Mens Health Blog. Medical Blog

At the turn of the century, the most common management technique for youngsters with ADHD was a sound thrashing when they misbehaved. Today, spanking has been replaced by an array of stimulant drugs. These drugs can often significantly curb the disruptive behaviors of ADHD and help patients lead a more normal life. However, stimulants are so widely prescribed in the United States today that some people wonder if they have become a method, like the spanking of yesteryear, that is indiscriminately and overly used.
Stimulants were first prescribed for symptoms of hyperactivity and distraction in youngsters following an outbreak of encephalitis in 1937. Doctors were amazed at the drugs’ paradoxical effectiveness on children who exhibited hyperactivity as a result of the viral infection, and stimulants have been used to curb all kinds of hyperactive behaviors ever since.
Researchers estimate that in 1970 about 150,000 children nationwide were taking prescribed stimulant medication. A decade later, that figure had escalated to between 270,000 and 541,000. By 1988, the number of school-age youngsters receiving stimulants was estimated at between 750,000 and 1.6 million, a figure that didn’t include the 25 percent of children in special education classes who received stimulants to improve academic performance. Today, the number of youngsters in the United States receiving various forms of stimulant medication is well over two million and climbing.
Benzedrine was the drug of choice in the 1940s and 1950s. Today it is methylphenidate (Ritalin), which is quite similar structurally to amphetamine. Doctors prefer Ritalin because it is fast-acting, clears the system well, and has a minimum of side-effects. Also effective are dextroamphetamine (Dexedrine) and pemoline (Cylert).
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Multiple substance abuse refers to simultaneous abuse of different mood-altering drugs, either one with another, or in combination with that all-time favorite, alcohol. Many who work in the alcoholism field have come to believe that addiction is addiction regardless of the substance being abused. For these people basic principles of treatment for drug abuse vary little from alcoholism treatment. Despite this view, the stereotype remains of drug abusers as different from alcoholics and more difficult to help. Thus, a tendency among some who work with alcoholics is to shy away from drug abusers or those who are cross-addicted to drugs as well as alcohol. Nevertheless, those working with alcoholics must become more knowledgeable and comfortable in working with clients who are also involved with other drugs. “Pure” alcohol abuse is less common than it used to be. A recent survey conducted by AA of its members revealed that 30% of those surveyed considered themselves addicted to drugs as well as alcohol. This was an increase of 7% from a similar survey 3 years earlier. Of AA members under 20 years of age, a whopping 76% said they were addicted to drugs as well, a 16% increase in just a 3-year period! Alcohol treatment units report that the number of clients being admitted who also abuse other drugs is increasing. Once again, the younger clients are more likely to use and abuse multiple substances.
Major substances of abuse
A complete listing of all the drugs of abuse and their effects is beyond the scope of this book. However, it is not necessary to be intimately familiar with every compound, if one is aware of the general classes into which psychoactive drugs or substances fall. Within each of the major classes there is similarity as to the drugs’ effects and the problems that may be encountered with use. The major classes of “abuse-able” drugs are as follows:
Depressants
examples: benzodiazepines (Librium, Valium, etc.); barbiturates, chloral hydrate, paraldehyde, meprobamate.
action: not completely understood, in general produce a reversible depression of the central nervous system, some more selectively than others.
desired effects: similar to alcohol; elation or excitement secondary to depression of inhibitions and judgment or reduction of anxiety.
common problems: tolerance; physical dependence; respiratory depression with overdose.
withdrawal syndromes: physical symptoms similar to alcohol withdrawal, including seizures; psychological withdrawal.
Stimulants
examples: amphetamines, cocaine, methylphenidate (Ritalin), action: stimulation probably due to increased levels of
norepinepherine and/or dopamine in-central nervous system, desired effects: increased alertness; feeling of well-being; euphoria;
increased energy; decreased appetite; rapid onset of mood change
with cocaine.
common problems: tolerance; anxiety; confusion; irritability; psychosis; with cocaine-delusions, some data indicating physical dependence.
withdrawal syndromes: depression (possibly suicidal); loss of ability to enjoy ordinary pleasures.
Opiates
examples: heroin, morphine, methadone, opium, codeine, Demerol, Percodan.
action: affect central nervous system, probably by mimicking or blocking normally occuring opiate-like substances in the brain, thereby causing mood changes and mental clouding.
desired effects: “the rush” (feeling of intense pleasure immediately following injection); state of mental and physical relaxation with decreased mental awareness and reduction of drives.
common problems: production of tolerance and both physical and psychological dependence; death by overdose or as result of injection.
withdrawal syndromes: psychological (drug craving); physical symptoms (chills and sweats, abdominal pain, diarrhea, gooseflesh, tears).
Hallucinogens
examples: LSD, mescaline, psilocybin, DMT.
action: alteration of normal functioning of central and peripheral nervous systems, central nervous system excitement.
desired effects: modification of perception of all sensory input (hallucinations, distortions); temporary modification of thought processes; claims of “special insights.”
common problems: acute anxiety and panic reactions; depression; flashbacks (post-LSD).
withdrawal syndromes: generally believed not to occur.
Cannabinoids
examples: marijuana, hashish, THC.
action: acts on the brain as a foreign substance.
desired effects: euphoria; detachment; modification of level of consciousness; relaxation; reported sexual arousal; altered perceptions.
common problems: psychomotor impairment; impairment in memory, comprehension, thinking, learning, and general intellectual function; respiratory problems with prolonged use; reproductive system problems with prolonged use; paranoia and psychosis in large doses; possible long-term psychological impairment with chronic use.
withdrawal syndromes: psychological dependence suggested; no physical withdrawal demonstrated.
Phencyclidine
examples: Phencyclidine (PCP).
action: nonspecific central nervous system depressant; anesthetic; psychedelic (multiple proposed actions on various neurotransmitters in central nervous system).
desired effects: visual illusions and distorted perceptions; depersonalization; distortion of body image; hallucinations; feelings of strength, power, and invulnerability; claims of “special insights.”
common problems: feelings of severe anxiety, doom, or impending death; bizarre behavior; outbursts of hostility and excitement.
withdrawal syndromes: potential for both psychological and physical withdrawal reported, but not well documented.
Inhalants
examples: aerosol sprays, paint, model cement, adhesives, gasoline, amyl nitrite, butyl nitrite, nitrous oxide, benzydrex inhalors, asthma inhilators
action: central nervous system depression, generally secondary to access through respiratory system.
desired effects: immediate effects—euphoria, excitement (also often inexpensive and legal).
common problems: impulsive and destructive behavior; slurred speech; ataxia; impaired judgment; development of tolerance; “Sudden Sniffing Death”; possible long-term central nervous system damage and damage to multiple physical systems.
withdrawal syndromes: psychological documented; physical, not clinically established.
In respect to the drugs of abuse, there are clearly trends as to what is and is not popular, or “in,” at any particular time. For example, the interest in psychedelics has waned. Cocaine use has become very widespread. Also apparently true is that drugs, though often touted as being nonaddictive when they are becoming popular, generally turn out not to be as universally benign as thought. Current terminology refers to “recreational” drug use, which by analogy is the counterpart of “social drinking.” Controlled studies of the effects of “recreational” drug use are for the most part nonexistent. The problems that can accompany “casual use” are the same as for “casual use” of alcohol, for example, auto accidents from driving in an impaired state. Or there is the possibility that casual use may not remain casual. Any use of illicit substances invites a host of other difficulties.
For the counselor, the importance of distinguishing between legal and illegal substances is less a matter of pharmacology than it is “quality assurance.” Inevitably, illicit drugs are pharmacologically of unknown strength and purity. And a safe, reliably available supply can never be assured. Also, the illicit drug use can invite social and legal problems. For example, while the price of cocaine may be coming down, it remains a very expensive drug. Therefore, large sums of money are spent for even “recreational” use. Heavy users may find themselves borrowing money, going into debt, or stealing. Or they begin to sell to others to cover the costs of their own coke use. Cocaine has thus been called the “Amway drug.”
The observation has been made that for illicit drug users, because the substance is not legally available, some of the behaviors common in the later stages of alcoholism are present virtually from the beginning of the drug use. Early on with the drug use there is a need for the secretiveness, concern about supply, and feelings of guilt and apprehension.
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Pollen is everywhere, and it flourishes where most people live. There are exceptions, such as at the polar caps and at very high altitudes, but these are sufficiently inaccessible to most of us to be, essentially, irrelevant.
The following are general guidelines that can reduce both your exposure to the ubiquitous pollens and the symptoms that result from that exposure:
1. Staying inside with closed doors and windows is the best way to reduce your exposure to pollens during your particular pollen season(s).
2. Window fans and attic fans are infamous for drawing pollens into homes. Any type of fan can stir up mite particles, mold spores, animal danders, and pollens already within your home. In general, if you are allergic to a variety of inhaled indoor and outdoor allergens, it is best not to use fans in your home.
3. Putting the car air conditioner on “re-circulate” while driving will help reduce pollen exposure.
4. Obviously, outdoor activities and yard work during your pollen season(s) can worsen your symptoms. If you are grass-or tree-pollen allergic, try to have someone else tend your yard during the weed, grass, and tree pollen seasons.
5. Don’t hang clothes or bedding outside to dry, as they become pollen catchers.
6. A good filter on your central air/heat system or a standalone filtering unit in your bedroom can be very helpful. Remember, though, filters filter. Since these filter systems work effectively only as long as they are kept clean, wash them weekly during your allergy season(s).
7. It is best if you are not the one to hose down, blow, or sweep the yellow pollen off of your driveway, porch or patio.
8. Get out of town – way out of town – during your season(s). If possible, plan your vacation and go to an area not filled with the pollen(s) to which you are allergic. If only we could escape for an entire season!
Getting away during a pollen season does work for some people, especially people who are very reactive to only a single pollen such as ragweed. They can go where the counts are generally very low, places like Florida, the big island of Hawaii, Alaska, eastern Canada, the Virgin Islands, or even Bermuda. If you live in south central Texas and happen to be very reactive only to mountain cedar pollen, you can go almost anywhere else and get relief during your season.
Unfortunately, most people with chronic allergic rhinitis are reactive to many different allergens: pollens, dusts, mites, and molds. So, even though they might vacation away from ragweed, they are likely to discover that their vacation paradise has grass or tree pollens, or mites and mold spores in abundance – that they have even worse allergies on vacation than they do at home.
Before you rush off someplace, be sure you’re not going from the frying pan into the fire. Talk to your allergist.
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Asthma is a particular type of allergy causing spasm of the plain muscle fibres in the bronchioles or tiny air passages in the lungs. It follows a definite pattern, not only causing obstruction to breathing but the productions of secretions of thick plugs of mucus which further impede free passage of air.

The blood of all asthmatics, especially during an attack, has been found to be very deficient in ascorboc acid as it is apparently used up in detoxifying the allergens which precipitate the attack; and asthmatics seem to have inborn need for this vitamin.

During the 1930s and 1940s there was a great deal of research on the role of Vitamin C in asthma with conflicting results, firstly because the doses were too small and too infrequent to affect the allergic condition, and secondly because insufficient doses seemed to actually stimulate the production of histamine that promotes broncho-spasm.

All interest in Vitamin C in asthma then flagged with the introduction of effective antihistamines, antibiotics and cortisone products, and is only just again finding a place in the prevention and treatment of this crippling condition.

It is now realized that the protective effect of Vitamin C, as with other allergies, is dose dependent; and large or mega-doses are needed to scotch asthma attacks and to keep the asthmatic free from an habitual allergic response to the particular allergens to which he is susceptible.

I have never tried giving intravenous sodium ascorbate to prevent or cut short an attack, but I have used large doses of Vitamin C — say, 6 to 10 grams a day — more con­veniently taken as sodium ascorbate powder — to maintain chronic asthmatics free from attacks, even from nocturnal wheezing for months at a time, even throughout their usual asthma season.

These cases must, of course, avoid as far as possible their particular allergic substances, and take a thoroughly well balanced diet with as much fresh non-additive food as possible and — more importantly — they must continue their regular supplements of Vitamin C in divided daily doses; for their need is greater than that of the non-asthmatic.

I have recently seen whole families with what is called an ‘asthmatic diathasis’ or tendency, grandmother, father and two children all kept practically free for a year from the asthma attacks that had previously plagued their lives by giving them doses of sodium ascorbate 5 to 10 grams daily according to age.
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Allergies are the body’s reaction to minute particles of foreign protein which gain access to the blood, and so to the tissue cells. Vitamin C strengthens the inter-cellular sub­stance and affords a barrier to these foreign proteins enter­ing the cells and to cell fluids leaking out between them.

The normal healthy individual can usually deal with these foreign substances — but when the adrenal glands are too exhausted by stress, malnourishment or certain inborn deficiencies, these glands cannot manufacture enough cor­tisone to detoxify the so called ‘allergens’.

Vitamin C not only assists the adrenals to produce their own cortisone, but it also detoxifies the foreign proteins. Large doses of the vitamin will often cut short attacks of hay fever or prevent them altogether if taken regularly. It is a wise precaution to suck several 500 milligram flavored tablets when going into an allergy ‘danger zone’ such as into the bush when the wattle is blooming or encountering any known allergen such as house dust, or face powder or taking certain drugs, or during the ‘allergy season’ when humidity or cold winds, etc., are liable to bring on an attack. Each allergy-prone person is susceptible in different ways, but Vitamin C is a general detoxifier and will render harm­less any foreign substance entering the blood, if there is enough to cope with it.

Vitamin C is itself harmless and non-toxic. Allergic persons both children and adults, should take enough to keep their blood and tissues saturated. As soon as the body contains sufficient for its use any surplus is excreted in the urine. This can be tested easily by a simple C-Stix test — a strip of paper impregnated with certain chemicals which changes color when dipped into a sample of urine. A change of color to orange shows that ascorbic acid is pre­sent and the body has enough vitamin to meet and over­come its stresses. No change of color indicates that it could do with a bit more.

During infections, after immunizing injections and after taking most drugs, even aspirin or smoking cigarettes, the Vitamin C is quickly used up and the blood again be­comes deficient.

It has just been found by Dr Ben Feingold, and his co-workers in California, that aspirin and certain aspirin like medicines and chemicals in artificial colorings and flavorings can build up allergic tendencies, especially when given to children.

This is one reason why allergies are so common in our babies and children here in Australia, as they eat much the same highly flavored and colored foods as American children, and are given just as many aspirin medicines of one kind or another.

Of course, Vitamin C alone cannot always prevent or cure allergies—other vitamins such as pantothenic acid, B6 (pyridoxine) and Vitamin A may be deficient and specially needed in some individuals and families, but a thoroughly adequate well balanced diet with natural foods, no artificial flavoring or colorings, plus ample Vitamin C can over­come most allergies and keep the allergy-prone person free of trouble.

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Spider bites

Australian spiders, other than the funnel-web and red-back, are not known to be lethal, but bites can cause severe pain, swelling and local tissue damage. See your doctor if your child’s pain persists, or the bite looks infected.

Treatment

Remove the tick immediately, being careful to get its head out too. It may need to be lifted out with a sharp point, for example, tweezers or scissors. Do no squeeze it or pull it suddenly, as this can release more poison into the body. After removal of the tick, apply a pressure immobilisation bandage and see your doctor. If your child is unwell and it is after hours, go directly to a hospital. An antivenom is available if your child is very sick.

Tick bites

Ticks are small insects which attach themselves to the skin and feed on the host’s blood. The bite usually goes unnoticed and is not painful. You may notice a tick engorged with blood embedded in the skin a few days after a bush walk, especially if long clothing was not worn. Ticks wait on foliage for a host to brush against.

The east coast of Australia is home to one particularly nasty type of tick called the Australian Paralysis Tick. Once embedded in the skin, this tiny creature swells to the size of a pea, engorged with blood. This may take several days. It releases poison into the body via its saliva. A bite from this particular tick can lead to gradual paralysis and even death.

Wasp stings

Wasps are aggressive and can inflict multiple stings. Stings usually cause pain and swelling, but allergic reactions are not common. Remove the insect carefully and if it is dead keep it for later identification. If your child has persistent pain, or develops sudden difficulty in breathing, seek immediate medical attention.

Beware of drinking straight from open soft drink cans when outside. Wasps are attracted to sugar and may enter a can and a child can inadvertently be stung if he then drinks from it.

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Choking

All babies put things in their mouths. Keep small objects out of reach. This includes beads, small parts of toys, and foods such as peanuts and pieces of carrot or popcorn. Teach your child to sit while eating, and always supervise him.

Poisoning

Store all medicines, and household chemicals such as bleach, caustic soda, cleaners, dishwashing liquids and detergents etc. out of reach, preferably in a locked or child resistant cupboard. Make sure that medicines and tablets are in child resistant containers, and remember to replace the lids. Get rid of all old tablets and medicines. Make sure you have written down the number of your Poisons Information Centre.

Playpens

Even though it is desirable for babies and toddlers to be able to freely explore their environment, we recognise there are occasions when their activity and mobility need to be restricted for short periods of time. If you decide to purchase a playpen, it is worthwhile checking with your local Child Safety Centre or Child Accident Prevention Foundation branch for information about which brands are considered safest for your child.

Babywalkers

We recommend that you do not purchase a ‘babywalker’ for your child. They do not help babies to learn to walk. Walking ability depends on their development, experience, personality and opportunity. Walking is more likely to be delayed if a baby spends time in a walker because they are missing out on normal experience.

Babywalkers may contribute to serious injuries in a baby — babies in walkers can reach things such as shelves and tables. In addition, falls down steps and stairs are relatively common. It is best not to use them.

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We never realized it until now, but we never took time to choose our sexual life-style. It just happened to us.

HUSBAND

You will need two “sexperts” for this sex clinic—you and your partner, the experts on your sexuality. The expert on your spouse is your spouse. And the expert on you is you. Each of you must take full responsibility for “your” patient in this clinic. Your patient is you.

You have already taken major steps toward the training of your staff. You have studied the history of sexuality, analyzed your sexual system, and learned a new model of human sexual response. As training continues, add to the records you have kept for the opportunities at the end of each chapter. Make up your own audio “sex tapes” in your private place. Listen to them altogether as a follow-up to your clinic program.

Training the staff depends on getting the staff in shape. If you have not had a recent physical exam, schedule one now with a doctor you trust. Tell the doctor that you both want a physical and want him or her to do it with both of you present. All health is a system, so there is no reason to go for medical checkups alone. Make sure the doctor schedules a feedback session to tell you both about the physical exam results and to plan healthy changes that may be needed, changes you can make together. Doctors complain that patients often fail to comply with their recommendations for healthy living. One reason for low compliance is the medical establishment’s insistence on an individual focus when changes can be made only within a system.

Two more steps are needed to train the staff. First, you must get some mutual exercise. From now on, every day of your life, rain, snow, or sun, walk together for twenty minutes holding hands. This one simple step was one of the most popular activities for the couples in the clinic. “I found out that we just never made time to be together. That simple walk has become a part of us.” Be sure to leave the dog and kids at home. This is a marital walk, not a family parade.

Lasdy, not only are you what you eat but you also may have sex related in part to what and how you eat. Of all physical functions, eating is one human function that seems to be related closely to sexuality. Researchers are learning that problems with sex can result in eating problems and the reverse also seems to be true. Both sex and eating have to do with timing, taste, feelings, self- and body esteem, pleasure, and general physical, emotional, and interactional health.

Caffeine, cigarettes, and sugar are not good for sex. All of these alter the metabolism in the direction of disruption and/or depression and all have impact on the neurohormonal system. Eating a low-fat, low-preservative, high-fiber diet is not only good health, but it positively affects sexual response. Kenneth Pelletier, in his book Longevity, presents evidence relating good health to longevity and continued sexual activity. The patients in the clinic who neglected sound health practices, particularly if they abused alcohol or other substances, had the most difficulty correcting their sex problems. Actually, there is no such thing as “sexual health,” for health is an all-inclusive term for the way we live and love.

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