August 2018 Newsletter

International Overdose Awareness Day (Aug 31st)

History of Opioids

Opioids have been around for thousands of years.  It wasn’t until the early 1900’s that regulation was put on the distribution and use of them.  From 1920-1950 in an attempt to prevent addiction, it was primarily used for terminally ill patients, many with cancer, that had acute pain, rather than chronic pain.  In the mid-1970’s other types of opioids such as Percocet and Vicodin were being developed and distributed.  Health Canada approved OxyContin to be prescribed for moderate and severe pain control in 1996. 

In 1998, Purdue Pharma spent $207 Million on the marketing of OxyContin.  This came with a push for physicians to prescribe opioids to patients for all types of pain such as back pain or fibromyalgia, not just for terminally ill or cancer patients.  By the early to mid-2000’s, the abuse and misuse of opioid products containing Oxycodone and Hydrocodone, along with brand names such as OxyContin, Vicodin, Percocet and Lortab doubled. 

The pharmaceutical companies began producing alternate formulations of extended-release and immediate release properties meant to deter abuse, however, none of these formulations prevented abuse.  Abusers quickly learned it could be crushed and broken down for immediate effects.  By 2010, heroin use, also an opioid, and overdose began increasing and in 2013 there was a significant increase in overdose deaths involving synthetic opioids, particularly manufactured fentanyl (IMF).

How Overdose Occurs

Opioids are highly addictive and even infrequent use can lead to dependency. Many opioid abusers progress their way to heroin because it’s cheaper.  Habitual or prolonged use can cause changes in the pain center part of your brain and prevent your body from naturally producing endorphins, which manage your pain center.  Tolerance to the euphoric effect of opioids that people become addicted to develops faster than the actual tolerance, creating a dangerous situation.  People will take more of it to get that high, however, high doses slow voluntary breathing, putting the individual into respiratory distress.  Fast acting injections of opioid fentanyl can cause the diaphragm and other muscles in the chest to seize up, eventually stopping your heart.  

Individuals that are in recovery for opioid addiction and relapse, have a higher rate of overdose.  The reason for this is because their brain thinks they can start where they left off on the amount taken, however, the body has detoxed and the tolerance is no longer there.  It becomes a shock to the system and can cause overdose.

Effects of Opioid Use: Who’s to Blame?

Today, Canada is the world’s second highest per-capita consumer of prescription painkillers.  The USA holds first place.  So who is to blame or hold accountable here?  The pharmaceutical companies promoting false advertising about the safety of it?  Doctors knowing from a clinical perspective the risks, yet still prescribing it?  The system who leaves their people in chronic pain waiting months, sometimes years, to have a surgery that would alleviate their pain?  Limited resources for those suffering from addiction and availability for prompt treatment programs?  It’s hard to say.  My opinion is that it is probably a little bit of everything.  

In 2007, Purdue Pharma acknowledged the marketing of OxyContin was misleading and paid $634.5 Million to settle criminal and civil charges.  They have stopped marketing opioids in the United States altogether due to mounting lawsuits.  Purdue’s Canadian operation has not made a similar admission of their wrongdoing and the marketing still continues in Canada.    

[ctt template=”2″ link=”E5aZR” via=”no” ]The rate of opioid use increased by 203% from the years 2000-2010.  In 2017 there were 3.987 apparent opioid-related deaths, 92% unintentional, reported by the Government of Canada. (1)[/ctt] The rate of opioid use increased by 203% from the years 2000-2010.  In 2017 there were 3.987 apparent opioid-related deaths, 92% unintentional, reported by the Government of Canada. (1)  This is a huge red light of just how dangerous usage in any form is.  Yet, leaders do not know why it is on the rise or how to combat it.  

The Canadian government has been trying to make changes to streamline things and have more transparent regulations.  Putting guidelines and regulations on pharmaceutical companies marketing and advertising opioids appears to be the place to start.

What To Do?

Health Vantis works with individuals that are put on long wait lists for surgery.  Many of our clients will have been in pain for months, often times years.  Unfortunately, the only way they can function is to mask the pain with medication and often times, an opioid will be prescribed.  These are people with chronic pain, not acute pain.  As indicated earlier, opioids were initially used for acute pain in terminally ill patients.  The dangers of being on these medications with chronic pain increase your odds of addiction, not to mention unintentional overdose.  No one wants to be in pain, myself included.  If you are put in a position like this, don’t just accept a prescription until your surgery date.  Explore your options to avoid an unnecessary risk.  

In the workplace, employers are very aware of how much mental illness can affect their bottom line, however, substance abuse is often overlooked.  For ways to incorporate this into your business plan and spot possible addiction, please check out these websites:

https://www.ncadd.org/about-addiction/addiction-update/drugs-and-alcohol-in-the-workplace

http://www.builderonline.com/builder-100/people/resources-for-addressing-drug-use-in-the-workplace_o

    1.     https://www.canada.ca/en/public-health/services/publications/healthy-living/national-report-apparent-opioid-related-deaths-released-june-2018.html

Benefits of Yoga 

When we think of yoga we often visualize pretzel shaped poses and movements you didn’t realize a body could do.  We know yoga provides for an improvement in flexibility, strength, balance, and endurance but what other benefits can yoga have?  Let’s explore some benefits yoga provides for chronic illnesses we may not have considered:

    ⁃    Fertility – Reducing stress levels, better blood flow to reproductive organs, improvement in organ and hormone function.

    ⁃    Back Pain – Greater flexibility to improve spinal movement and muscle strength to hold your core better.  Utilizing your core muscles protects the back from being used.

    ⁃    Heart Disease – Can help reduce arterial plaque and overall heart health.

    ⁃    Asthma – Breathing practice is essential in yoga.  It helps ease the symptoms of asthma.

    ⁃    Memory Booster – Releasing negative thoughts and tension improve your ability to organize your thoughts.  This allows for improved cognitive function.

    ⁃    Multiple Sclerosis (MS) – Improves fatigue with the building of muscles and coordination. 

    ⁃    Arthritis – Can improve pain and disability with slow, gentle movement.  Hot yoga also helps reduce muscle tightness allowing for deeper stretching.

    ⁃    Insomnia – Focusing on breathing can calm your mind from the hamster wheel of thoughts.  Certain positions such as lying on your back with feet on a wall yield better circulation for relaxation.

    ⁃    Sexual Performance – Yoga increases blood flow to the genital area, which can improve sexual desire, arousal, and performance.

    ⁃    Depression or PTSD – Practicing meditation and mindfulness results in higher serotonin levels (the happy hormone) and oxytocin (the bonding hormone).  It teaches you how to cope by easing stress and shifting your awareness to other positive thoughts, sensations, and emotions yoga produces.

    ⁃    Migraines – Hunching over your computer or cell phone can cause tightness in the neck and misalignment.  Correcting with yoga poses has shown a reduction in migraines or less painful ones.

    ⁃    Hypertension (HTN) – Stress is the leading cause of hypertension (HTN).  Learning how to reduce this and simplify your mind produces great results.

    ⁃    Fatigue – Yoga gives yourself a boost in natural energy and motivation that lasts longer than any energy drink or caffeine.  

There are probably many more benefits to yoga that can help a chronic disease not listed here.  The clarity you get from a clear mind can increase your creativity, focus, motivation, confidence and overall health.  Being able to tackle all of these with one form of exercise is what makes it so popular today.  With over 100 different types of yoga, there should be no problem in finding which one suits you.

The Cost of Depression and Anxiety In The Workplace

The Conference Board of Canada reported in 2016 that the Canadian economy lost almost $50 billion a year in productivity due to depression and anxiety. (1)  It accounts for about 30 percent of all short- and long-term disability claims, with the value of these claims ranging from $15 billion to $33 billion annually. The report goes on to say that almost a quarter of Canadians living with mental health issues are unable to work full or part-time.  It adds, if better treatments and supports were available to Canadians, the economy could see up to 352,000 of those with depression or anxiety enter the workforce as fully functional employees each year until 2035. (2) Wrap your brain around those figures!

True Absenteeism?

It has been increasingly evident that absenteeism is not the major factor when looking at a loss of productive time.  It is thought to be presenteeism, which means ‘the practice of coming to work despite illness, injury, anxiety, etc., often resulting in reduced productivity.’  

So why are depression and anxiety so much more prevalent today?  Some experts would say the increase is ‘garbage’ because of 2 possibilities.  1) It has become socially more acceptable due to the level of education and awareness available to us now and no longer taboo like it was in the past and 2) Not everyone taking an anti-depressants has a ‘true’ depression but rather a high level of stress that warrants the doctor to put them on a ‘chill pill’.  I remember a Medical Director I worked with once joked that they should just put Prozac in the water.  Regardless, it is real and it does affect the workplace.

As a society, we’ve become lazy, entitled and lost the mentality of ‘what can I do for your company’  to ‘what are you going to do for me if I work here’.  We spend less time outdoors, rely on our phones or computers for communication as opposed to actual human interaction, we overschedule ourselves and our children with extra activities, and spend less family time together.  All of these things contribute to our well-being and it trickles over into our place of work.  When you spend 8 hours+ of your day working, it’s bound to.

What Can The Employer Do?

Social norms and competitiveness in attracting top talent force businesses to respond to having such programs to keep their employees happy and healthy.  After all, if you take care of your employee, they will take care of your customer.  Offering an extension to the Employee Assistance Program such as a service like Ringside MD that offers in-house access to doctors at any time.  This gives the employee an opportunity to talk to a professional allowing for openness and candor as opposed to the HR Manager, where one might hold back.  These programs are a cost to the employer, however, when you look at how much money you save by having a healthy, productive employee, your bottom line will also be healthier.  

    1.     http://www.cbc.ca/news/business/canada-economy-depression-anixety-1.3744300 

    2.    http://www.cbc.ca/news/business/canada-economy-depression-anixety-1.3744300 https://www.conferenceboard.ca/e-library/abstract.aspx?did=8245