• Health

    The Obesity Paradox: Weigh More and Live Longer

    Person weighing themselves on scale

    The health blogosphere is awash with the new study that says overweight people may indeed live longer.

    But, wait.

    The counterintuitive findings that people who are overweight live longer, published today in the Journal of the American Medical Association, couldn’t have been more perfectly timed, coming as it has right when people are resolving to be healthier — which involves, for many, losing weight.

    In many places where this story has been picked up, including The New York Times, The Wall Street Journal, and Time, the implication seems to be that the push to get people down to a “healthy” weight has been overblown.

    But that being overweight is associated with increased lifespan isn’t new. It’s called the “obesity paradox,” and studies documenting it have lead to widespread speculation about the potential “protective benefits” of excess body fat.

    For some health advocates, the implication is downright offensive. Walter Willett of the Harvard School of Public Health, for example, lost his cool this morning on NPR, declaring, “This study is really a pile of rubbish and no one should waste their time reading it.”

    But the study’s author, Katherine Flegal of the Centers for Disease Control and Prevention, mounted a solid defense: “It’s statistically significant.” Those three words carry weight — if an association has been found to be significant, it tells us that if nothing else, we need to acknowledge that the results are in some way legitimate and warrant our attention.

    The findings are without doubt interesting, which on its own makes the study worth reading. The problem is that despite the grandness of the meta-analysis — it takes into account over 3 million people! — it still has an extremely limited scope. It looks at BMI, and only BMI, in relation to death, regardless of cause. It’s impossible to report on its baseline conclusion without taking into account substantial caveats.

    Just remember your weight is only one metric to your overall health.

    It is very important, and do not think you can slack because of this study. But, do keep the context in mind.

  • Health,  Smoking

    American Smoking Sinks to One in Five – Tied for All-Time Low

    Gallup Poll on American Smoking frequencyAccording to the latest Gallup poll.

    The prevalence of smoking in the U.S. is currently tied for the all-time low in Gallup trends dating from 1944, after a long, slow decline in smoking rates since the 1970s. Currently, 20% of adults say they smoked a cigarette “in the past week,” down from 22% last year but matching the 2009 level.

    Gallup recorded the sharpest decline in smoking between the early 1970s and late 1980s, with the rate dropping roughly 15 percentage points during this period. Smoking leveled off at about 25% for much of the 1990s, but has since descended slowly, if unevenly, to 20%. The latest results are from Gallup’s annual Consumption Habits poll, conducted July 9-12, and are in line with the smoking rate the Gallup-Healthways Well-Being Index finds in daily surveys of Americans.

    According to an analysis of Gallup trends since 2001 — combining data from Gallup’s Consumption Habits polls into three periods, 2001-2005, 2006-2010, and 2011-2012 — the most recent decline in smoking has not occurred across the board, but is seen mainly among certain groups. Smoking rates have fallen particularly sharply among young adults — those 18 to 29 — as well as among college non-graduates and those living in the East and West.

    Great news as I am reminded what my parents told me over fifty years ago.

    Smoking is a dirty, nasty habit – don’t ever start because it will be hard to quit.

    Face it smoking is “unhealthy” and “addictive” behavior.

    In the next decades, let’s hope the numbers of Americans who smoke drop even further.

  • Methamphetamine,  Mexican Drug Cartels

    Update: Methamphetamine Lab Cleanup is Big Environmental Business

    Methamphetamine Lab

    Good for the businesses, but I would really like to put them into another line of work.

    Methamphetamine labs are more than just dangerous and illegal. They leave a mess  an environmental hazard that, according to Indiana law, must be cleaned up.

    And it takes a special process, certification and inspectors who scour the property in full-gear Hazmat suits and respirators to do the dirty work.

    Welcome to the world of meth lab cleanup companies, a growing and profitable business.

    Indiana, which ranks in the top five for meth production, has 22 companies certified by the Indiana Department of Environmental Management to decontaminate properties.

    And business is, um, booming.

    “It’s such a growing epidemic,” said Donetta Held, CEO of Crisis Cleaning, a Bloomfield, Ind., company. “It’s everywhere — from a high-dollar house in downtown Indianapolis to these rural counties.”

    Held’s company has already done 25 meth cleanups this year, in less than three months. That’s already half as many as the company completed last year.

    “Some people say there is not as much meth or meth has gone down,” Held said. “Um, no. I don’t see that at all.”

    Neither do police, which have seen a steady growth in meth lab seizures in the past three years. In 2009, law enforcement shut down 1,364 labs. In 2010, 1,395 labs were seized. Last year, that number climbed to 1,437.

    That has meant lots of revenue for meth cleanup companies. Most companies charge about $2 to $3 per square foot to do a cleanup. Depending on the size of the property and how many rooms need to be decontaminated, the cost can range from $5,000 to $10,000.

    And, now, who is saying that the states should not require a prescription for pseudoephedrine?

    Well, it is the drug company that makes allergy and cold pills that contain the meth precursor chemicals. They are afraid of reduced sales.

    Most of these labs would go away with NO precursor chemicals with which to make methamphetamine. So, why the delay?

    A solution is easy – limit the precursor chemicals and secure the Mexican border from the drug cartels.

    Update:

    Here is a post from The Economist about the Global Methamphetamine business.

    STORMING a ranch south of the city of Guadalajara, Mexican soldiers last month made one of the biggest drug busts in history. They found 15 tonnes of the banned stimulant methamphetamine, which in America retails for more than $100 per gram, seven tonnes of chemicals used to make it, and a laboratory. The manufacturers had fled.

    This was the latest sign that meth, once primarily a home-cooked drug, has become a mass-produced one. Unlike cocaine and heroin, imported from the limited regions where coca and poppy are cultivated, meth can be made anywhere. In most countries the ingredients, principally ephedrine and pseudoephedrine, can be bought as medicine for colds. Cooking them is dangerous. But meth is so addictive that the risk of blowing off your hands is little deterrent: in 2010 the authorities discovered 6,768 makeshift labs in America.

    Read it all.

  • Methamphetamine

    Methamphetamine Lab Cleanup is Big Environmental Business

    Methamphetamine Lab

    Good for the businesses, but I would really like to put them into another line of work.

    Methamphetamine labs are more than just dangerous and illegal. They leave a mess — an environmental hazard that, according to Indiana law, must be cleaned up.

    And it takes a special process, certification and inspectors who scour the property in full-gear Hazmat suits and respirators to do the dirty work.

    Welcome to the world of meth lab cleanup companies, a growing and profitable business.

    Indiana, which ranks in the top five for meth production, has 22 companies certified by the Indiana Department of Environmental Management to decontaminate properties.

    And business is, um, booming.

    “It’s such a growing epidemic,” said Donetta Held, CEO of Crisis Cleaning, a Bloomfield, Ind., company. “It’s everywhere — from a high-dollar house in downtown Indianapolis to these rural counties.”

    Held’s company has already done 25 meth cleanups this year, in less than three months. That’s already half as many as the company completed last year.

    “Some people say there is not as much meth or meth has gone down,” Held said. “Um, no. I don’t see that at all.”

    Neither do police, which have seen a steady growth in meth lab seizures in the past three years. In 2009, law enforcement shut down 1,364 labs. In 2010, 1,395 labs were seized. Last year, that number climbed to 1,437.

    That has meant lots of revenue for meth cleanup companies. Most companies charge about $2 to $3 per square foot to do a cleanup. Depending on the size of the property and how many rooms need to be decontaminated, the cost can range from $5,000 to $10,000.

    And, now, who is saying that the states should not require a prescription for pseudoephedrine?

    Well, it is the drug company that makes allergy and cold pills that contain the meth precursor chemicals. They are afraid of reduced sales.

    Most of these labs would go away with NO precursor chemicals with which to make methamphetamine. So, why the delay?

    A solution is easy – limit the precursor chemicals and secure the Mexican border from the drug cartels.

  • Dentistry,  Methamphetamine

    Stratfor on Methamphetamine Production in Mexico

    Meth Mouth – the effect of Methamphetamine use

    Stratfor has an excellent piece on the production of methamphetamine in Mexico and Central America, production techniques and precursor chemicals.

    Based on evidence obtained from raided laboratories in the United States and Mexico, it appears there are two primary methods of methamphetamine production in those countries: the phenyl-2-propanone (P2P) method and the reduction method.

    Sometimes referred to as “building up,” P2P is considered the more difficult of the two methods. It requires more chemicals and materials and more sophisticated chemistry. In fact, the chemical process is so technical and complex that it requires several days to complete, necessitating a skillset akin to that of licit chemists. It also entails a purification step that increases the potency of the final product. While P2P produces a more potent final product, the method is subject to the competence of the manufacturers and the quality of the chemicals being used. P2P is the method most employed by Mexican criminal organizations because its two primary requisite precursor chemicals, methylamine and phenyl acetic acid, are loosely regulated in Mexico.

    Reduction is the manufacturing method primarily used in Asia and the United States. This method involves mixing ephedrine or pseudoephedrine with a few easily attainable precursor chemicals. With reduction, a manufacturer can cook a small volume of meth (a few ounces) in as few as eight hours. Indeed, the key difference between the manufacturing methods is that reduction requires less time and less sophistication than P2P, and ultimately it produces an inferior product.

    It should be noted that the manufacturing method has nothing to do with production scale. Either method can be used to cook large or small quantities of the drug. It can be manufactured in a hotel, apartment, home, car trunk or backpack. However, to produce meth on an industrial scale, a manufacturer would need more space. Past seizures have taken place in large warehouses (around 1,600 square meters, or 17,000 square feet), small ranches (6-40 hectares, or 15-100 acres) or even mid-sized homes.

    Cost of production also differentiates the two methods. While meth is more cheaply rendered by reduction, both methods are extremely cost effective. Depending on the price of chemicals used — determined by the quantity of chemicals purchased and the legitimacy of the supplier — the cost of manufacturing 1 kilogram (2.2 pounds) of meth comes to anywhere between $150 and $4,000. The use of methylamine, which is highly regulated, expensive and, as stated, only used in the P2P method, is the key factor in this price range; substituting methylamine with a mixture of methanol and anhydrous ammonia drastically reduces the cost. According to the U.S. Department of Justice’s National Illicit Drug Prices Mid-Year 2009 report, the wholesale market price for meth is $19,720 per kilogram while its street value is $87,717 per kilogram. Needless to say, this is a huge markup.

    But it is not necessarily the overall cost that determines the production method of Mexican criminal organizations, or any meth manufacturer. Rather, it is the availability of precursor chemicals that matters. Mexican manufacturers could save vast sums of money by exclusively using the cheaper reduction method. But the Mexican government’s strict regulation of ephedrine and pseudoephedrine compels criminal organizations to use other methods, such as P2P, that require less-regulated precursor chemicals.

    Read all of the report and then you can watch this video on the effects of methamphetamine on the mouth. The American Dental Association authored the video.

  • Dentistry,  Methamphetamine

    Does Saliva Quality Play an Important Role in Meth Mouth?

    The effects of Methamphetamine on the Teeth – Meth Mouth

    Perhaps, according to a new study. Here is the abstract.

    Methamphetamine abuse and oral health: A pilot study of “meth mouth”

    Michele C. Ravenel, DMD/Carlos F. Salinas, DDS/Nicole M. Marlow, MS/Elizabeth H. Slate, PhD/Zachary P. Evans, PhD/Peter M. Miller, PhD

    Abuse of methamphetamine (meth), a potent central nervous system stimulant, has been associated with significant dental disease. Current descriptions of “meth mouth” are limited in their scope and fail to illuminate the potential pathogenic mechanisms of meth for oral disease. The purpose of this pilot study was to characterize the oral health of subjects with a history of meth abuse as compared to nonabusing control subjects. A total of 28 meth abusers and 16 control subjects were enrolled. Interviews and surveys regarding meth abuse, dental history, oral hygiene, and diet were collected. A comprehensive oral cavity examination including salivary characterization was completed. We observed significantly higher rates of decayed surfaces, missing teeth, tooth wear, plaque, and calculus among meth abusers. No significant difference in salivary flow rates were noted, yet results showed significant trends for lower pH and decreased buffering capacity. These findings suggest that salivary quality may play a more important role in meth mouth than previously considered. Salivary analysis may be useful when managing a dental patient with history of methamphetamine abuse. (Quintessence Int 2012;43:229–237)

    So, what causes Meth Mouth?

    Dr. Bicuspid has an excellent post here.

    The ADA lists the suspected causes as dry mouth, poor oral hygiene, frequent consumption of sugary and carbonated drinks, tooth grinding and clenching, and possibly the acidic nature of MA itself.

    In a study in ISRN Dentistry (June 26, 2011), street samples of MA had pH levels from 3.02 to 7.03, with 72% of samples below the critical pH point of 5.6, i.e. able to cause significant damage to tooth enamel if abused by a route that brings MA into contact with the oral cavity.

    Although this would seem to indicate that injecting MA rather than smoking or snorting it may lead to less enamel damage, this hasn’t been borne out by the research. Researchers at the University of California, Los Angeles (UCLA) reported in the Journal of the American Dental Association that, among abusers of MA, IV users actually had a higher prevalence of oral disease and missing teeth than those who smoked MA, probably due to more advanced addiction and greater self-neglect.

    “Those who use MA may make the transition from noninjecting drug use to injecting drug use, as their dependence on MA becomes more severe,” Vivek Shetty, DDS, DMD, professor of oral and maxillofacial surgery at the UCLA School of Dentistry and lead author on the JADA study (March 2010, Vol. 141:3, pp. 307-318), told DrBicuspid.com.

    “The injected substance has almost 100% bioavailability, and the onset of the drug high is fairly rapid, generally 15 to 30 seconds.”

    It is interesting that IV Meth users have more dental disease than those that smoke the drug. One would think that the constant heat and dehydration of the oral tissues would contribute to more dental destruction. But, perhaps, the more intense rush from IV drug use leads to more self-neglect.

    In any case, salivary analysis of patients may give dentists a better idea of the mechanism of addiction and how to combat it at an early stage.

    Watch below an embedded video below from a dentist colleague, Dr. Mitchell A. Goodis, DDS in Northern California and his interview of the many methamphetamine user patients, whom he has treated.

  • Consumer Healthcare Products Association,  Methamphetamine

    Kentucky to Settle for Compromise Methamphetamine Legislation?

    Methamorphosis as a result of chronic Methamphetamine abuse

    Looks like methamphetaime making precurors pseudoephedrine and ephedrine’s best friend, the Consumer Healthcare Products Association (CHPA) is working its lobbying magic again.

    A compromise bill aimed at curbing methamphetamine production in Kentucky would place further restrictions on the sales of over-the-counter cold and allergy medicines containing pseudoephedrine.

    Last week, Sen. Robert Stivers, R-Manchester, withdrew a bill that had made it to the Senate floor. That bill would have required a prescription for all medicines containing pseudoephedrine, except those in liquid or gelcap form.

    The new bill would only require a prescription for the medicines after a patient has purchased 3.6 grams per month and a maximum of 15 grams annually. Gelcaps and liquids would still be excluded.

    The bill would also prohibit anyone convicted of a meth-related offense from buying the drugs without a prescription for five years.

    Stivers said the new bill, Senate Bill 3, gives people who use the medications “adequate opportunity without incurring medical expenses or the cost of a prescription to access these on a monthly basis and an annual basis.”

    Currently, purchases are limited to 9 grams per month and 120 grams annually.

    Legislation aimed at requiring a prescription has been opposed by several senators and the Consumer Healthcare Products Association, an industry group that has spent hundreds of thousands of dollars on advertising and lobbying against the bills presented by Stivers.

    Yet, Kentucky had 1,200 Meth Labs discovered in 2011, which is an increased number from the previous year.

    This is all about money folks and just for a few drug manufacturers. I detailed the story earlier here.

    Kentucky like other states should simply require a prescription for pseudoephedrine and be done with the hometown or local Meth Lab. Then, law enforcement can concentrate on the importation of methamphetamine from Mexico.

    These compromise bills, including electronic tracking systems are just BS and not as effective.

    Who are the drug companies trying to fool?

  • Cocaine,  Methamphetamine,  United States Border Patrol

    Methamphetamine Watch: $2.55 Million Worth of Meth and Cocaine Seized in California – Smuugled in From Mexico

    Photos courtesy of the U.S. Border Patrol

    Another day and more Mexican smuggling of methamphetamine and cocaine.

    Two people were arrested Friday by U.S. Border Patrol agents on suspicion of smuggling more than $2.55 million worth of illegal narcotics.

    The arrests, announced Monday, were made at the Highway 86 Border Patrol Checkpoint near the Salton Sea.

    According to the U.S. Border Patrol, agents arrested a 40-year-old woman after a dog team searched the 2004 Chevrolet Malibu the Mexican national was driving.

    They found a hidden compartment holding 11 packages of cocaine, weighing about 27 pounds, with a street value of about $880,000.

    A 42-year-old man was arrested about 10:45 p.m. after a dog team searched the 2004 Honda Accord the Mexican national was driving.

    Agents found 42 vacuum-sealed packages of methamphetamine hidden in several compartments in the car.

    More poison for Californians and probably other Americans.

    Good work on the part of the United States Border Patrol.

    The United States needs to lock down the Mexican border.

  • Methamphetamine,  Mexican Drug Cartels

    Mexican Methamphetamine Replacing American Domestic Supply



    And, the methamphetamine is being manufactured via a different process since Mexico has banned the sale of ephedrine and pseudoephedrince. The precursorsfrom which the Mexican meth is made have been banned in the United States since the 1980’s.

    Seizures of methamphetamine at the Laredo customs district — the nation’s largest inland port — are on pace this fiscal year to surpass last year’s total by about 60 percent, reaching an expected total of about 1,650 pounds.

    The statistic supports the theory that Mexican cartels are increasingly supplying the heavily addictive narcotic in the U.S., replacing domestic meth labs that were prevalent in rural areas only a few years ago. And analysts say that the ease with which meth can be produced in Mexico could help spark major changes in the bloody turf war between drug cartels.

    Program directors in Laredo’s treatment centers have said the heavily addictive narcotic doesn’t appear to be staying in the area, as meth addicts aren’t filing in for treatment in greater numbers.

    But researchers caution that demand is increasing away from the border and that Mexican gangs are becoming experts at cooking a cheap and highly potent version of the drug.

    “The Mexicans have moved to an old recipe that existed in the ’70s and ’80s that is called P2P,” said Jane C. Maxwell, a senior research scientist at the Addiction Research Institute at the Center for Social Work Research at the University of Texas at Austin.

    “It uses precursors that have been banned in the U.S. since the 1980s, but the Mexicans have taken up making it,” Maxwell said of ingredients — including a substance called propanone — used to make the drug. “They are making it in mass quantities, and they are damn good chemists.”

    Methamphetamine manufacturing is like a cockroach. Snuff it out in one area and it springs up some place else.

    Is there any wonder why the border with Mexico has to be secured?

    While the amount of meth produced, shipped and used pales in comparison with the produced amounts of marijuana, cocaine and heroin — the leading cash generators for Mexican cartels — the street value of methamphetamine proves it has potential to continue being a significant revenue source for criminal groups. In 2011 a pound of meth was valued at $11,000 to $15,000 in Brownsville and $20,000 to $25,000 in San Antonio.

    Because of that economic potential — and because it can be produced domestically and year-round — analysts are positing that meth could become responsible for a turning point in the wars between Mexican cartels.

  • Methamphetamine

    The Coming Legislative War Over the Oklahoma Methamphetamine Bill

    Methamphetamine Lab Incidents, 2004-2010

    You know how I feel about the issue – I favor requiring tablet form of pseudoephedrine being a prescription only drug. Here is a story about the State of Okalahoma.

    Oklahoma authorities have been at the forefront of the nation’s battle against methamphetamine, but they will soon have a tough new opponent: a politically connected, well-heeled pharmaceutical industry.

    At issue is a proposal to require a prescription for certain cold and allergy tablets containing pseudoephedrine. Police and prosecutors say the measure is essential for curbing an out-of-control meth trade. Drug companies and their lobbyists are eager to keep pills such as Claritin-D and Advil Cold and Sinus on store shelves.

    There has been plenty of evidence that Oregon has had great success over the past five years since they have required a doctor’s prescription for pseudoephedrine.

    Five years ago, Oregon became the first state to require a prescription for products containing pseudoephedrine — a step that authorities say was effective. Since then, the state has seen a 96 percent reduction in meth-lab incidents, a 32 percent drop in meth arrests and a 35 percent reduction in meth-related emergency room visits and health care costs.

    In 2008, two years after the law took effect, the state experienced the nation’s largest crime rate decrease, said Rob Bovett, a district attorney in Lincoln County, Ore.

    Mississippi is the only other state to impose a similar restriction, and it also has seen a tremendous drop in the number of meth labs.

    “If you see a reduction between 10 and 15 percent, that’s a big deal, and we’re between 60 and 70 percent. And it almost happened overnight,’’ said Marshall Fisher, director of the Mississippi Bureau of Narcotics.

    Oklahoma should pass a prescription only law. The inconvenience to a few allergy sufferers is NOTHING compared to the devastation of this drug on the health and welfare of its citizens. Besides the Oklahoma law only applies to the tablet form of pseudoephedrine. Gel caps and liquid would still be available over the counter.

    But, the pharmaceutical companies will wage a war against the legislation because it is all about the money and profits.

    Oklahoma legislators should weigh the cost/benefits carefully.

    Methamorphosis as a result of chronic Methamphetamine abuse