Monday, March 29, 2010

Headline: "Most kids don't drink. "Oh, wait: not alarmist enuff...

"Most kids don't drink, and portion of drinkers drops every year;" See Figure

3.6. Oh, wait: not alarmist enuff: "28% of U.S. Kids Drank Alcohol in Past

Month." OK, that's better.





http://www.nlm.nih.gov/medlineplus/news/fullstory_96861.html











"Most kids don't drink, and portion of drinkers drops every year;" See Figure

3.6. Oh, wait: not alarmist enuff: "28% of U.S. Kids Drank Alcohol in Past

Month." OK, that's better.





http://oas.samhsa.gov/nsduh/2k8nsduh/2k8Results.cfm#Fig3-1

---figure 3.6...

..or any such report.









How will all of us health experts and researchers and psychologists get public

support if we cannot prove that some catastrophe is afoot?



Public Health Crisis I tell ya!!! Plus: look at that poor "kid:" pooring red

wine into a container that is obviously not a red wine glass! The Horror!





Without the Public Health Crisis alarmism, how can we air bold statements such

as this, " "Underage drinking is a national crisis putting the lives of

millions of Americans at risk as well as the futures of many of our youth,"

agency administrator Pamela S. Hyde said..."



Well, we thought about this: "Public health, education, and law enforcement

efforts aimed at reducing teen alcohol use are working."



But it just did not have the zing to it that "28% of U.S. Kids Drank Alcohol

in Past Month" has.



Who are these kids?





They are adults.





They are from the ages of 18 to 20. In most states, a person becomes a legal

adult at the age of 18.



I am not arguing here for or against a drinking age other than 21.



What I am noting is that the term "kids" does not apply to a legal adult.



Unless you want to create a sense of panic amongst the general public.



We don't say, "A thousand kids were just sent into a war zone last week,"

leaving the reader to note in the fine print that these were legal adults in

the armed forces, fighting as armed forces do.



well, some people do. Some don't like 18 yr old to 20 yr old kids being sent

into war zones, trained or not. However, that group of concerned citizens is

strongly the group who are opposed to persons of any age being sent into a war

zone as part of a normal, standing army.





As you might guess, now that you have moved beyond their headline to consider

mine, is that past-month use of alcohol increases for these demographic groups

as age rises. You got it. By time you get to the 18-20yo cohort, you see fair

amts of past-month alc use. By time you get to legal drinking age, you see a

big jump, too.





So, what we are left with is alarmism.





When do we get to pat ourselves on the back? Drinking rates are dropping. We

need encouragement so that we do not get burnout from the disaster-scenario

headliens we hear every day, and or get the idea that, despite efforts across

decades, nothing seems to work.





What does work?



Here is a clue: Lowest rates are in Utah.



What are we to do with that info?

Thursday, March 18, 2010

Dumb Criminals! Stole the wrong drugs. Unless you think dry mouth, suicidality, and weight gain are cool ways to get high.

Dumb Criminals! Stole the wrong drugs. Unless you think dry mouth, suicidality, and weight gain are cool ways to get high. This news story cracks me up...
"Thieves grab up to $75 million in Eli Lilly drugs"

"The thieves disabled a burglar alarm in the building and carted away dozens of pallets loaded with Lilly antidepressants Prozac and Cymbalta, anti-psychotic Zyprexa and other company medicines, according to published reports."

http://www.reuters.com/article/idUSSGE62G07D20100317?loomia_ow=t0:s0:a49:g43:r2:c0.140110:b31982992:z0

Here is a post on the terrible weight gain issue with Zyprexa...
http://www.medsvstherapy.com/2009/10/pharmaceuticals-or-harmaceuticals-kids.html

The SSRIs have all kinds of troubles. I have blogged about the most alarming: birth defects from pregnant moms taking these drugs...

http://www.medsvstherapy.com/2009/11/ssris-in-pregnancy-associated-with-5.html
http://www.medsvstherapy.com/2009/10/bmj-2009-heart-septum-defects-twice-as.html
http://www.medsvstherapy.com/2009/10/fox-spokesdoctor-doubling-of-hear.html

...and other problems including suicidality, withdrawal problems, etc., are well-noted at a couple great sites...
http://www.ssristories.com/
http://seroxatsecrets.wordpress.com/

Those drugs are the last drugs I would want to steal!

Wednesday, March 17, 2010

Am Psychiatric Assoc recently publishes review of Guidelines for Panic. Somehow they favor meds over therapy. I will have to dig in.

Am Psychiatric recently publishes review of Guidelines for Panic. Somehow they favor meds over therapy. I will have to dig in. Has pro-meds focus, while declaring that "CBT" is also beneficial.

It is 65 pages. I will have to dig in and see how they tilt the world to have meds, mainly SSRI, be preferable for panic, over behavioral interventions.

In February 2010's Am J Psychiatry.

This will be fun.

Monday, March 8, 2010

Thankfully, a new placebo for knee pain. Electromagnetic pulses.

Thankfully, a new placebo for knee pain. Electromagnetic pulses.
http://www.healthday.com/Article.asp?AID=636730

"Electromagnetic Pulses May Stem Arthritic Knee Pain."
"New device could improve life quality without side effects, expert says"


After surgery got the ax (Mosely et al NEJM, 2002), knee pain sufferers have had to be satisfied with the chondrointin/glucosamine placebo effect (There are a lot of studies finding little to no benefit from this well-markted remedy; an example- Houpt JB, McMillan R, Wein C, Paget-Dellio SD. Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. J Rheumatol. 1999 Nov;26(11):2423-30: "CONCLUSION: There was no significant difference in pain reduction between the glucosamine hydrochloride and placebo groups as measured by WOMAC. However, the secondary endpoints of cumulative pain reduction as measured by daily diary and knee examination were favorable, suggesting that glucosamine hydrochloride benefits some patients with knee OA.")
Seeming much less scientific-y, and not so mechanical, these pills just have not delivered the way some good ol blood and guts surgery would deliver. Not necessarily in measureable outcomes, but in patient satisfaction.
Thankfully, some one has come along to hitch some mechanical device up to your knee, and give you a placebo response that way.
Note how carefully the quote is crafted: the researchers are almost admitting the goal is patient satisfaction. The same as the neighborhood palm-reader. They (the researchers, not Marie Laveaux), say: ""We look at electromagnetic pulses as a potential way to improve quality of life and independence for those who suffer from osteoarthritis of the knee."
In the meantime, a continual parade of studies repeat the finding that you need to engage in regular physical activity to stave off knee arthritis itself, and to stave off knee pain. These medication and device studies rarely perform the study the proper way: use only exercisers, or get people up to some decent level of regular physical activity, THEN test their pet theory drug or gismo.
Here is an aexample of one of a parade of studies:

Gail D. Deyle, Nancy E. Henderson, PhD, Robert L. Matekel, Michael G. Ryder, Matthew B. Garber, Stephen C. Allison. Effectiveness of Manual Physical Therapy and Exercise in Osteoarthritis of the Knee. A Randomized, Controlled Trial. Annals of Internal Medicine 2000 v. 132, 173-181.
They conclude: "A combination of manual physical therapy and supervised exercise yields functional benefits for patients with osteoarthritis of the knee and may delay or prevent the need for surgical intervention."
Why am I commeting on this at a psych blog?
I see it as the same phenomenon: we want medical establishment-authorized cures for our maladies, even when the best answer is good old fashioned work: psychotherapy work, or physical rehab / physical activity work.


This preference for the easy way out, plus the placebo effect on a soft outcome such as "patient satisfaction" makes a big market for pill pushers. And device pushers.


Should you invest in this gizmo? I don't know. If it gets marekted the right way, millions will be sold.
Does it actually work? I doubt it. Also, I am kind of afraid of it: if it is moving around calcium in knee pain cells, where else is it affecting calcium in the vicinity? You stick it on your knee, which is close to the largest bones and muscles in your body. Bones make red blood cells. I am sure it is not a good idea to mess with calcium there in the bones as they make their red blood cells.

Hopefully the physiomechanical effect is just strong enough to evoke the placebo response, so we will all be satisfied and safe.