over prescribing opioids, and reduce risks linked to improperly stored opioids in the home.

Drug Accidents

The opioid crisis revolves around medications often prescribed for painkillers that have led to too many overdose deaths., as nearly everyone knows. From 1999 to 2016, more than 200,000 people died in the U.S. from overdoses related to prescription opioids.

Accidental drug overdoses are also too common in the U.S. From 2006 to 2011 unintentional poisonings from prescription opioids alone accounted for 138,603 trips to the emergency room, according to Consumer Reports. 

Too Much Prescribing, And Sending Home?

Various studies have shown that opioid painkillers are prescribed often after surgery, yet one of three patients who were evaluated in a Mayo Clinic study didn’t take a “single pill.”

“That showed us there’s an opportunity to prescribe a certain select group of patients zero opioids,” said Elizabeth Habermann, scientific director for surgical outcomes at the Mayo Clinic in a statement to HealthDay. Instead, patients should be able to take care of their pain with non-opioid medications, such as anti-inflammatory drugs that are considered over-the-counter, and not prescribed.

One of the problems is that physicians write too many prescriptions for patients to use at home after their hospitalization — simply because they don’t know exactly how much is needed, the researchers found.

“There’s a lot we don’t know about how much pain medication people really need or use after common operations,” said Mark Bicket, MD, an assistant professor of anesthesiology and critical care at Johns Hopkins University School of Medicine and the paper’s first author in the report published in the Journal of the American Medical Association Surgery in a press station.

The studies say that non-opioid drugs like acetaminophen and naproxen can often suffice for moderate post-operative pain. Prescribers should spend more time assessing post-operative pain and prescribe smaller amounts of opioids or alternatives as appropriate.

“If we can tailor the amount of opioids prescribed to the needs of the patients, we can ensure patients receive appropriate pain control after surgery yet reduce the number of extra oxycodone and other opioid tablets in many homes that are just waiting to be lost, sold, taken by error or accidentally discovered by a child,” says Bicket.

Some of the surgeries involved in the unused opioid medications were orthopedic, urology, Cesarean section, dental and general. The researchers said that 67 to 92 percent of the patients reported unused opioids. Some of the patients never filled their prescriptions, or did so and didn’t take the opioids.  Overall, 42 to 71 percent of prescribed pills were unused among more than 800 patients, according to the study.

Unused and Discarded Medications

The problem, too, is what happens to these drugs when they aren’t used? They wind up left homes, “inviting abuse and the potential for addiction,” according to the report.

In 2017, a national survey by Consumer Reports found that one-third of Americans hadn’t cleaned out a medicine cabinet in the past year, and nearly one-fifth hadn’t done so in five years. Occasionally, patients stopped using the drugs because they had adequate alternative pain control, or because of the opioid-related side effects.

When it came to storing the drugs, most patients took inadequate measures, studies showed.

Take the Proper Disposal Steps

When medicines are no longer needed, they should be disposed of promptly. Consumers and caregivers should remove expired, unwanted and unused medications from their homes as quickly as possible.

Experts say don’t leave medications in your medicine cabinet for a lengthy period or give them to friends or throw them away.

While medications are ready to be disposed, some types of prescription drugs can be disposed of in your household trash. But the Food and Drug Administration says opioids are too dangerous to go out with your garbage. Drugs may go into the wrong hands and be fatal.

In some cases, flushing unused opioid medication is OK when the medication cannot be safely or securely stored. That would include oxycodone, hydrocodone, fentanyl and many other opioids. – Joe Cantlupe

Also published in HCPnow.com

References:

Johns Hopkins Medicine. Study Adds to Evidence That Most Prescribed Opioid Pills Go Unused. 2017. Retrieved from: https://www.hopkinsmedicine.org/news/media/releases/study_adds_to_evidence_that_most_prescribed_opioid_pills_go_unused_

Dennis Thompson. HealthDay. Addictive Opioids Still Overprescribed After Surgery: Study. Retrieved from:   https://consumer.healthday.com/bone-and-joint-information-4/opioids-990/addictive-opioids-still-overprescribed-after-surgery-study-733107.html

U.S. Food and Drug Administration. Disposal of Unused Medicines: What You Should Know. Retrieved from: https://www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm

Consumer Reports. 2018. Retrieved from: https://www.washingtonpost.com/national/health-science/many-people-fail-to-get-rid-of-unneeded-and-expired-drugs/2018/07/20/0c87e024-65d6-11e8-a768-ed043e33f1dc_story.html?utm_term=.97b069f7190e

Mayo Clinic. 2018. How to use opioids safely.

https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-to-use-opioids-safely/art-20360373

Salynn Boyles. Study: Trash Old, Unused Drugs. WebMD. Retrieved from: https://www.webmd.com/women/news/20120518/study-trash-old-unused-drugs#1

With All This Going On…Are There Moments When You Are….Dare I Say It? …Bored (but continue reading)

One of a HealthDataBuzz series: Our Daily Lives — Things That Impact Our Everyday Health

It certainly can be a busy time, with work, kids, family and friends, commuting, to-do-lists and the constant barrage of news to absorb.

And I mean constant.

Amidst it all, there are simple tasks that have to be accomplished. Washing the dishes, throwing out the trash, cleaning the house or apartment, mowing the lawn or wondering when you won’t be stuck in traffic. And while doing those tasks, there is something else that may draw your attention: you are bored.

Bored. Let that sink in. During those times you are bored you may feel anxious about it, because we are so stimulated that you may feel guilty about not being engaged in something. You may decide then to quickly check emails on a smartphone, watch TV. The feeling of uncertainty may make you feel even more stressed.

Leading to Creativity

But oddly enough, there have been recent studies, books and other research that shows boredom may spur your inner creativity. Boredom actually encourages people to explore and push toward new ideas, in some respects because there is something lacking at the current time. In addition, it opens the door for daydreaming, and may add positive connections.

The recent studies contradict earlier reports from years ago that people who were bored had been prone to being easily frustrated by doing something challenging.

Manuosh Zomerodi, a journalist who has written a book on the issue, “Bored and Brilliant,” said in a Ted Talk

her conversations with neuroscientists and cognitive psychologists showed that when you are bored you ignite something in the brain – the “default mode.”  She describes what’s happening inside the brain like being on “autopilot.” While someone may be doing laundry, or walking, she says, “the brain actually takes the seeming down time to be really busy.”

When it appears you are doing mundane tasks, the brain is “really busy,” she says.

“Once you start daydreaming and allow your mind to really wander, you start thinking a little bit beyond the conscious, a little bit into the subconscious, which allows sort of different connections to take place,” said Zomerodi. “ It’s really awesome actually.”

Reseacher Andreas Elpidorou of the University of Louisville writes in a journal article that boredom is a helpful motivator for people, and possibly helps them to pursue other goals or a path they would normally go.

“Despite its impressive historical backing, the view that boredom is entirely negative should be rejected,” Elpidorou writes. “Boredom helps to restore the perception that one’s activities are meaningful or significant. It acts as a regulatory state that keeps one in line with one’s projects. Boredom is both a warning that we are not doing what we want to be doing and a ‘push’ that motivates us to motivates us to switch goals and projects.”

Researchers also found in several studies  the creative power of boredom. Boredom during passive activities, like reading reports or some drawn-out meetings, heightens the “daydreaming effect” on creativity, the more passive the boredom, the more likely the daydreaming and the more creative you could be afterward,” the researchers said.

So what should you do?

Well, if you find you are doing some boring tasks, do them first, but while you are accomplishing them, let your mind just  embrace dreaminess.

“So don’t feel guilty about a little boredom, let your mind wander, embrace the state of boredom because feelings and emotions highly affect the things you think about,” Zomerodi writes.

Don’t Overdue It

Like many things, if you get bored too often, that’s probably no good. If you are easily bored, there may be signs that you are more prone to depression, or engage in addictive behaviors, which may be a mistaken attempt to cope with their feelings.

REFERENCES:

HuffPost. Wellness. 2015. 8 Ways to Harness the Power of Boredom. Retrieved from: https://www.huffingtonpost.com/2015/01/18/boredom-hacks_n_6479468.html

Vivian Giang. Fast. Company. The Science Behind How Boredom Benefits Creative Thought. 2015. Retrieved from: https://www.fastcompany.com/3042046/the-science-behind-how-boredom-benefits-creative-thought

Manoush Zomorodi. TedTalk. 2017. Retrieved from: https://www.ted.com/talks/manoush_zomorodi_how_boredom_can_lead_to_your_most_brilliant_ideas#t-151506

Now I Know. The Power of Being Bored. 2017.

http://nowiknow.com/the-power-of-being-bored/

Eipidorou, A. The bright side of boredom. Frontiers in Psychology. 2014. https://doi.org/10.3389/fpsyg.2014.01245.

David Burkus. The Creative Benefits of Boredom. 2014. Harvard Business Review.  Retrieved from: https://hbr.org/2014/09/the-creative-benefits-of-boredom

A Fast Way To Health Problems? Fast Food

You know it: Too often, we are living in a buzz fast world.  And when it’s time to eat something, Americans often  opt for the quick way to try to satisfy hunger: now, ready, set: fast food.

Go to a nearby fast food establishment and you’ll see a line of cars outside as patrons wait to give orders, without stepping out of their cars. And many fast food restaurants are open day and night, 24 hours.  How many young adults have that craving for food at any hour? And where do they go? Fast food.

Over 36 percent of adults – 84.8 million – in the United States consume fast food on any given day, according to the Centers for Disease Control and Prevention’s National Center for Health Statistics data brief that covered 2013 to 2016. Among adults, a higher percentage of men, (37.9 percent) than women (35.4 percent) consumed fast foods.  That could include the usual staple of fare, such as burgers – and bigger burgers – and French fries and even larger fries, among other fried foods.

“Fast food is definitely a part of the American diet and has been associated with high caloric intake, and poor diet quality,” the CDC says in a new report. “There are many reasons why people go and get fast food: time, convenience, and price.”

Fast food, however, isn’t considered healthy because there is often too much sodium, calories, fat, cholesterol, and sugar associated with it. When too much fast food is eaten, it can be linked with an increased risk of obesity, Type 2 diabetes, heart disease and other health problems.  Some people also may want to avoid fast foods such as hamburgers or sandwiches, if they are trying to maintain a relatively low-carb diet.

The CDC issued its report because fast-food is so much a part of how Americans eat. “We focused on fast food for this report because fast food has played an important role in the American diet in recent decades,” said Cheryl Fryar, a health statistician at CDC and a first author of the report in a statement. “Fast food has been associated with poor diet and increased risk of obesity.”

Among adults who consumed fast food, the most commonly reported times for when they did so were lunch, (43.7 percent) and dinner, (42 percent) followed by breakfast, 22.7 percent, and snacks, 22.6 percent.

Men were more likely to eat fast food at lunch, and women as a snack.

Young People Like Fast Food – And the More Well-to-Do

In the CDC study, there are some interesting revelations. Mostly, younger people opt for fast foods – and that may be no surprise! – and those people with higher incomes eat more fast food, and that may be surprising.

    • The percentage of adults who consumed fast food decreased with age, the CDC said. While nearly 45 percent of those aged 20 to 39 were among the adults who consumed fast food on a given day, 37.7 percent aged 40 to 59, and 24.1 percent for those 60 and over. That age pattern was observed for both men and women.
    • The percentage of adults who consumed fast food increased with “increasing family income,” the CDC says, with more than 31 percent of lower income people, 36.4 percent of middle-income, and 42 percent of higher income adults consumed fast food on a given day.

Some healthy alternatives

Hungry consumers don’t need to be bogged down in simply fast food choices if they are in a hurry or on the run. There are various alternatives, including low fat cheese sticks, yogurt, cut vegetables, or fruits, such as bananas and grapes.

If you want that burger, maybe put aside the bun, which generates higher calories. And replace the fries or potatoes chips with salad or fruit. And ask for meat that is grilled, or without the skin.

Just Don’t….Light Up!

One of a HealthDataBuzz series: Our Daily Lives — Things That Impact Our Everyday Health

Check it out. Restaurants. No smoking. Big buildings. No smoking inside. Not many people, it seems, are taking quick puffs from a cigarette. When you drive on the highway, in the next lane of cars, not many windows are rolled down, to allow curls of smoke to go up. Indeed, tobacco control efforts have contributed to a decline in U.S. cigarette consumption by nearly 25 percent since 1968.

Decades of education and research reduced much of the smoking, and the impact is saving millions of lives.

The good news ends there.

Despite the enormous progress in reducing smoking, tobacco use is still the leading cause of preventable death in the U.S. and posses a terrible toll on families, businesses and government.

Despite the enormous progress in reducing smoking, tobacco use is still the leading cause of preventable death in the U.S. and posses a terrible toll on families, businesses and government.

Tobacco kills more than 480,000 people annually from their own smoking or exposure to second-hand smoke – “more than AIDs, alcohol, car accidents, illegal drugs, murders and suicides combined,” the government says.  About 15.5 percent of all adults, and 17.5 percent of males and 13.5 percent of females were current smokers in 2016.

One of the major problems is the addiction caused by the nicotine in cigarettes.

This week, pharmacologist Lynn Hull of the FDA Center for Tobacco Products, noted:

“Making all cigarettes minimally addictive could significantly reduce the morbidity and mortality caused by smoking,” she said, according Seeking Alpha.  It said “Hull seemed to indicate with her comments that the agency may be looking at implementing reduced nicotine standards as soon as 2020.”

Cigarette smoking impact

Cigarette smoking is seen as the greatest preventable cause of premature death in the U.S. In fact, cigarette smoking accounts for one out of five U.S. deaths: 87 percent of lung cancer deaths and at least 30 percent of all cancer deaths each year. People who quit smoking before age 50 reduce by half their risk of dying in the next 15 years. The World Health Organization estimates 1.27 billion tobacco users worldwide, and says that one billion people may die in this century if the global tobacco consumption remains at current levels. The problem doesn’t involve not only smoking, but also secondhand smoke – just being around smokers – that harm children and adults in homes, work and public places.

The smoking habit. 

 Smoking is a physical and psychological habit that is hard to erase. Withdrawal symptoms include irritability, fatigue, headache or a feeling like the flu. The big culprit is nicotine. Besides being highly addictive, nicotine has consistently been linked to being carcinogenic. There are many nicotine preparations that do not involve tobacco, but research shows they are still harmful.  There are e-cigarettes, e-hookahs, mods, vape pens, all nicotine based, nicotine gums, and patches, often marketed as remedies or alternatives to cigarette smoking,  but still pose a significant health risk. Too often, young people are attracted to these cigarette alternatives. One in six high school students reported using e-cigarettes in the past month.

“The overwhelming amount of death and disease attributable to tobacco is caused by addiction to cigarettes – the only legal consumer product that, when used as intended, will kill half of all long-term users,” FDA Commissioner Scott Gottlieb, MD, said in a statement. “Unless we change course, 5.6 million young people alive today will die prematurely later in life.”

Do you have the will?

The brain will try to make excuses to have you smoke again. Experts advise you to train your subconscious mind to prevent you from getting back to smoking.

Stay away from herbal cigarettes, experts say

Because many people are concerned about smoking “regular” cigarettes, some turn to “herbal” cigarettes, made of a mixture of different herbs that contain no tobacco or nicotine.  A study that examined the issue said, “our findings showed that herbal cigarettes did not deliver less carcinogens than regular cigarettes.” — Joe Cantlupe

REFERENCES:

Mishra, A, Chaturvedi, P, et al.Harmful effects of nicotine 2015. Indian Journal of Medical and Paediatric Oncology. 2015. 24-31. Doi: 10.4103/0971-5851.151771.

Kitikannakorn, N, Chalyakunapruk, et al. An overview of the evidences of herbals for smoking cessation 2013. Complementary Therapies in Medicine. Vo. 21, Issue 5, pages 557-564. 

Lee, H, and Lee, J. Effects of medicinal herb tea on the smoking cessation and reducing smoking withdrawal symptoms. 2005. American Journal of Chinese Medicine. 2005;33(1): 127-38.

Diane Joswick, L.Ac, MSOM. Quit Smoking with Acupuncture. From Acufinder.com .

https://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=119

https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/index.htm

E-cigarettes and lung health. American Lung Association From: http://www.lung.org/stop-smoking/smoking-facts/e-cigarettes-and-lung-health.html

Diane Joswick, L.Ac, MSOM. Quit Smoking with Acupuncture. From Acufinder.com .

https://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=119

https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/index.htm

E-cigarettes and lung health. American Lung Association From: http://www.lung.org/stop-smoking/smoking-facts/e-cigarettes-and-lung-health.html

Docs Blame Increasing Regulatory Burdens For “What’s Ailing” Their Practices

When the Medical Group Management Association recently asked its members about some of the regulatory burdens they’ve experienced, one question was about the Stark Law Anti-Kickback statute. Formally known as the Physician Self-Referral Act, it prevents doctors from referring patients in whom there are financial interests or investments.

The law itself appears cut-and-dried, though like many regulations, there are complexities attached. There were two slight extremes in MGMA’s  survey results: At least 15 percent of the MGMA’s 425 medical group practices who filled out its survey said they had no problem with the regulation, saying it was not burdensome. Yet, at least 32 percent said it was extremely burdensome.

Depending on someone’s view, the regulations involving the Stark Act may appear to be troubling – with at least one-third of the doctors seeing it that way.

But there’s another pressing issue that the results showed. Of all the questions about regulations that the MGMA posed, the one about the Stark Act showed a response that basically said:

Hey, this is an easy regulation.

Indeed, MGMA’s members found other regulations far – far – worse than the Stark Act.

Overall, the medical groups say that wasteful regulatory burdens are driving up too many costs and generating too much of their time that they say could be better spent on patient care. In some cases, the regulations continued to worsen over the past year.

Regulatory Issues

When asked in the survey about “how burdensome would you rate each of the following applicable regulatory issues,” the respondents were overwhelming in saying they were either “very or extremely burdensome:”

The worst — Medicare Quality Payment Program (MIPS/APMs) – 88 percent. MGMA officials said that “ranked as the most burdensome issue” and “little clinical benefit.”

Others:

  • Prior Authorization – 82 percent.
  • Lack of electronic health record “interoperability.”– 80 percent.
  • Government EHR requirements – 77 percent.
  • Audits and appeals – 68 percent.

 Survey Findings

The findings were included in the so-called 2018 Regulatory Burden Survey at MGMA18, the annual conference. MGMA includes 40,000 medical practice administrators, executives and healthcare leaders. The organization says it represents more than 12,500 organizations that deliver almost half of the healthcare in the U.S.

  • A vast majority – 86 percent – of respondents “reported the overall regulatory burden on their medical practices has increased over the past 12 months,” MGMA said. Even more respondents – 94 percent – agree that a “reduction in regulatory burden” would allow their practices to reallocate resources toward patient care, according to the organization.

“This precipitous increase in regulatory burden over the past 12 months should alarm policymakers,” said Anders Gilberg, senior vice president of federal affairs. “MGMA’s survey provides valuable insight into what’s ailing medical practices.”

What’s ahead?

As healthcare moves toward value-based payment, a “staggering 90 percent” of those surveyed reported that it resulted regulatory burden increases on their practices, MGMA said. And 76 percent said it did not improve the quality of care delivered to patients.

As far as the doctors see it, the regulations rumble ahead.

Gilberg has hope. He says MGMA’s findings “will enable HHS (Health and Human Services) to refocus and redouble its efforts to create meaningful regulatory relief for physician practices.” — Joe Cantlupe

 

Study: Poring Cold Water On Your Beer (or Wine…) And Bingers?….Slow Down

While there have been conflicting reports over the years about how much alcohol someone could drink and maintain good health, a recent study pores cold water on that: No alcohol is good for you, it says.

That could be an eye-opener for a lot of people. At least one third of the people around the world drink alcohol at some time, for social events, or celebrations, or part of a dining experience, whether having beer or wine or liquor.

The latest study  in Lancet says there is growing evidence that people should not drink alcohol at all because it is unhealthy. Alcohol contributes to 2.8 million deaths a year worldwide, and is the leading risk factor for disease and premature death in men and women between the ages of 15 and 49 in 2016, the study says.

The study contradicts previous reports, even touted by major U.S. organizations, in which public officials said moderate drinking, such as having two per day for men, or one for women, would be ok. Such advice is included in the Dietary Guidelines for Americans, and supported by the American Heart Association and the American Cancer Society. The Dietary Guidelines for Americans also do not recommend that individuals who do not drink alcohol start drinking for any reason.

What is the risk? 

For women, low-risk drinking is defined as no more than 3 drinks on any single day and no more than seven drinks per week, according to the U.S. government. For men, it is defined as no more than four  drinks on any single day, and no more than 14 drinks per week.

The latest Lancet study about drinking not only upsets many habits but millions of dollars in industry.  The analysis included those of hundreds of studies about drinking from 1990 to 2016.

According to the 2015 National Survey on Drug Use and Health, 86.4 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime: 70.1 percent reported that they drank in the past year; 56 percent reported that they drank in the past month.

An estimated 88,000 people die from alcohol-related causes annually, making alcohol the third leading preventable cause of death in the United States. The first is tobacco, and the second is poor diet and physical inactivity, according to the  National Institute on Alcohol Abuse and Alcoholism. 

Accidents and Disease

The deaths stem from alcohol-related cancer and cardiovascular diseases, infectious diseases, such as tuberculosis, intentional injury such as violence and self-harm and traffic accidents and other unintentional injuries such as drowning and fires. Alcohol consumption is also associated with a variety of short and long term health risks, including motor vehicle crashes, violence, sexual risk behaviors, high blood pressure and various cancers. The risk of harm increases as the amount of alcohol you drink, researchers say.

 Surprising Findings

Among the reports for years that said moderate drinking was OK, included studies that said alcohol could even protect against heart disease, but the latest study shows that it is outweighed by the problems it causes.

“The most surprising finding was that even small amounts of alcohol use contribute to health issues globally. We’re used to hearing that a drink or two a day is fine, but the evidence is evidence,” says senior study author Emmanuela Gakidou, professor of the University of Washington Institute for Health Metrics and Evaluation.

Due to their population sizes, China, India and Russia led the world in total number of alcohol related deaths in men and women. The U.S. ranked fifth among men and seven among women on that list, the UK ranked 21st for men and ninth for women.

Binge Drinking

For too many people in the U.S., they don’t drink moderate amounts of alcohol, but simply drink too much. A separate Centers for Disease Control and Prevention study shows increased health problems such as injuries, violence, liver diseases and cancer, are linked to “binge” drinking.

Binge drinking means having five or more drinks on an occasion for men, and four or more drinks on an occasion for women, during a two-hour period. CDC researchers found that one in six or 37 million people adults binge drink about once a week, consuming an average of seven drinks per binge.

In a March study, U.S adults consumed more than 17 billion binge drinks in 2015 or about 470 binge drinks per drinker, according to the CDC.

“This study shows that binge drinkers are consuming a huge number of drinks per year, greatly increasing their chances of harming themselves and others,” said Study coauthor Robert Brewer, MD, MSPH, lead researcher in CDCs alcohol program.

About two-thirds of people – 66.6 percent – age 12 and older reported in 2014 that they drank alcohol within the past 12 months, with 6.4 percent meeting the criteria for an alcohol use disorder, according to SAMSHA’s National Survey on Drug Use and Health (NSDUH) – 2014.

Alcoholism

 study published in JAMA Psychiatry this month found that the rate of alcohol use disorder, or “alcoholism,” rose by 49 percent in the first decade of the 2000s. That means one in eight American adults, or 12.7 percent of the U.S. population. — Joe Cantlupe

REFERENCES:

Wood, A, Kaptoge, Butterworth, et al. Risk threshold for alcohol consumption: combined analysis of individual -participant data for 599 912 current drinkers in 83 prospective studies. The Lancet. 2018. Vol. 391. Issue 10129, P1513-1523, April 14, 2018. DOI: /10.1016/SO140-6736(1)30134-

Medicine Net. Alcohol Helps Kill 2.8 Million People Globally Each Year. Retrieved from:

https://www.medicinenet.com/script/main/art.asp?articlekey=214800&ecd=mnl_day_082418

Sandee LaMotte. CNN. 2018. No amount of alcohol is good for your overall health, global study says. Retrieved from: https://www.cnn.com/2018/08/23/health/global-alcohol-study/index.html

Jamie Ducharme. Time. 2018. A New Study Says Any Amount of Drinking Is Bad for You. Here’s What Experts Say. Retrieved from: http://time.com/5376552/how-much-alcohol-to-drink-study/

Fact Sheets-Moderate Drinking. Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm

CDC Newsroom: During binges, U.S. adults have 17 billion drinks a year. Retrieved from:

https://www.cdc.gov/media/releases/2018/p0316-binge-drinking.html

https://www.pacificcollege.edu/news/blog/2015/03/15/rough-road-alcoholism-and-how-chinese-medicine-can-help%E2%80%A6

 Substance Abuse and Mental Health Administration. Alcohol, Tobacco and Other Drugs. Retrieved from: https://www.samhsa.gov/atod

National Institute on Alcohol Abuse and Alcoholism: Alcohol Facts and Statistics. Retrieved from: https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics

https://jamanetwork.com/journals/jamapsychiatry

The National Academies of Sciences: “Unacceptable” Food Waste in U.S.

In millions of households, restaurants and other locations across the United States, food is discarded, lost or wasted.

Elsewhere in the country, about one in eight people struggle with hunger and simply want something to eat, even though the world is producing enough food.

The dichotomy is great. The National Academies of Sciences  states that more than one third of the food produced in the U.S. is unconsumed – an “unacceptable loss of food and nutrients” at a time of heightened global food demand. That one-third amount of food lost or wasted applies to the world as well.

There are fruits and vegetables, plus roots and tubers, seeds, meat and root crops wasted or lost. And that doesn’t just occur from kitchen to trash. The problem “extends throughout the supply chain, from the initial agricultural production to final household consumption,” and amounts to 1.3 billion tons a year, says Food and Agriculture Organization of the United Nations. 

Food Loss and Waste

There’s a difference between food loss and food waste. According to the FAO, bananas that fall off a truck, for instance, is considered food loss. But if a food is fit for human consumption but is not eaten, that’s waste.

Those food losses and waste are among the growing food challenges, never mind the obstacles to get food at all: weather, floods, and drought.

Looking to the Future

But the NAS is looking beyond the natural into the intellectual space: the need for greater advances that uses data sciences, technology, behavioral sciences, and economics, it says.

The NAS identifies what it calls the most promising scientific breakthroughs that are possible to achieve by 2030 that, it said, would increase U.S. food and agricultural industry’s sustainability, competitiveness and resilience.

Recommendations

NAS envisions and calls for scenarios in which soil and crop sensors could provide continuous data that feed and alert a farmer about moisture content not only for an area but for a specific group of plants, “eliminating the need” to irrigate an entire field. It foresees gene editing to accelerate breeding in microbes, plants and animals, or crops that could be effectively modified to improve taste and nutritional value.  Gene editing refers to a technique in which researchers can control traits of certain plants by removing some DNA.

The country, and the world, has no choice but to promptly re-examine and step up its innovations to maintain a food supply, as NAS sees it.

Need Changes

“In the coming decade, the stresses on the U.S. food agricultural enterprise won’t be solved by business as usual – either in the field or in our current research efforts,” said Susan Wessler, Neil and Rochelle Campbell Presidential Chair for Innovations in Science Education, and co-chair of the committee that conducted the study and wrote the recent report.

High Technology

The NAS says developing highly sensitive, field deployable sensors and biosensors will enable rapid detection and monitoring capabilities across various food and agricultural disciplines.

Applying integrated data sciences, software tools and system models will enable advanced analytics for managing the food and agricultural system, the NAS says. NAS officials call for establishing an initiative to exploit the use of genomics and precision breeding to genetically improve traits of agriculturally important organisms.

“Understanding the relevance of the microbiome to agriculture and harnessing the knowledge will improve crop production, transform feed efficiency and increase resilience to stress and disease,” the NAS says.  Microbiome refers to the micro-organisms in the living environment.

Through gene editing, and other techniques, steps can be made to thwart some of the food loss and waste.

“Incorporating essential micronutrients or other quality-related traits in crops through gene-editing tools offers an opportunity to increase food quality and shelf life, enhance nutrition and decrease food loss and food waste,” says NAS’s  pre-publication report. 

Current Gaps

While there have been advances in agriculture techniques and through technology, much more needs to be done, NAS says.

“The food and agricultural system collects an enormous amount of data, but has not had the right tools to use it effectively,” the report says. “Data generated in research laboratories and in the field have been maintained in an unconnected manner.”

Evolving sensing technology also is important and not quite where it should be right now, it says.  Sensing technology refers to the practice of using a device to measure different environmental elements, ranging from heat to motion to light.

“Sensing technology has been used widely in food and agriculture to provide point measurements for a characteristic of interest, such as temperature, but the ability to continuously monitor several characteristics at once is the key to understanding both what is happening in the target system and how it is occurring,” according to the report.

NAS recommends initiatives that should be created “to more effectively develop and employ sensing technologies across all areas of food and agriculture.”

The committee’s other co-chair, John Floros, president of New Mexico State University, said, “Realizing the vision this report recommends will require a holistic approach that combines scientific discovery, technological innovation and incentives to revolutionize the way we approach greater food security and human and environmental health.”

The group concedes that it may be necessary for significant public and private investment to accomplish the plans.

“The food system of tomorrow will depend on how well we are able to prepare for resiliency today and how well we are able to build our capacity for the future,” the report says. — Joe Cantlupe

(from my piece at HCPnow)

REFERENCES:

http://www.fao.org/food-loss-and-food-waste/en/

https://www.fhfh.org/hunger-in-america.html?gclid=CjwKCAjwns_bBRBCEiwA7AVGHkEyRtYlPUcL_PfLAOFKYdocSChpLIl4NNSb8-jNjcWc1wZ9vSxrSxoC76kQAvD_BwE

http://www.nasonline.org/news-and-multimedia/

http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=25059