A report in the American Journal of Clinical Nutrition gives the latest on the link between cow’s milk and type 1 diabetes. Researchers have long known that type 1 diabetes occurs when white blood cells attack the pancreas and kill off the insulin-producing cells. The question is, what triggers this deadly autoimmune reaction? Is it a virus? Perhaps some kind of bacterium? Many have pointed a finger of blame at cow’s milk. After all, people who were formula-fed as infants are much more likely to develop type 1 diabetes, compared with their breast-fed counterparts.
A major international study, called the Trial to Reduce Insulin-dependent diabetes mellitus in the Genetically at Risk (TRIGR) study, aims to nail down the role of cow’s milk in diabetes risk. The research team encouraged a group of women to breastfeed. Those who then transitioned their infants to baby formula were given a specially prepared formula in which proteins were broken up, so that no intact cow’s milk proteins remained. The full study results are not yet in. However, the TRIGR pilot study, including 230 infants followed until about 10 years of age, showed that those who followed the special feeding plan were 60 percent less likely to develop type 1 diabetes, compared with children who drank regular cow’s milk formula during infancy.
_____________ Diabetes Mellitus Profile Of The Diagnosed There are more than 1.2 million people in Malaysia who have diabetes. Diabetes is actually a general term for a number of separate but related disorders. These disorders fall into two main categories:
type 1, which usually occurs during childhood or adolescence, and type 2, the most common form of the disease, usually occurring after age 30. What is type 1 (insulin-dependent) diabetes?
Type 1 (insulin-dependent) diabetes is a disease which results from the body's failure to produce insulin -- the hormone that "unlocks" the cells of the body, allowing glucose to enter and fuel them.
This is most often the result of an autoimmune process in which the body's immune system attacks and destroys the insulin-producing cells of the pancreas. Since glucose cannot enter the cells, it builds up in the blood and the body's cells literally starve to death.
People with type 1 diabetes must take daily insulin injections and regularly monitor blood sugar levels.
There are an estimated 24,000 people with type 1 diabetes in Malaysia today.
The risk of developing type 1 diabetes is higher than virtually all other severe chronic diseases of childhood.
Peak incidence occurs during puberty, around 10 to 12 years old in girls and 12 to 14 years old in boys. The symptoms for type 1 diabetes can mimic the flu in children.
Type 1 diabetes tends to run in families. Brothers and sisters of children with insulin-dependent diabetes have about a 10% chance, or a 20-fold increased risk, of developing the disease.
What is type 2 (non-insulin-dependent) diabetes?
type 2 (non-insulin-dependent) diabetes results from the body's inability to make enough or properly use insulin. Often type 2 diabetes can be controlled through diet and exercise alone, but sometimes these are not enough and either oral medications or insulin must be used.
The fact that few people with type 2 diabetes require insulin has led to the myth that this is a "mild" form of the disease.
Of the 1.2 million Malaysians with diabetes, more than 98% have type 2 diabetes.
People with type 2 diabetes often develop the disease after age 30, but are not aware they have diabetes until treated for one of its serious complications.
The risk for type 2 diabetes increases with age.
Studies indicate that diabetes is generally under reported on death certificates, particularly in the cases of older persons with multiple chronic conditions such as heart disease and hypertension. Because of this, the toll of diabetes is believed to be much higher than officially reported.
High Blood Glucose Levels Doctors diagnose diabetes on the basis of too-high levels of glucose in the blood. If you have diabetes, your blood glucose levels rise because of the foods you eat. Foods have little effect on blood glucose in people without diabetes. Normally, insulin, a hormone that is made in the pancreas, allows glucose to enter your body's cells and be used as fuel. Insulin also makes the liver store excess glucose in the form of glycogen until it is needed. Insulin is the main tool your body uses to lower your blood glucose level. People with diabetes can have insulin deficiency (they make too little insulin) or insulin resistance (their bodies don't respond well to insulin). Some people have a combination of the two. In people with diabetes, insulin is not doing its job, so glucose can't get into the cells to be used for energy. Instead, the unused glucose builds up in the blood and, if high enough, passes through the kidneys. If a person's blood glucose level rises high enough, the extra glucose causes frequent urination. This in turn leads to thirst, as the body tries to make up for the fluid lost in urination. What Urine Tests Measure High urine glucose levels give doctors a clue that something is wrong. But urine tests are not a good way to diagnose diabetes. Urine tests are not as accurate as blood tests. And the level of blood glucose needed to make glucose appear in the urine is different for each person.
Your glucose level could be high, yet high levels of glucose may not appear in the urine. So in diagnosing diabetes, doctors measure glucose in the blood. (Urine tests are a very useful way to measure ketones, substances that build up when blood glucose is very high. Because ketones are acids that are toxic to the body, they are flushed out in urine quickly.)
Blood Tests The goal of blood glucose tests is to find out whether you have a very large amount of glucose in your blood. There are two types of tests, screening tests and diagnostic tests. Screening tests are performed on people who have no symptoms of diabetes. On the other hand, diagnostic tests are done to confirm a diagnosis that is already suspected from the patient's symptoms. Screening tests are fast, easy to perform, and cheap. (Health fairs often offer screening tests, for example.) Screening tests require as little as a drop of blood from your fingertip and take only a minute or two to complete. Most doctors don't screen everyone for diabetes during regular checkups. The chance of finding the disease in most people is just too low. But screening tests are useful for people who may be at risk for developing diabetes. People at risk include:
Blood relatives of people with diabetes.
Women with unexplained miscarriages or stillbirths or who have had babies weighing 9 pounds or more at birth.
People with a condition known as "impaired glucose tolerance" (see Oral Glucose Tolerance Test below).
People with high blood pressure or very high blood cholesterol or triglyceride levels.
People who are obese.
People over age 35.
All pregnant women should be screened for gestational diabetes (diabetes that starts during pregnancy) between the 24th and 28th weeks.Having a screening test every three years is often enough as long as the results are normal. If you have an abnormal screening test result, you should have a diagnostic test. For diagnostic tests, the doctor's office draws one or more samples of blood from a vein and sends them to a lab for analysis. When you get your test results, ask your doctor to explain them to you. Comparing your test results with those of family or friends may confuse or alarm you. You may not have had the same type of test, and so your results could have a completely different meaning. You should ask your doctor to explain your results to prevent any confusion. Several types of diagnostic tests are commonly used to diagnose diabetes. Normal response. A person is said to have a normal response when the fasting glucose level is less than 5.6 mmol/L and the 2-hour glucose level is less than 7.8 mmol/L.
Impaired glucose tolerance. A person is said to have IGT when the fasting plasma glucose is higher than 5.6 but less than 7.0 mmol/L, the 2-hour glucose level is between 7.8 and 11.1 mmol/L.
Diabetes A person has diabetes when glucose tolerance test show that the blood glucose level at fasting is 7.0 mmol/L or more or the 2 hour level is more than 11.1 mmol/L. In diagnosing your diabetes, your doctor needed test results. But test results are just part of the information that goes into the diagnosis of diabetes. Your doctor also took into account your physical exam, symptoms, and medical history in order to decide to test. The Blood Test with a Memory
Once you've been diagnosed with diabetes, your doctor may order another type of blood test called glycated haemoglobin or glycohaemoglobin (HBA1c). This test is easy to do during routine office visits. HBA1c lets the doctor take a backward look at your diabetes control.
What Is Hypertension? Hypertension, is the medical term for High blood pressure (HBP). It is a serious condition that can lead to ischaemic heart disease (also called coronary heart/artery disease), heart failure, stroke, kidney failure, and other health problems.
"Blood pressure" is the force of blood pressing against the walls of the arteries as the heart pumps blood. If this pressure rises and stays high over time, it can damage the body in many ways.
HOW COMMON? In 3rd Malaysian National Health Survey, 42% o fadult older than 30 years old have hypertension.
The condition itself usually has no symptoms. You can have it for years without feeling sick or any other abnormality. During this time, the high blood pressure can damage the heart, blood vessels, kidneys, and other parts of your body.
Knowing your blood pressure numbers is important, even when you're feeling fine. If your blood pressure is normal, you can work with your health care team to keep it that way. If your blood pressure is too high, treatment may help prevent damage to your body's organs.
BLOOD PRESSURE STANDARD Blood pressure is measured as systolic (sis-TOL-ik) and diastolic (di-a-STOL-ik) pressures. "Systolic" refers to blood pressure when the heart beats while pumping blood. "Diastolic" refers to blood pressure when the heart is at rest between beats.
You most often will see blood pressure numbers written with the systolic number above or before the diastolic number, such as 120/80 mmHg. (The mmHg is millimeters of mercury—the units used to measure blood pressure.)
Categories for Blood Pressure Levels in Adults (measured in millimeters of mercury, or mmHg)
Blood Pressure Standard
Category
Systolic
Diastolic
Normal
<=120
And
<=80
Pre hypertension
121-139
Or
81-89
Hypertension Grade 1
140-159
Or
90-99
Grade 2
160-179
Or
100-109
Grade 3
>=180
Or
>=110
The ranges in the table apply to most adults (aged 18 and older) who don't have short-term serious illnesses.
Blood pressure doesn't stay the same all the time. It lowers as you sleep and rises when you wake up. Blood pressure also rises when you're excited, nervous, or active. If your numbers stay above normal most of the time, you're at risk for health problems.
All levels above 120/80 mmHg raise your risk, and the risk grows as blood pressure numbers rise. "Prehypertension" means you're likely to end up with HBP, unless you take steps to prevent it.
If you're being treated for HBP and have repeat readings in the normal range, your blood pressure is under control. However, you still have the condition. You should see your doctor and follow your treatment plan to keep your blood pressure under control.
Your systolic and diastolic numbers may not be in the same blood pressure category. In this case, the more severe category is the one you're in. For example, if your systolic number is 160 and your diastolic number is 80, you have Grade 2 HBP. If your systolic number is 120 and your diastolic number is 95, you have Grade 1 HBP.
If you have diabetes or chronic kidney disease, HBP is defined as 130/80 mmHg or higher. HBP numbers also differ for children and teens.
OUTLOOK
Blood pressure tends to rise with age. Following a healthy lifestyle helps some people delay or prevent this rise in blood pressure.
People who have HBP can take steps to control it and reduce their risk of related health problems. Key steps include following a healthy lifestyle, having ongoing medical care, and following your treatment plan.
Tobacco is a big business. Each day, while many smokers try to reduce or stop. Unfortunately, many youngsters start experimenting this enslaving habit.
Habit associated with many essential parts of life, ie after meal, initiating bowel movement etc
Help to focus, think and solve problems
Others
Do smokers desire to quit?
Yes, >90% of the smokers I meet express their desire to stop, but find it difficult. In fact, most of them have tried.
Click here to find out what happen to some famous smokers. If you are searching for help to attain freedom from Tobacco, you can contact Breathe Free Seminar Organiser for group support plus education on the process of breaking free. Check out the program outlinehere.
Analyse smoking pattern. Reflect and examine the reasons for current smoking. A smoking diary for 3 -4 days will help to clarify this, if one needs pointers. Smoking diary is a record of the time and situation of each cigarette lit up in that day. And at the end of the day, find a quiet time when one can reflect on the record and give a reason for each stick smoked. it might be early morning, feeling the urge; have to initiate the bowel movement; post meal urge; feeling stress; feeling bored; feeling happy; friends lite up; etc
Once the reasons for smoking are known, decide which reasons are pretty strong and difficult to deal with.
Start developing strategies to deal with those tough areas
Do trial run of the strategies on occasion; you might need to do some more research, if you do not have enough from my website
Once you gain confidence of handling small successes, you are ready for the full quit to ACHIEVE FRESH BREATH. SET A Special date in near future (one month or less) to achieve this very special status. You can do it!
If you would like to join Support Group or learn more theory on Quit Smoking, please contact wellness@pah.com.my or call 604 222 7732 for Seven-Sessions BREATHE FREE Workshop
Sharing 1 I used to smoke 1 pack a day for the past 10 years plus and now after the 3 months treatment with champix I am smoke free.Over the years I had tried many times to quit smoking with a lot of different methods but was not successful but Champix seems to help me quit with less effort.Well let me start at the beginning of my treatment.The first few days when I took champix somehow or rather I seem to have had more than a pack a day maybe thinking that I will quit smoking.Anyway it took me around day 10 or 11 to totally stop smoking.The only reason that made me stop was the taste of the cigarette not only there was no rewarding feeling but it tasted different and very bad. In the first 2 weeks of treatment I had experienced slight nausea,dizziness and vivid dreams.The nausea feeling for me was mild and transient and also was the dizziness it was bearable cause I was still able to drive to work and so on. The vivid dreams (sometimes nice) I had experience more than 2 months. I seem to be able to remember my dreams pretty well the next day when I woke up.
I also didn't seem to experience very bad withdrawal symptoms i guess it must be the help of champix . During the course of the treatment I still meet up with friends whom are smokers but even I wanted to join them for a stick I was not able to do it due to the terrible smell . Smoking for over 10 years I realized that I had already adopted a very bad habit or routine that I had been doing for example 1 stick in the morning while I do my business,1 stick after meals and also driving long journeys I had to smoke to keep me awake.All this I had found new ways to replace my old habits like having chewing gums after meals and driving long journeys it actually works for me and the good news is I do not actually feel asleep .Reading a magazine while I do my business so far it has worked for me too cause at first I had this fear that I was not able to do my business without the help of smoking well I was wrong.I guess it is all conditioning the body.I found that The beauty of quit smoking is my sense of smell is back,food taste better, I don't smell like an ashtray now,no more second hand smoke to my wife and kids, my wallet is thicker and last but not least better Health.
Sharing 2 Tam became am a smoker at the age of 17 and achieved smoke free at 30 years old. He has been having Clean Breath for 4 years since his 4th attempt. Tam admitted he loved smoking as it helped him to think, and was a great companion, and an excellent social catalyst. And despite those few pluses, he strongly felt it is GREATER to have CLEAN BREATH. WHY??
Some of the factors that motivated him to work on achieving CLEAN BREATH are
His determination to prove his boss wrong.
He witnessed his puffer friend nearly losing his life by heart attack in the office, now needing to take those expensive medications+++
His observation that great majority of the HIGH ACHIEVERS in Corporate are also CLEAN BREATH people. Ya Good observation.
A MTV show revealed to him the almost inevitable end of every puffer (yes, even doctors admit few smokers get lung cancers, none can miss this deadly end if he/she lives long enough) Chronic obstructive pulmonary disease. Even Tam had experienced symptoms of COPD. The goodnews is that our bodies/lungs can heal itself to some extent, if the insult is removed.
Sharing 3 “Please be informed I have successful quick smoking since last August 31st 2004. I am now an independent man. Thanks you all so much & I'm a free man now”–Mohd.
“I quit smoking after 21 years. It really works! I would highly encourage anyone who wants to quit smoking! It has absolutely changed my life in many ways!” –Ooi.
“I save money and the smell of tobacco is gone. I want to see my kids to grow up in a clean environment.” – Andy. ~-----------------------------------------------------------~
Sharing 4 I was a smoker since I was 17 years old and have totally quit when I was 30 years old and now I am 34. It was my 4th attempt. The 1st time was for 2 weeks, the 2nd time was for 3 days and the 3rd time was 8 months. The 1st and 2nd attempt failed as I was struggling with the withdrawal symptoms. The 3rd time failed as I had too much work stress and needed another brain to help me to think and Marlboro Light helps. For the record I love smoking, it helps me to think, it is a great companion, it is an excellent social catalyst as almost all of my friends smoke. I still miss it but it is not worth it.
Why I quit? A few factors that motivated me to quit
My boss told me when I failed my 3rd attempt that I can not quit. It will always be a part of me. I was determined to prove him wrong.
My best friend at the office had a heart attack at the office in front of me. We smoke together every working day. I saw how bad it was for him and his family. He almost died and still on medication till today. The cost of his medication is more expensive than the cigarettes.
The higher the level you climb in Intel, the peer pressure not to smoke increases as the number of smoking managers becomes smaller and smaller the higher the grade. In some meetings that I go to, it is hard to find a smoking partner. Thus smoking breaks in meetings was an imposition and unfair to others. Not forgetting the look you get from them coz of the smoking smell.
I saw a short real life show in MTV about a lady who was going to die due to COPD as a result of smoking. They interviewed her and her daughter. It was distressful for them. It also showed a scene where they cut a deceased smoker’s lungs and a deceased non smoker’s lungs. The smoker’s lung was really awful. Imagine a rotten raw meat.
I was having some medical problems like shortness of breath. I find KHTP stairs a challenge. I was unfit to jog for even 100m. I can not sleep well, having a lot of insomnia, feeling lethargic most of the time and I was having chest pains.
Was it hard? Extremely hard.
I dreamed that I was smoking and missed it terribly. It is like missing a best friend. I still have those dreams but not that frequent anymore. It used to be weekly, then monthly, then once every 3 to 4 months.
The first side effect was to start eating more. I gained a few kilos but starting to lose it as I pick up more exercise.
Then I started to feel stupid. I can think and I can solve problems like I use to for about 2 or 3 weeks. The work stress started to pile up. This is where you need your friends, office colleagues, boss and family to support you.
So I decided to quit for the 4th time. How did I do it?
Buy nicorette, a nicotine gum. You need this to help you fight the cravings. If you do not, it will be really tough.
Avoid your smoking friends for a while. Do not ever visit the smoking zones.
Get yourself busy. The first 3 days I quit, I cleaned my house, may car and jog to get my mind off from smoking and make me physically tired so that I fell asleep earlier each night.
Avoid the habits that you normally do with smoking like no coffee or the tarik at nights out with your friends, no spicy food and no political talk or anything discussion that excites you to smoke. In other words, stay at home .
Always motivate yourself that you can do this and you want to do this. Get your friends and family to support you.
The benefits outweigh all the reasons to smoke. I started to improve after 3 months I quite smoking.
I don’t smell like a chimney anymore. I started to realize that smoker’s breath really stinks when they talk in an air con environment is very unpleasant to others. Smokers do not realize this till they stop smoking.
I can taste food. I used to be able to take really spicy food. Now I can’t coz I can not stand the hot taste on my gums. I can feel sweet and salty food almost immediately. Normally when I go out, I just eat the food while my wife complains about the taste. It was the same for me most of the time till I quit smoking.
My teeth look a lot better.
My skin is not as rough as before.
I can run and play active aggressive sports. I have better endurance and stamina.
My kids and family are not exposed to 2nd hand smoke. My house and my car are cleaner now that we do no have ash trays.
My kids love to hug and kiss me. Kids don’t lie. In the past, I used to ask my kids to kiss me and hug me and they are hesitant, they still do it but they tell me I stink.
My boss had to pay me his bet for being able to quit smoking.
Sexual improvement. When I was smoking, my doctor told me that the risk of ED is higher for smokers. Of course there are aphrodisiacs to help but quitting smoking is the best option. Your sexual capability improves and your partner appreciates you more. A simple example, your lover would love you more coz your breath does not stink anymore.
Financial gain. You guys can calculate to know the saving. I lost track of the how much a pack of Marlboro cost now.
My hope is I do not smoke again. I still need to avoid smoking zones and never ever try one. I know I can get hooked back again coz I love the habit of smoking. My friend started smoking again after 10 years quitting coz of stress. So I should never be proud that I stopped smoking coz I can start again for some reasons but I am sharing my experience coz it does helps and improve life. Stop smoking. Enrich your life. Rgds, Zam
Bad breath:
This is a common, embarassing problem. Hope you don't have it. If you do, try these remedies out. They are harmless, and cheap, little or no side effects.
Mouth is a good habitation for many bacteria. Certain bacteria (gram positive- called for the way they stain) which feast on starches and sugar are the ones that cause dental cavities. When gram negative bacteria eat, the by product is the release of airborne compounds that causes bad breath. The smell they produce depends on what they feed on. A menu of sulfur-containing molecules produces methyl mercaptan, which smells like rotten cabbage.
Tryptophan, an amino acid, produces indole and skatole, which is the same compound that gives feces their characteristic odor. Short chain carboxylic acid molecules are rendered into isovaleric acid, which smells like sweaty socks. The bacteria most likely to make these stincks prefer anaerobic or oxygen free conditions. For the same reason, you may have bad breath if you haven't talked or eaten a while (eg early morning just up from an overnight sleep). A thick coating of plaque on the tongue or teeth creates anaerobic conditions in its innermost layers. Low salivary flow also can be a factor. Sluggish saliva gives bacteria a chance to feed on peptides and proteins. Xerostomia, or dry mouth, can cause bad breath, although it is sometimes offset by the fact that the saliva tends to be acidic; the bacteria responsible for the bad breath prefer alkaline saliva.
Other causes of bad breath breath
Tonsillitis and sinusitis are occasional culprits. Nasal foreign bodies.
On rare occasions, respiratory tract tumors can sometimes be a source.
Just how often gastrointestinal problems are the cause of bad breath hasn't been resolved.
Fetor hepaticus, or liver breath, is the term for a kind of bad breath peculiar to cirrhosis.
Trimethylaminuria is a rare metabolic disorder that gives urine, sweat and saliva a fishy odor.
No one needs a study to tell them how the scent of raw garlic can linger, but why it lasts so long, and why brushing teeth doesn't help-- has been a mystery. The garlic odor has been attributed to one of its active beneficial nutrients- allyl methyl sulfide. It is postulated that since body does not alter sulfur compound in any way, it circulates in the blood intact and seeps out into a person's airway, fouling exhaled air. Treatments:
If you have nose allergy (many called it sinus), a consultation with an ENT specialist will be helpful.
Aerobic exercise, and do some deep breathing exercises too(in through the nostrils, out through the mouth)
Adequate water intake (most people will need at least 8 (8-oz) glasses per day)
Early morning drinking water on waking up is a good habit.
Lemon water gargle.
Take ultracarbon tablets ( 4 tablets 3 times a day, 2 hours after meals). Keeping the tablets in the mouth will give the tablets time to absorb the foul gases away. However, it may stain the tongue black. This problem can be solved by rinsing your mouth after the tablet sucking.
Eat slowly, chew well. Avoid food that is not easily digestable ie dairy product (milk, cheese)
If all the above fails, contact 604 222 3563/222 7701/2227702 for specialised breath rescue products - PD Dental Mouth Spray, Mouth Gargle, Tooth Paste. Try one of these for 2 weeks and see amazing effect.
Addictions and at-risk behaviors obviously impact our health very negatively. What is the best way to educate our youth in order to prevent these behaviors? You ask a vitally important question. We often think that education and information are the main pillars of prevention. Information and facts are important, but they are not enough. If education or the understanding of the dangers of tobacco use was enough of a deterrent, warning signs and notices on cigarette boxes would be sufficient to stop people from smoking. Unfortunately, this is not the case.
Warning labels are very necessary, and some countries are placing warnings of the dangers of drinking alcohol during pregnancy on bottles of alcoholic beverages. There should be more of this. Sociologists and psychologists, however, have found that even life-threatening events such as heart attacks or the diagnosis of cancer are not sufficient to produce changes in health behaviors in a large percentage of individuals. This is frightening! Should we be reading labels on the foods we eat and what we drink? Absolutely! It is essential to know the sodium content, fat content, transfat content, number of calories, etc., of the products we consume. If we paid more attention to labels, we would have fewer cases of high blood pressure and diabetes.
In the area of behaviors—specifically addiction—if education alone is not enough, what else should we be doing? There are many well-conducted and analyzed studies that show there is power in connection, or connectedness. This should not be surprising to a people who preach that our religion depends on a close relationship with Jesus. (Maybe as with our health habits, we preach more than we practice!)
But to what or whom should we be connected? In order to help people resist at-risk behavior (alcohol, drugs, premarital sexual experimentation, etc.), they need to have a meaningful relationship with a person of significance in their life. This would be a parent, grandparent, teacher, pastor, or other trusted friend. There is also a second and equally important component, and that is a connection to a set of values. We identify these values as those found in the Bible and exemplified in the life of Jesus.
What is the result of this kind of connectedness? The development of resilience. Resilience is the ability to cope under difficult circumstances and in stressful situations. Resilience is something that develops over time and is nurtured by a support system such as that found in families, churches, and communities. Youth who are connected to those of significance in their lives have more confidence and self-respect. This is fostered further by love, respect, and acceptance from the significant individuals in their lives and environment. Such relationships provide golden opportunities and methods for addressing the very serious problem the Adventist Church faces in trying to retain its youth.
Two other important factors strengthen the benefits of supportive relationships. One is the active mentoring of our youth. We need to become mentors and life coaches, sharing skills and knowledge that will help youth travel life’s road. Mentoring needs to be combined with the other essential ingredient—service. Our youth are tired of our attempts to entertain them; they need rather to be involved in service. Service for others (volunteerism) has been shown to strengthen resilience and the ability to cope despite the chaos that shows up in life from time to time.
Meaningful relationships and good friends are beneficial to our health. Positive friendship connections promote positive mental health, a sense of belonging, self-respect, and the strengthening of purpose. This can occur at any age. It is vital to foster resilience in our youth; investment in our friendships can improve health and brighten disposition for the long haul.
Allan R. Handysides, M.B., Ch.B., FRCPC, FRCSC, FACOG, is director of the General Conference Health Ministries Department.
Peter N. Landless, M.B., B.Ch., M.Med., F.C.P.(SA), F.A.C.C., is ICPA executive director and associate director of the Health Ministries Department.
Addiction: An unhealthy relationship between a person and a mind altering substance or experience that renders the person unable to quit a disease of extreme. Preoccupation to the point of avoiding reality or sidestep the challenges and responsibilities of everyday life
Chemical dependencies:alcoholism, drugs, tobacco. Nonchemical dependencies: Process or activity addictions ie gambling, working, netsurfing, sex, eating
Characteristics -The impulse to ignore the problem and hope that it will go away
-Rationalization : creating logical explanations to explain one’s behavior.
-Preoccupation with the activity and a drivenness to engage in it. In contrast, moderation and integration into real life mark a behavior as healthy
-Addicts are secretive about their activity and deceptive when discovered. The tendency to make a single substance, person or process one’s sole source of meaning, identity and value. -Unhealthy dependence.
-Isolation and unreality. The narrower one’s focus and the more removed from the real life and real relationships one’s behavior, the greater the likelihood that he/she is developing an addictive disorder.
-especially true for nonchemical dependencies such as compulsive worrying, caretaking or control, workaholism, cyberspace addiction etc
Any activity a person make highest priority in his/her life when s/he does so to his/her own detriment or the detriment of the people closest to them and when they continue to do so in the face of adverse consequences ie the loss of family, job, freedom or health.
Neglect important social, occupational or relational responsibilities
Behavior becomes increasingly unmanageable
Make futile attempts to regain control
All activities are scheduled around the habits
Unable to predict how much s/he will take after first dose (powerless to stop)
Inability to quit is a by product of changes in the brain
Fears – fear of failure/rejection – ‘thin is beautiful’
Self esteem – low sense of self worth more prone
Age. Anorexia (15-30). College age more prone to addiction. Older more successful in life –other rewards; more coping skills. Older age – drug addiction/dependence
~-----------------------------------------------------------~ Are we addicted? • Our unique ‘addictions’ chocolate, ice cream • Addictive behavior in different areas ; food, work, sex, net, exercise’ • Complex issues involved
Addictive Cycle • Mind-body relationship • Experimentation à Habits à Addiction à Brain chemistry • Example : cigarette, psychosocial and physiological rewards • Adolescent à adulthood -smoking Nicotine Addiction • Biphasic stimulation depression • Dopamine effect • Fagerstrom Fagerstrom Tolerance Questionnaire • an instrument to gauge the severity of Nicotine addiction • It has a scoring range of 0-11 points • Score of 0 minimum Nicotine dependence • Score of 11 maximum dependence • The mean score is usually within the range of 5-7 points • For an unselected group of smokers, the mean score is about 5.5; for smokers asking for treatment, the mean is usually 6.5. • 1. How soon after you wake up do you smoke your first cigarette? • Within 30 min = 1 pt. / After 30 min = 0 pt. • 2. Do you find it difficult to refrain from smoking in places where it is forbidden? • Yes = 1 pt. / No = 0 pt. • 3. Which cigarette would you hate most to give up? • First in the morning = 1 pt. Any other = 0 pt. • 4. How many cigarettes per day do you smoke? • < 15 = 0 pt. 15 - 25= 1 pt. > 25 = 2 pt. • 5. Do you smoke more frequently during the first hours after awakening than during the rest of the day? • Yes = 1 pt. No = 0 pt. • 6. Do you smoke even though you are so ill that you are in bed most of the day? • Yes= 1 pt. No= 0 pt. • 7. What is the Nicotine level of your usual brand of cigarette? • <1.0 mg = 0 pt. 1.0-1.2 = 1 pt. > 1.2 = 2 pt. • 8. Do you inhale? • Never = 0 pt. Sometimes =1 pt. / Always = 2 pt. Alcohol use & Abuse • Legal drug • Central to celebration, enjoyment, relaxation, reward • Belief protective of coronary heart Prevention • Parent’s role • Education system • Public health education Stages of Change (Prochaska) Pre-contemplation Contemplation Preparation Action Maintenance Termination ~-----------------------------------------------------------~
Pre-contemplation (Not Ready) Has no intention to take action within the next 6 months. • not really ready for a change: • simply not aware of the need • Or denying the need. • Or feel overwhelmed by what it would take to make a change; so one feel change is not a realistic option. • May need a rude awakening to jolt the person out of complacency or fear of change. Contemplation (Gettting serious) Intends to take action within the next 6 months. • become conscious of the problem • intention to do something about it, but not right now • incubation stage, a transition towards doing something. Internally become more open to the possibility of change • Paying more attention to the consequences of not making the change will motivate you to start doing something about it. Preparation Intends to take action within the next 30 days and has taken some behavioral steps in this direction. • closer to actually doing something, paying more attention to the specifics internal negotiation going on plan shapes up, taking into consideration goals as well as the realities of life. • Understanding that the plan need not be perfect, and setting a date to actually start acting on it. Action Has changed overt behavior for less than 6 months. Actually carrying out plan Likely assailed by all kinds of negative thoughts, fears, doubts. • The more specific the plan, the easier it is to follow • treat one’s goals as a priority & plan for some rewards
Maintenance Has changed overt behavior for more than 6 months. • An important part of making lasting changes is not taking these changes for granted. Keep working at it • Prevent relapse • Whole lifestyle supports (friends) • Being aware that the temptation to relapse • not an "all or nothing" proposition: Relapse is not failure
Termination • Overt behavior will never return, and there is complete confidence that one can cope without tear of relapse. • New habits have now become second nature • no longer feel tempted to go back to the behavior, under any circumstances • However, the power of habits is such that one may always be fighting against temptation. It's human nature. ~-----------------------------------------------------------~
Dealing with Addiction Step 1 • Does he want to stop? • Does he need to stop? • Does he have to stop? Until one comes to the stage where s/he admits and wants to deal with the problem, it will be very difficult to change.
Step 2 • When does s/he plan to do it? • Select a date in the near future • Plan, and prepare for the day
Step 3 • Quit date • Get rid of all things associated with the addiction • Avoid association with people involve in the addiction • Firm resolution to change way of life even though it is tough • For drug, nicotine – juice fast is helpful • Medication can help – methadone, Bupriprion, anti depressants • Hydrotherapy – bath, shower
Step 4 • Talk to someone about the habit and its effect • Reinforce the knowledge about the harmful effect • Repeat the decision of wanting to be Free from the addiction • Write down how s/he feels; and the coping options when the urge comes • Exercise – brisk walk – bring positive feeling
Step 5 • Make a plan for drug free life • Visualize/imagine what it will be like • Keep active • Stay alert. Beware of pitfall. Keep close to mentor/buddies/counselor
Rehabilitation Treatment • Basic elements • Initial evaluation • Abstinence • Learning about addiction • Group counseling • Individual counseling • Family program
Advantages of Rehab • Abstinence • Removal of Denial • Removal of Isolation • “Basic training”
Inpatient or Outpatient? • Outpatient requires • Willingness and ability to attend sessions diligently and regularly • Ability to abstain for 48 hours at a stretch of time, with little supervision/support
What if the addicted person does not believe s/he has a problem? • External motivation is OK. Most people start recovery because of a push from someone else • All rehab program is voluntary. So, all patients must give his/her consent. This level of acceptance is good enough to begin the journey to recovery • For adolescent, basic training is worthwhile even if the addicted clearly plans to return. Many needs multiple attempts before finally successful
What if s/he has been treated before? • If previous failure, get an evaluation and advice from a professional familiar with recovery. • Evaluation esp these areas • Was there ever a full recovery program in place? • Is there a source of enabling that is preventing recovery from working? • Is there an internal ‘stuck point’ that stops the recovery process at a certain spot?
What if the problem has significant psychiatric aspects? • Professional evaluation is a must • There is a problem in recognition of this aspect as • Anxiety is part of the addiction, or result of the addiction or contributor to the addiction • When in doubt, ask for second opinion or professional opinion
Management of Addiction • Professional treatment – addiction recovery treatment centre • Twelve step program ie Alcoholic Anonymous
Keys to solution • Honesty • Open-mindedness • Willingness ~-----------------------------------------------------------~
5 Steps to Help Mild Addiction
Recognizing the problem
Acknowledging powerlessness
Seek God’s help
Seek help from others
Offer praise and thanksgiving
i) Recognize the Problem • Addictive behavior is enjoyable • Denial is common • Helping another person to recognize addiction needs a lot of wisdom and patience – listening heart, appropriate words at appropriate time
ii) Acknowledging Powerlessness • Step one of the 12 Steps of AA “We admitted we were powerless over alcohol-that our lives had become unmanageable” • Addiction is powerful – one is incapable of shutting it off by his/her own strength • AA says “ We were the victims of a mental obsession so subtly powerful that no amount of human willpower could break it • Helping the addict to see this point again need lots of wisdom and patience
iii) Seek God’s Help • Powerless, therefore need help • Most important help is God’s help • “God, I’m powerless over this obsession (name it). Please remove the desire for it and give me instead a desire for what’s right” iv) Seek Help from Others • Encourage him/her to join support group • Or/and see a Counselor • Professional treatment
v) Offer Praise & Thanksgiving • Help him/her to have Faith • “Thank You, God, for Your power that is breaking the hold this addiction has had over my life” • “God I thank You for accepting me right where I am” • Praise God even for small progress
We admitted we were powerless over alcohol--that our lives had become unmanageable.
Came to believe that a Power greater than ourselves could restore us to sanity.
Made a decision to turn our will and our lives over to the care of God as we understood Him.
Made a searching and fearless moral inventory of ourselves.
Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
Were entirely ready to have God remove all these defects of character.
Humbly asked Him to remove our shortcomings.
Made a list of all persons we had harmed, and became willing to make amends to them all.
Made direct amends to such people wherever possible, except when to do so would injure them or others.
Continued to take personal inventory and when we were wrong promptly admitted it.
Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
This episode opens some windows on the world of addiction, whether this addiction is with gambling, drug taking or other behaviours. There is dialogue with some who describe its nature, others who have battled to escape its grasp, and a counsellor who helps in the ongoing struggle with it.
A - Addiction According to one dictionary definition, to be addicted is to give oneself over to something as a habit or pursuit, or to devote oneself habitually to something.
I love my addiction. I’ve got to have it.
Compulsion is always associated with addictive behaviour.
Being a compulsive gambler we are very manipulative. We are con-artists.
1. What is addiction? Do you think that the descriptions of addiction by the various personalities in the video reveal the essence of what addiction is? 2. Is there a difference between passion for something, and addiction to it? 3. How do you think addiction takes charge of people despite their good resolutions? B - The Addiction Scene There is a view that certain living conditions or circumstances seem to encourage addiction.
First time I came here (Vegas) was in 1971 and it was a fantasy land, an amusement park for grown-ups as far as I was concerned.
You look around, you watch TV, you look at advertising, you look around you at that extreme force, that extreme free. Extreme everything.
You always have to pass the machines to get to where you’re going to eat, or the rest room.
1. Is the environment of Las Vegas and other similar cities so superficial, so unreal and so fast, that they are especially conducive to addiction? 2. There are many drug addicts in country towns. Do you think it matters where you live?
C - How the Addiction Process Works Somehow addicts of drugs, gambling or other behaviours are compelled by a desire or need too strong to resist. The accounts convey a strong sense of helplessness to resist addiction.
I guess “out of control” is the actions that precede the addiction.
At first gambling is very social and relaxing and fun.
My drug use started at a fairly young age for me. Started off real simple smoking a little pot, drinking on the side. As I got older it progressed into harder drugs, psychedelic, cocaine, pills.
When I was gambling I didn’t think. I just acted.
1. How do you think it happens that some people first use drugs for pleasure, then lose control of their emotions and behaviour to lose the pleasure? 2. Why do you think some people become addicted to things while others manage to control their compulsion? Is there a basic reason?
D - Addiction as a Path to Meet Needs One explanation for addiction is that it is the result of peoples’ attempts to meet their deepest needs.
Mum, just tell me that you love me.
He needed his family, his family support..
Addiction also has to do with the want or need to control people.
I don’t know about food but when it comes to alcohol and drugs it’s a way of becoming not me. I don’t want to be me, therefore I can check out.
1. Do you think that addiction sometimes develops because people are searching for acceptance or love or some other basic need that has been denied them? 2. Paul claimed that for many addicts, drugs meet their need to escape from their past or present problems. Do you agree that addiction is largely an attempt to cope with things that are difficult or painful? 3. We all need fun and pleasure, and drugs can provide intense pleasure. What other things could compete with drugs or gambling as a pleasure source? E - Addiction as Search for Meaning Addicts speak of peace, serenity, optimism and appreciation of nature as things they could not see when addicted. These relate to life meaning.
Taking drugs is an escape. It becomes their god.
I was sitting here thinking as I looked over the mountains, that probably while I was gambling I don’t recall ever coming out here — only when I stopped.
The most important thing to me is my peace of mind and the little serenity that I have. For example, when I wake up in the morning I look forward to each day.
1. Do materialism, the media and fast urban pace rob life of its quality for many people? How do you think they can live with purpose in modern society? 2. Some take drugs to get emotionally and physically high. Would you agree that addiction can be a kind of search for spirituality? 3. Do you think that there are positive things that could replace addiction as a search for meaning and spirituality?
F - The Down Side There is clearly an ugly side to addiction, one that involves an increasing demand for the habit or drug that stops at nothing to satisfy the craving.
It just turns into a vicious circle where they live for the next fix that will numb their pain.
Because you’re high, you’re emotionally unavailable to yourself.
There was almost nothing I wouldn’t do to get money to gamble.
1. Almost all accounts of addiction trace progression from pleasure to pain. Do you think that this is always the way it goes? 2. Would you say that addiction brings pain and death because it is a false form of pleasure, a kind of evil? G - How We Beat Our Addictions It seems that addicts need good personal support, a daily programme and perseverance to beat their addiction.
It’s not one of those things you can just give up on your own. It’s definitely a “support issue” kind of disease where you have to work at a particular program.
I reached in my pocket for my last twenty, going to put it in the machine and I said “I can’t do this any more, it’s over.”
Instead of running away from our past, why not accept it and use it as a stepping stone to make a difference.
1. How do you think some people can decide “it’s over” and quit addiction, while others are helpless to the point of death? 2. How do you think people can address issues that made them addictive? 3. How may value priorities and strategies for making better choices help people overcome addiction? H - Overview 1. There are many causes, pleasures and behaviours besides drugs and gambling that you could be potentially addicted to. What do you think makes any of these addictive? 2. How can you see education and religion competing with the frenzied worlds of entertainment, pleasure and crime in combating addiction?
