Month: January 2017

Choosing a Drug Treatment Program

Many people are under the misperception that drug abuse and addiction are problems that they are somehow exempt from or immune to. However, the reality is that anyone, no matter who they are or what their station in life, can develop an addiction to drugs. Oftentimes, a person only realizes this when they (or someone they love) come to the realization that they have addiction to drugs. Once this realization is made, the next step will be to choose a drug treatment program to help them overcome their addiction. There are numerous factors to consider when choosing a drug treatment program. Get to know some of these important factors so that you can better choose your drug addiction counseling and treatment program here in Lynnwood, Washington and get yourself into treatment as soon as possible.

 

Be Sure They Are Licensed And Accredited

Perhaps the most basic factor to consider when choosing a drug treatment program is whether or not the program is licensed and accredited to provide you with drug addiction treatment services. Accreditation is a state-level determination that indicates whether or not a company meets the state’s standards of care and health standards to operate within the state as a treatment facility. Licensure, on the other hand, has to do with the people in charge of the treatment program and those that provide services. The program you choose should be run by licensed mental health professionals and at the very least, there should be at least one doctor or nurse associated with the facility.

 

The Living Arrangement Of The Program

Different people require different levels of care when it comes to drug addiction treatment. Some will do well with an outpatient treatment program in which they live at home and go to treatment for a few hours several days a week. Others require residential treatment in which they live at the treatment facility 24 hours a day. And even others require additional mental health and physical health services which requires inpatient drug treatment from a hospital. Choose the program that suits your living needs.

 

The Aftercare Services Provided

Almost more important that the time you spend in treatment itself, is the aftercare that is required following initial treatments. Aftercare includes everything from group meetings to individual and family counseling, and even assistance finding a job and dealing with finances and legal issues. Be sure that the program you select has extensive aftercare service options to help you stay on track once your treatment is complete and to help keep you from relapsing.

Now that you know some of the factors that you should consider when choosing a drug treatment program, you can be sure that you are choosing the right program for you. If you have additional questions or want to get your treatment started, you can contact Alpine Recovery Services, Inc to give you the help you need.

UK gov’t to invest nearly £1bn in mental health services

Prime Minister David Cameron has announced that the government is to spend nearly £1 billion on improving mental health services across the country. 

More than £400 million is being set aside to help secure round-the-clock treatment for mental health patients in the community, “as a safe and effective alternative to hospital”.

Crisis resolution and home treatment teams have already been rolled throughout England as part of a transformation of the community mental healthcare system, but the extra funds will ensure “more complete coverage around the country,” according to the Department of Health.

Elsewhere, a cash injection of £247 million over the next five years will ensure that mental health services are available in every emergency department and that they are accessible 24 hours a day, 365 days a year in at least half of England’s acute hospitals by 2020.

The move should not only boost the care of patients with mental illness in A&E, but also generate important savings for hospitals through fewer admissions and shorter stays, says the DH.

A £290-million investment has also been announced to improve the care of expectant or new mothers with mental health issues, giving at least 30,000 more women each year access to specialist mental healthcare before and after having their baby, while services to help teenagers with eating disorders such as anorexia, which kills more people than any other mental health condition, are also to be expanded.

New psychosis treatment target

Cameron has also unveiled a new waiting time target so that, from next year, at least half of those experiencing psychosis for the first time must be treated within two weeks, rising to at least 60% by 2020. 

The mental health taskforce report is due to be published in the next few weeks, unveiling plans for further investment and service expansion over the next five years, with the aim of transforming care. 

“Putting mental and physical health on an equal footing is a far reaching idea whose time has now come,” said Simon Stevens, chief executive of NHS England. “A sea change in public attitudes coupled with an increasing range of effective mental health treatments mean that now’s the time to tackle the huge unmet need that affects families and communities across the nation”.

How to Eat a Healthy Diet

If you are what you eat, it follows that you want to stick to a healthy diet that’s well balanced. “You want to eat a variety of foods,” says Stephen Bickston, MD, AGAF, professor of internal medicine and director of the Inflammatory Bowel Disease Center at Virginia Commonwealth University Health Center in Richmond. “You don’t want to be overly restrictive of any one food group or eat too much of another.”

Healthy Diet: The Building Blocks
The best source of meal planning for most Americans is the U.S. Department of Agriculture (USDA) and U.S. Department of Health and Human Services Food Pyramid. The pyramid, updated in 2005, suggests that for a healthy diet each day you should eat:

  • 6 to 8 servings of grains. These include bread, cereal, rice, and pasta, and at least 3 servings should be from whole grains. A serving of bread is one slice while a serving of cereal is 1/2 (cooked) to 1 cup (ready-to-eat). A serving of rice or pasta is 1/2 cup cooked (1 ounce dry). Save fat-laden baked goods such as croissants, muffins, and donuts for an occasional treat.
  • 2 to 4 servings of fruits and 4 to 6 servings of vegetables. Most fruits and vegetables are naturally low in fat, making them a great addition to your healthy diet. Fruits and vegetables also provide the fiber, vitamins, and minerals you need for your body’s systems to function at peak performance. Fruits and vegetables also will add flavor to a healthy diet. It’s best to serve them fresh, steamed, or cut up in salads. Be sure to skip the calorie-laden toppings, butter, and mayonnaise, except on occasion. A serving of raw or cooked vegetables is equal to 1/2 cup (1 cup for leafy greens); a serving of a fruit is 1/2 cup or a fresh fruit the size of a tennis ball.
  • 2 to 3 servings of milk, yogurt, and cheese. Choose dairy products wisely. Go for fat-free or reduced-fat milk or cheeses. Substitute yogurt for sour cream in many recipes and no one will notice the difference. A serving of dairy is equal to 1 cup of milk or yogurt or 1.5 to 2 ounces of cheese.
  • 2 to 3 servings of meat, poultry, fish, dry beans, eggs, and nuts. For a healthy diet, the best ways to prepare beef, pork, veal, lamb, poultry, and fish is to bake or broil them. Look for the words “loin” or “round” in cuts of meats because they’re the leanest. Remove all visible fat or skin before cooking, and season with herbs, spices, and fat-free marinades. A serving of meat, fish, or poultry is 2 to 3 ounces. Some crossover foods such as dried beans, lentils, and peanut butter can provide protein without the animal fat and cholesterol you get from meats. A ¼ cup cooked beans or 1 tablespoon of peanut butter is equal to 1 ounce of lean meat.
  • Use fats, oils, and sweets sparingly. No diet should totally eliminate any one food group, even fats, oils, and sweets. It’s fine to include them in your diet as long as it’s on occasion and in moderation, Bickston says.

Healthy Diet: Eat Right and the Right Amount
How many calories you need in a day depends on your sex, age, body type, and how active you are. Generally, active children ages 2 to 8 need between 1,400 and 2,000 calories a day. Active teenage girls and women can consume about 2,200 calories a day without gaining weight. Teenage boys and men who are very active should consume about 3,000 calories a day to maintain their weight. If you’re not active, you calorie needs drop by 400 to 600 calories a day.

The best way to know how much to eat is to listen to your body, says Donald Novey, MD, an integrative medicine physician with the Advocate Medical Group in Park Ridge, Ill. “Pull away from the table when you’re comfortable but not yet full. Wait about 20 minutes,” he says. “Usually your body says, ‘That’s good.’ If you’re still hungry after that, you might want to eat a little more.”

Healthy Diet: Exercise Is Part of the Plan
At the bottom of the new USDA food pyramid is a space for exercise. Exercise is an important component of a well-balanced diet and good nutrition. You can reap “fabulous rewards,” says Dr Novey, just by exercising and eating “a healthy diet of foods that nature provides.”

How to Choose the Best Doctor for an Assured Medical Treatment?

Over the last few decades, the medical profession has been alluded to multiple polysyllabic names that don’t restrict them to any particular profession, and there are sufficient reasons for this. There’s no doubt that the doctors do work hard, but when compared to what the country doctors did in the past, it’s almost nothing. Although previously there were multiple chores that the doctors did, it was somewhat easy for them to survive, since there wasn’t much competition in the market. But with the medical studies getting within the reach, more and more of students have come up to be the doctors and serve the nation.

With the 21st century slowly progressing, it has also become affordable for the general mass to go through the medical curriculum and that brings in more and more of competition for one in the market. Anyone who delivers anything short of the best, gets to lose his/her market, and with the intrusion of Internet in everyone’s home, finding the best doctor in town has got really easy. While choosing a doctor, make sure you go through the following three considerations for choosing the right doctor.

Convenience! Yes that’s the key word that the famous doctor Christen W Altermatt herself thinks is essential while selecting a doctor for your family. While someone is really sick in home, no one would like to waste the most crucial time to travel and carry the patient to the doctor’s center. So it is best that one finds a doctor who’s conveniently located near their residential spaces. The doctor who’s selected must be available for an appointment anytime, because the illness won’t wait for the doctor’s appointment and keep spreading. So it is always expected to have a doctor who listens to the concerns well. Even the doctor who’s selected must be open during emergency situations. At times, doctors are on their medical conference trips and are not available. A good doctor will always provide an option while he’s unavailable for emergency cases.

Experience! Just learning few pages doesn’t make a doctor, rather it’s the experience and prolonged years of stay in the medical field that trains the doctors to handle critical situation that might arrive anytime in the medical field. There are multiple websites which reviews these doctors in the market, and allows the patients as well, to share their experience with anyone in particular. It is always safer to go through them, have a clear idea of their reputation in the market and then approach for him or her.

While most of the doctors work individually, there are many like Christen W Altermatt who work with insurance companies, and that’s a great bonus for her patients. Since the treatment procedures are getting costlier and the latest medicines are on the higher ends, most patients try working with doctors who accept insurance policies. That takes care of the financial responsibilities as well.

Just taking reside of the medical aid is not enough, make sure all the peripheral concerns are taken care of as well. A successful medical practice must be a joint venture of both the doctor as well as the patient.

Campus Researchers Try New Ways to Close a Gap in Mental-Health Care

As college campuses grapple with mental-health issues, researchers are trying new ways to bring treatment to students from ethnic-minority backgrounds, who experts say often don’t get the care they need and are more likely to have negative consequences due to their illness. Even highly educated minority students tend to seek care for mental-health issues less frequently than whites.

Academic researchers and foundations such as the Steve Fund are trying to improve the quality of mental-health care for ethnic-minority populations and their engagement with it. They want to bring treatment to the patient rather than waiting for a person to come to a traditional health setting, and they are using technology as an alternative to face-to-face treatment.

The vast majority of people with a diagnosable mental-health disorder don’t seek help, according to the Centers for Disease Control and Prevention. Members of ethnic-minority groups, such as African-Americans, and immigrant populations are even less likely than whites to get care, especially high-quality services, experts say.
Dr. Margarita Alegria, chief of the disparities research unit at Massachusetts General Hospital, where interventions and studies aim to help ethnic-minority patients feel more supported by clinicians and improve communication. ENLARGE
Dr. Margarita Alegria, chief of the disparities research unit at Massachusetts General Hospital, where interventions and studies aim to help ethnic-minority patients feel more supported by clinicians and improve communication. Photo: Thomas McGuire

Undertreatment of ethnic minorities has long been a concern in the mental-health community, highlighted by the first-ever Surgeon General’s Report on Mental Health issued in 1999. Common universal barriers such as cost, lack of availability and stigma against seeking mental-health care are compounded for some ethnic minorities by mistrust of the health-care system, racism and difficulties with language and communication, according to a supplemental report on culture, race and ethnicity issued with the Surgeon General’s report.

Most of these barriers are still a problem today, according to mental-health experts. Minorities are likely to wait longer with symptoms before seeking care compared with whites, and they are more likely to drop out of treatment, making retention an important goal for professionals. Generally, though, if they receive good care, outcomes are similar for ethnic minorities and whites, experts say.
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Research suggests that minorities often prefer counselling or talk therapy to medication yet they often don’t have the opportunity because of limited service options. If offered medication and willing to try it, however, they respond as well as whites, says Jodi Gonzalez Arnold, a psychologist and professor in the department of psychiatry at the University of Texas Health Center in San Antonio, who has studied the issue.
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Of course, not all ethnic minorities, both within and across subgroups, are the same, and there is a need for improving mental health universally. Still, “clinicians should be aware not only of within-culture norms but also what does the research shows across cultures to make a decision based on the totality of the information,” says Dr. Arnold.

Lower educational levels and tough economic circumstances are barriers for some racially and ethnically diverse populations. But the disparity in treatment-seeking exists even among highly educated individuals from these populations, such as college students at elite universities, research shows.

Abhilasha Belani, a 22-year-old recent Stanford University graduate, says many of her ambitious, high-achieving classmates had difficulty admitting when they were struggling and needed help. They dubbed the pressure to look in control “duck syndrome”—looking calm on the surface but paddling furiously underneath.

While there are countless differences between and among members of different ethnic groups, children of immigrants of Asian heritage seem to have particular trouble asking for help because to do so has been seen as a failure, says Ms. Belani, who was born in France to Indian parents and worked as a peer counselor and residential adviser while at Stanford.

In her junior year, Ms. Belani found herself struggling alone with stress from academics and extracurriculars, which led to increased anxiety. She went to the school counseling center but after being encouraged to seek out a therapist in the community on her own, she says she “lost motivation” and didn’t pursue the lead.

Because she worked in counseling, she eventually cobbled together support from other peer advisers and faculty members, who became mentors and helped her learn to take better care of herself, she says.

Students from ethnic-minority backgrounds need more support alternatives, some advocates believe. A new initiative, to be launched by the Steve Fund, one of the few groups focused on supporting the mental health of college students of color, and a website offering online therapy called 7cups.com, focuses on offering them emotional support online.

The goal is to offer a first step for students of color having emotional or mental-health concerns. It is a way for them to talk with someone and get encouragement in an environment where a person may feel isolated, says Annelle Primm, a psychiatrist and senior medical advisor to the Steve Fund. Interventions focused on specific populations are intended “not to stigmatize or separate or segregate,” Dr. Primm says, “but to have the capacity to communicate with a diversity of populations.”

So far about 1,500 volunteers have received training as listeners. The service is expected to launch in February, according to fund president Evan Rose, whose family started the Steve Fund for his brother, a Harvard College graduate who died from suicide in 2014.

Academic researchers at Massachusetts General Hospital have been running interventions to improve patient-clinician communication and help ethnic-minority patients feel more supported by clinicians who may or may not share their ethnic or cultural backgrounds. One trial of 278 patients and 48 clinicians that has been taking place over the past 2.5 years is aimed at training providers to do more shared decision-making with minority patients, as a way to decrease the “interpersonal gap” minority patients often describe experiencing with health-care providers.

The intervention is trying to give patients a stronger voice, such as telling a clinician which topics they want to discuss during a session. And it is training clinicians to be more responsive and to make fewer assumptions about patients’ feelings, especially because there might be cultural differences in how people express emotion.

The trial is nearly complete. Scientists will be analyzing the outcome of the data in coming months, says Margarita Alegria, chief of the disparities research unit at Massachusetts General Hospital and a Harvard Medical School professor of psychology.

Another intervention, funded by the National Institute on Aging, is trying to train health workers in community agencies that serve the elderly, many of whom are ethnic minorities, on how to provide evidence-based mental-health interventions for depression and anxiety, sleep and nutrition, in Chinese, Spanish and English. The study, called “Positive Minds, Strong Bodies,” increases often-limited resources for providers and takes place in settings where patients are already going, rather than referring them to a new provider or a clinic.

“Rather than wait the average eight years that people with behavioral health problems wait before they get to care, we should move treatment where people are to serve them sooner,” Dr. Alegria says.

Letter from the Founder Has It Really Been 10 Years

Wow! It’s been ten years since Health In Harmony started. I still find that very hard to believe. Ten years ago in February, Cam Webb (currently ASRI’s Conservation Advisor) and I were in Aceh helping after the tsunami and we were horrified to see not only the trauma, but how few of the non-profits were listening to communities.

I came back and called a good friend, Julia Riseman, in despair, “How could I ever work for any of these organizations? Not only do they not listen to the communities, but none of them see that human health and environmental health are totally intertwined. They just do one or the other.”

And Julia, said, “Kinari, we are going to start our own and it will be founded on the principle that the best solutions will always come from the communities that are experiencing a problem.”

Thank goodness I listened to her and thank goodness people came out of the woodwork to support us with time, money, great ideas, and love. Thank you all! Together we have seen a remarkable ten years and I am so grateful to all the people who have come together all over the planet to make it possible.

Today I spoke with a young man who has been working on conservation for years in Indonesia but who become very disillusioned. He said the models he’d seen were to try and convince people that if they changed their behavior, they would get benefits from conservation. He told me how excited he was to see that Health In Harmony recognizes what he had seen, that without up-front benefits people are forced to destroy the environment in order to get access to things like health care. They fully understand that protecting the environment is in their long-term best interest, but if their child is sick what choice do they have?

Now he has decided to go to medical school, and he told me how happy he was that Health In Harmony has shown him that he can do both health care and conservation and in fact, that by combining the two, both will benefit.

I told him, that he might very well have a job when he finishes medical school – working for Health In Harmony, starting other sites!

Thank you all for saving lives, saving rain forest, and helping inspire another generation of young people who see how interconnected all of our well-being is.

Sending gratitude to you all,

Choosing the Right Short-Term Rehab Facility for Seniors

Short-term rehabilitation facilities exist to help seniors overcome medical setbacks in a safe, professional and caring environment.  Senior rehabilitation centers are not the nursing homes of past eras. Modern facilities provide intensive focus on healing and therapy that allows seniors to maximize their abilities after treatment. Finding the right one for your elder’s needs should include a number of different aspects of care:

Medical Care

Ensuring that patients have appropriate medical care during the rehabilitation period is critical to their recovery. Generally, seniors enter short-term rehab facilities after surgery for period of weeks or months. A rehab facility should provide the necessary level of medical care for seniors’ needs. This may include wound care, IV therapy, injected medications and other necessary procedures.

Physical Therapy

In many cases, the senior may be in the rehabilitation facility as a result of a problem that affects their mobility or daily physical function. The facility should be able to provide regular physical therapy on the premises to allow these patients to receive the appropriate follow-up care they need for full recovery.

Recreational Therapy

A good short-term facility will also provide a variety of recreational activities to keep seniors mentally engaged and socially interactive. Music, art, film, gardening and other modalities should be available to help stimulate patients’ attention and creativity.

Safety and Security

The facility should be well lighted, clean and without clutter, to allow easy movement by patients and staff. The facility should have bathrooms that are convenient for patients’ use, with call buttons to allow them to receive help when needed. It should register visitors going in and out of the facility during the day, and they should have security measures on hand at night.

Lifestyle Factors

Another aspect of care for your senior is the general lifestyle of the facility. The staff should be upbeat and friendly, encouraging the patients to become involved both mentally and physically, to their best ability. Activities should be scheduled at regular times throughout the day. The environment should be cheerful and well lighted, with windows available to allow patients contact with the outdoors. There should also be outdoor areas for sitting and conversing. Meals should be appetizing and healthy, tailored to the nutritional needs of the patients. In general, the facility should be upbeat and pleasant, providing a positive environment for their recovery.

If you or a loved one needs short-term rehabilitation care, contact the A.G. Rhodes Health and Rehab Center for information about care at their Marietta GA facility.

Global Health Forecast For 2016: Which Diseases Will Rise … Or Fall?

No one predicted the Ebola epidemic before it burst forth in 2014 and continued to claim lives throughout 2015. And so, as 2016 begins, readers might well wonder what biological culprits — parasites, bacteria and viruses — are lurking out there, ready to unleash another outbreak of something terrible on an unsuspecting world.

We put the question to four infectious disease experts: What are your best educated guesses about the big global health stories in 2016?

Before making any predictions, Dr. Dyann Wirth, chair of the Department of Immunology and Infectious Diseases at the Harvard School of Public Health, wanted to take an optimistic look back. Three researchers shared the 2015 Nobel Prize in Physiology or Medicine for their work in discovering treatments for malaria, river blindness and lymphatic filariasis, also known as elephantiasis. “We’re at a very interesting time in global health,” says Wirth. “That these diseases were recognized by the Nobel Committee raised awareness in the public eye.”

In the future, relatively unheard-of diseases could emerge from the shadows. Some experts are already looking suspiciously at a mosquito-borne culprit that had been a relatively small player in global health but is now alarming health officials in Brazil — the Zika virus. The incidence of Zika infection has been low but has shown signs of increase in South America and other areas of the world. And in November, chilling reports out of Brazil have health experts worried that the Zika virus might be connected to an upsurge in microcephaly in infants — a condition in which the infant’s brain is smaller and less developed than normal. “This virus might be causing birth defects in Brazil,” says Dr. Michele Barry, dean of Global Health and director of the Center for Innovation in Global Health at Stanford University. More research is needed, but similar reports of increased Zika virus coinciding with increases in brain and spine malformations in French Polynesia have health officials worried.

A challenge in 2016 will be to hold on to hard-won health advances in an unstable world. For example, Wirth said, during the Ebola crisis, malaria treatment fell lower on the priorities list in the affected countries and fewer protective bed nets were available. The result was a rebound in cases of malaria. One study estimated the number of cases of and deaths from malaria in Guinea, Liberia and Sierra Leone. The study found a probable increase of 3.5 million malaria cases in those three countries during the Ebola epidemic, resulting in 10,900 additional deaths.

Disease doesn’t respect borders, and cross-border infection of malaria is a big problem in Africa, says Dr. Peter Agre, director of the Johns Hopkins Malaria Research Institute and a Nobelist in chemistry in 2003. “It’s like crab grass. You can take care of it, but if your neighbor doesn’t, it comes right back,” says Agre. Factors having nothing to do with health-care systems can be at play in disease spread: chaos, war, natural disasters, economic downturns and refugees on the move. “In sub-Saharan Africa, malaria, HIV and TB could be rapidly re-established,” says Agre.

Past progress can be fragile. “It’s possible we could have a re-emergence of Ebola. Ebola and SARS and avian flu have taught us that we have to be prepared for the unknown, for epidemics from an agent we haven’t precisely seen before, or we didn’t anticipate as having a huge impact,” says Wirth.

She remembers being on a scientific panel about a decade ago when the topic of Ebola came up. “One expert said that it was an irrelevant disease. That’s the kind of attitude we have to guard against. Perhaps Lassa fever [a viral illness transmitted by rats, seen in West Africa] or chikungunya virus [an infection transmitted by mosquitoes] could lead to a pandemic,” says Wirth.

The world health community needs a cadre of people busy cultivating a base of knowledge of diseases like Zika virus so that the world health community can react quickly to new threats and cultivate a base of knowledge to help the world act quickly. That didn’t happen with Ebola. “The people working on Ebola before the outbreak — you could probably count them on one hand,” says Wirth.

Fortunately, that’s not the case today when it comes to avian flu researchers. “There has been a constant interest in understanding how the influenza virus moves between species,” says Wirth. “Should something happen, that group of people is prepared.”

But for a lot of other potential outbreaks, the world needs to be better prepared than it has in the past, says Barry.

So for her, the big health story of 2016, Barry predicted, will be the reorganization of the World Health Organization. “The WHO is broken,” she says. “They felt they were just a technical adviser [on Ebola] and waited eight months to call a public health emergency. They weren’t ready to roll out vaccines or drug trials. They were not prepared to ramp up experts and medical volunteers.”

The WHO has been publicly shamed over its response to Ebola, says Dr. William Moss, head of epidemiology at the International Vaccine Access Center at Johns Hopkins University. “There were critical reports of their response. What the world needs is an organization that’s going to step up and take a leadership role,” he says. “I think the WHO learned, and the next time this happens, the global health community will be better prepared.” WHO itself acknowledged shortcomings and has drafted recommendations for change.

No one knows for certain what the next global health challenge will be. Moss says the U.S. will probably have additional outbreaks of measles because of some parental resistance to vaccines. And advances in infectious disease and in maternal and child health are new and fragile and could suffer setbacks.

But the news won’t all be bad. Pakistan and Afghanistan remain the only two countries still reporting cases of wild polio virus, or virus that occurs naturally. (Three cases of vaccine-derived polio — two in Ukraine and one in Mali — occurred in 2015. That rare event can happen when weakened live virus from the oral vaccine is shed in stool and infects an unvaccinated person.)

“I’m going to be an optimist and say the big public health story of 2016 will be the last case of polio in the world,” Moss says.

A Health In Harmony Volunteer Goes to COP21

Over 40,000 civil society observers, government delegation members, heads of state (from over 190 countries), lawyers, negotiators, policymakers, healthcare professionals, scientists, students (the list goes on…) gathered in Paris the last two weeks to come to a global agreement about where we stand, where we are headed, and more specifically, what needs to be done about rapid climate change and its impact on people and planet. That’s no small order.

This was my second time attending the UN Climate Negotiations. I have had the opportunity to work with both civil society organizations (last year at COP20 in Lima, Peru) and government delegations (this year, with the country of Seychelles and other small island developing states). On this global, UN level, I work to advocate for a fair, equitable, and legally binding global agreement, especially in terms of gender justice and human and indigenous rights.

This year, with better planning and more time, I was also able to incorporate the work that I like to be involved with on-the-ground – tropical forests and health care. After spending my summer in Sukadana, I wanted to understand how a program like ASRI fits into the global climate agenda.

With this in mind, I was keen on following not only how gender was being addressed in the Paris Agreement, but how the 190+ countries will 1) address the human health concerns of climate change, 2) allow emerging economies to continue economic development, and 3) still aim to protect Earth’s limited natural resources, namely tropical forests.

The Agreement

Forests, and especially tropical forests, are not typically figured into the climate negotiations or agreements as prominently as they should; same goes for health. This ignores the facts that deforestation is a major source of greenhouse gas emissions and that a rapidly changing climate impacts human health in innumerable ways. A few champion countries and NGOs have battled for years to get forests, and health care, in the legally binding text – a way to inextricably tie them to climate change in a global accord.

So where does the new Paris Agreement leave us with this?

The Moment

 

I was sitting in the Closing Plenary as Heads of State, including John Kerry and Ibu Nur Masripatin, a representative from the Indonesian Ministry of Forestry, filtered in. Still frantically reading the final document that had been released (checking for the terms forest, health, and gender), I felt unprepared for the historic, emotionally overwhelming, moment that came. The COP President called out to the audience for any objections to the agreement – NONE from any of the Parties! The gavel struck. I couldn’t believe it! The agreement was final, binding, and officially accepted.

It is hopeful, but just a start.

Forests finally made it into this global agreement. Countries collectively recognized that the ecosystem services and benefits of buffering climate change through forests and reducing deforestation is a key part of tackling this issue. Specific mentions of forests were listed under the Finance section of the document, highlighting the need for developed countries to support developing countries in their efforts to curb emissions from deforestation, and work on on-the-ground solutions to protect their remaining forests. Another positive outcome from the agreement was highlighting how (finance for) climate adaptation is a central pillar in helping communities that are most vulnerable.

However, the mention of health and directly connecting it to the impacts of climate change were largely left out of the agreement. Thankfully, the right to health was mentioned as a key tenet to sustainable, safe development moving forward, especially when climate mitigation efforts are taken seriously.

 

The Aftermath

Again, countries coming together to agree on a global agreement is hopeful, but just the beginning. The real work comes when the details of the agreement are put into motion at the national and sub-national levels.

Thinking about my time at ASRI, I could not help but recognize how the model established by Health In Harmony contributes directly to the ideals put forth by the Paris Agreement. ASRI actively works to curb and disincentivize deforestation, provides the opportunity to the right to health (to communities that are most vulnerable to the health and long-term economic impacts of this very deforestation from slash-and-burn agricultural practices), and serves as a unique example of climate adaptation that tackles environmental degradation through behavior change and provision of essential services and basic rights.

In also attending the Global Climate and Health Summit and the Global Landscapes Forum, held over the weekend of the negotiations, one thing struck me – I never came across another program that made a connection between tropical forests, rural poverty, and health care access, or how this could relate to climate change.

How Heroin And Opioids Hijack The Brain

When Jack O’Connor was 19, he was so desperate to beat his addictions to alcohol and opioids that he took a really rash step. He joined the Marines.

“This will fix me,” O’Connor thought as he went to boot camp. “It better fix me or I’m screwed.”

After 13 weeks of sobriety and exercise and discipline, O’Connor completed basic training, but he started using again immediately.

“Same thing,” he says. “Percocet, like, off the street. Pills.”

Percocet is the brand name for acetaminophen and oxycodone. Oxycodone is a powerful opioid. It’s one of the most commonly prescribed painkillers, and is a key factor in one of the country’s most pressing public health problems — an opioid addiction epidemic. It is a crisis that started, in part, from the overprescription of painkillers like Percocet, and then shifted to heroin as people addicted to prescription drugs looked for a cheaper high.

O’Connor is one of an estimated 2.5 million Americans addicted to opioids and heroin, according to the National Institute on Drug Abuse. Over three years, he detoxed from prescription painkillers — and heroin — more than 20 times. Each time, he started using again. So why is it so hard for opioid addicts to quit? You can boil it down to two crucial bits of science: the powerful nature of opioids and the neuroscience behind how addiction hijacks the brain.

“The first recording of opioid use was 5,000 years ago,” says Dr. Seddon Savage, an addiction and pain specialist at Dartmouth College. It was “a picture of the opium poppy and the words ‘the joy plant.’ “

‘It Ruined Me That Time. But I Loved It’

Jack O’Connor says he ended his freshman year of college as an alcoholic. He went home that summer desperate to replace alcohol with something else. And it was not hard to do. In 2012, 259 million opioid pain medication prescriptions were written — that’s enough painkillers for every American to have a bottle of the pills. O’Connor got his hands on some 30-milligram Percocet.

“I ended up sniffing a whole one, and I blacked out, puking everywhere,” says O’Connor. “I don’t remember anything. It ruined me that time. But I loved it.”

Opioids got him higher faster than any drug he had tried. And even though different drugs produce different highs, they all involve the same pathway in the brain.

How Opioid Addiction Works

Opioids increase the amount of dopamine in a part of the brain called the limbic reward system. Dopamine causes intense feelings of pleasure, which drives users to seek out the drug again and again.

 

LA Johnson/NPR

They trigger the release of dopamine, which is a neurotransmitter that causes intense pleasure in parts of the brain that include the limbic system, according to Savage. It links brain areas that control and regulate emotions such as the pleasures of eating, drinking and sex. “This is a very ancient part of the human brain that’s necessary for survival,” says Savage. “All drugs that people use to get high tickle this part of the brain.”

People can become psychologically and physically dependent on opioids very quickly. Breaking the physical dependence involves a several-day nightmare called detox, when the body gets used to being without the drug.

“It is an amazing thing to see someone basically vibrating in their chair, feeling nauseated, looking like hell,” says Jeffrey Ferguson, a detox specialist at Serenity Place in Manchester, N.H.

Jack O’Connor put himself through detox 20 times, but that didn’t stop his addiction. O’Connor’s limbic reward system had hijacked other systems in his brain — systems that drive judgment, planning and organization — driving them all to seek that pleasure of getting high. This process can go on during years of sobriety, according to Savage.

“Addiction recruits memory systems, motivational systems, impairs inhibitory systems and continues to stimulate the drive to use,” she says.

O’Connor says all his decisions began to serve his addiction. When he was using, everything was about getting the next drink or drug.

Over his years of addiction, O’Connor lied to his family and stole from his job — all while also trying to get sober. A little over a year ago, he put himself through a five-day detox clinic and managed to get through five more days in the real world sober. Then he couldn’t take it. One day he started obsessively searching his credit cards for drug residue. He found a bag of heroin in his wallet.

“Somebody’s telling me I need to get high,” he thought at the time.

And that’s what he did.

‘I Don’t Need It Anymore’

Feelings like joy and shame also play a role in drug dependence, and make it hard to quit. Practical issues are a challenge, too. “Finding the job, saving money, finding a place to live,” says Ferguson. “Maybe they have some felony convictions. It’s a lot.”

And the country is facing a shortage of addiction treatment facilities and specialists; the shortage ranges wildly from one state to another. Treatment for opioid addiction includes a variety of services: medication, talk therapy, job support, all stretched out over years. Detox isn’t enough.

Greta Rybus for NPR

O’Connor is now 23 and he’s finally sober — Jan. 11 is his one-year sobriety date. In that time he’s been in a nonmedical residential treatment program in Dover, N.H., where he lives and works. He has support — a girlfriend, his family, the Marines. And in the same way that he once replaced his coping skills with drugs, he has rebuilt his coping skills around quitting drugs.

“I don’t need it anymore,” he says. “I literally, physically and emotionally don’t need it.” And as much as O’Connor loved the feeling of getting high on heroin, now there is something he loves more: “I love the way I feel sober,” he says.