JACKSON, United States: Five female pro-life activists stand outside Mississippi’s last abortion clinic, intercepting patients on their way in.
“There’s a baby that loves you,” they preach. “Jesus loves you”.
The noisy scenes outside the Jackson Women’s Health Centre, known as the Pink House, play on repeatedly in this deeply conservative and religious state in the heart of America’s Bible Belt.
Both men and women take up positions in front of the bubblegum-pink art deco building in Jackson attempting to sway women against exercising their abortion rights — an already high hurdle due to immense social and economic pressure in the poorest US state.
Mississippi is among seven US states with just one place where women can seek an abortion.
“Life is precious, and I believe what’s done here is wrong because a baby is a baby at the time of conception,” said one activist, 21-year-old Rebekah, the speaker blaring music at full volume.
She grounds her stance in religion: “The father says in the word that, before he formed them in the womb, he knew them, before they were even born”.
Another anti-abortion activist, Pam Miller, urges women to reconsider their choices.
“Go with me and I’ll take you to the CPC, Centre for Pregnancy Choices,” she tells one patient. “They have beautiful, life-affirming options”.
“Not too late to change your mind.”
Women have been able to legally seek an abortion throughout the United States since 1973’s landmark Supreme Court decision Roe v. Wade.
But the right to reproductive choice remains tenuous as debate rages over the issue, especially in conservative states like Mississippi that have introduced measures restricting access to services — effectively creating a ban for many women.
The southern state’s Republican Governor Phil Bryant enacted a law currently tied up in court banning abortion beyond 15 weeks of pregnancy, well below the limit generally allowed in the US between 22 and 24 weeks.
The bar is high for women who want to go to the Pink House, where an abortion costs a steep US$600, (RM2,339) and often requires distant travel and hotel bills.
Terminating a pregnancy in Mississippi also demands two clinic visits: after the initial consultation, women must reflect on their decision for 24 hours.
The Pink House, which carries out some 200 abortions a month, flies doctors in from other states, as finding in-state physicians willing to perform the procedure proves nearly impossible because they risk severe harassment.
The clinic, therefore, offers abortion services only two-and-half days a week.
And even those who overcome legal, financial and logistical obstacles face social shaming: the Pink House sets the stage for an almost daily showdown between pro-choice and anti-abortion activists.
Sporting jeans and aviator sunglasses, Derenda Hancock escorts women seeking services to the clinic, sheltering them from anti-abortion demonstrators.
“Besides all of the physical barriers that they have to overcome, then they have to overcome the emotional barriers of the position that these people and this state and religion puts them in,” she said.
After signing the “Gestational Age Act” last month banning abortions after 15 weeks, Bryant declared on Twitter he was “committed to making Mississippi the safest place in America for an unborn child”.
In 2012, he had enacted legislation requiring all doctors associated with an abortion facility to also have the right to admit patients to local hospitals — which would effectively shutter the Pink House.
The Jackson Women’s Health Organization sued the state government over the legislation, which was blocked by a federal court and remains tied up in legal wrangling.
Kaylie Hanson Long, communications director for the pro-choice organization NARAL, points to a number of legal attempts to undermine Roe v. Wade, saying they hurt low-income women in particular.
“You’re impacting these women disproportionately,” she said. “Lower-income women may not have the opportunity to take time off of work from their job to go have an abortion”.
Despite legal threats and vitriolic protests in front of the Pink House, its owner and women’s rights activist Diane Derzis refuses to back down from her commitment to providing access to safe, legal abortions.
To her clinic’s vehement critics, Derzis, a long-time women’s rights activist, points to the social injustices many people face when considering the course of their futures.
“You want to stop abortion? Then make it easier for women to have children, and give these children a good life, feed them, clothe them, educate them,” she says.
“As far as the state of Mississippi is concerned, if you’re in the utero, you need help, but if you are not, when you emerge, God help you — because we’re not going to.” — AFP
When it comes to one’s overall health, good gut health is crucial. As one of the largest organs in the human body, the gut (also called the gastrointestinal [GI] tract), has to perform several major tasks.
Its main task is to digest food to provide you with energy and nutrients. By extension, it’s also in charge of disposing the “leftovers” from both digested and non-digested foods. Another critical role the gut plays is as a major part of your immune system.
However, a lesser known fact about the gut is that it is home to trillions of microorganisms (also known as gut microbiota), all of which contribute to good gut health and your overall wellbeing.
What are gut microbiota?
Gut microbiota are the microorganisms that make their home in your digestive ecosystem. This population consists of both “good” and “bad” bacteria. A healthy digestive gut would typically have a balance of about 85% good bacteria against 15% bad bacteria.
I’ve heard the term probiotics. What is it?
Probiotics are living microorganisms, mostly bacteria that provide health benefits to humans when consumed in adequate amounts. Also recognised as good bacteria, probiotics have been shown to be able to keep you gut healthy.
In view of this, probiotics have been incorporated into several food products, and are even available in the form of dietary supplements. Some common probiotics in the market are bacteria in the Lactobacillus and Bifidobacterium families.
Is there any law in this country that regulates the sale of probiotics?
Yes, the Health Ministry (MOH) has enacted a law that spells out specific requirements for products to be recognised as “probiotic cultures”. These include the particular type and number of bacteria that are recognised.
The law permits the addition of probiotic cultures to food and allows that food to be labelled as containing “probiotics” or “probiotic cultures”. As a savvy consumer, you can correctly identify genuine probiotics products by reading the label.
Where can I find probiotic foods?
Some common probiotic foods include cultured and fermented milk products that have probiotic cultures, e.g. cultured milk drinks, fermented milk products, yoghurt, cultured cream or sour cream.
What should I look for when choosing cultured milk drinks with probiotics?
There are five main points to be aware of:
1. Check the label for the words “probiotic cultures”.
2. It should also specify that the cultures are alive or viable.
3. The genus, species and strain of probiotics used in the product (only certain strains have been approved by MOH).
4. The quantity of probiotic cultures present in the food product must be clearly stated (it must contain a minimum of 10,000,000 cfu/ml or cfu/g; CFU is short for colony forming units, a measure of the number of microorganisms).
5. Directions for storage before and after (if applicable) the package is opened.
Potential sources of beneficial bacteria in foods include fermented foods such as homemade yoghurt, kimchi, tapai and tempeh, as seen in this filepic.
Are there other food sources of probiotics?
Traditional fermented foods are usually home-made, and the types and number of bacteria are usually not well characterised and standardised. As such, they may not meet the criteria stipulated by MOH for probiotics.
Nevertheless, they are potential sources of beneficial bacteria. Some examples of such fermented foods include tempeh, homemade yoghurt, kimchi and tapai.
What about probiotic supplements?
Probiotic supplements exist and are commonly found in either powdered or pill form. Do ensure that you follow the instructions on the product label when it comes to proper dosage and frequency of consumption in order to maximise the effectiveness of the probiotic.
Remember to check the product’s label to find out which probiotic genus and species (e.g. Lactobacillus casei) it contains and its CFU count. If in doubt, consult a pharmacist or a healthcare professional before buying.
How do probiotics contribute to overall health and wellbeing?
Probiotics have been demonstrated to bring about several beneficial health effects. Current evidence supports the role of probiotics in tackling a broad range of digestive system problems.
Certain probiotics have been found to be effective in improving symptoms of patients with irritable bowel syndrome, diarrhoea (which includes traveller’s diarrhoea, antibiotic-associated diarrhoea and acute infectious diarrhoea), constipation and certain type of inflammatory bowel diseases.
There is also emerging evidence that probiotics can positively influence immunity. In addition, there is on-going research on the potential role of probiotics in positively influencing a person’s mental health or mood.
What are some of the factors that may affect the effectiveness of probiotics?
It has been established that the effectiveness of probiotics can be significantly influenced by many factors, such as the species and strain, the formulation or mixture, the dosage taken, and the duration of consumption.
While probiotics are an important component of good gut health, one should not rely solely on it. There are other lifestyle aspects that are also important for ensuring good gut health, such as consuming a balanced and varied diet high in dietary fibres.
Some of the do’s and don’ts include:
• Do practise balance, moderation and variety in your daily diet.
• Do include foods rich in fibre.
• Do drink plenty of water.
• Do be more physically active.
• Do get enough sleep.
• Don’t eat too much fried foods.
• Don’t take too much salt and sugar.
Dr Tee E Siong is a nutritionist and president of the Nutrition Society of Malaysia (NSM). Assoc Prof Dr Raja Affendi Raja Ali is a consultant physician and gastroenterologist at Universiti Kebangsaan Malaysia Medical Centre. This article is contributed by Probiotics Education Programme (PEP) by the NSM. To obtain more information on the activities of the PEP, visit www.nutriweb.org.my/probiotics.
The most important aspect of any bedroom is the bed – the place where one seeks sanctuary after a long day to rest and refresh before facing the following one.
However, lying to sleep on the perfect mattress is not only important to gain a good night’s sleep, but is also crucial for health reasons.
Nonetheless, choosing the mattress that is ideal for you may seem like a daunting task, given the various types available and their hefty prices, but if you follow these simple steps in picking them, restful moments are nothing but a liedown away.
It is well known that we spend one-third of our lives in bed, so it’s important to be mattress-savvy before heading out to the nearest store to make that investment.
Knowing the marketing gimmicks to avoid is already half the battle won when buying.
Some unsubstantiated claims that often become consumers’ pitfalls include the notions that mattresses with more coils are better, that gel provides a cooler sleep, and that natural means 100% natural.
The best way to find out if a mattress will work for you is to lie down on it before buying.
Shake away any feelings of self-consciousness that you might have and test out all the models available in the store.
The most important factor in finding the correct mattress is proper comfort and support. A good mattress should hold you in proper alignment from head to toe.
However, that does not mean getting hard, stone-like bedding because your body isn’t a straight line.
Sleeping on a hard, unsupportive mattress will create gaps that put pressure on your shoulders and hip area, causing your spine to bend, whereas a mattress that is too soft will cause you to sink into it – both will result in backache.
You need a supportive mattress that can contour to the unique shape of your body and hold it in its neutral alignment – a feature inherent in 100% natural latex.
Most materials used in mattresses, such as springs, are not able to provide the flexible total surface support that 100% natural latex does.
In addition, 100% natural latex is pure, clean, safe and environmental-friendly, with natural anti-dust mite properties and a honeycomb-like ventilation design to promote excellent airflow.
The flexibility of this natural resource also reduces motion disturbance as each surface point reacts to weight and pressure independently.
Sleep experts studied the curves and edges of the human body and choose 100% natural latex for its natural resilience and elasticity for postural alignment, providing ideal pressure relief with excellent support and comfort that prioritises your body’s needs.
Specialising in 100% natural latex since 1969, Getha has an extensive line-up of metal-free mattresses and bedding products suitable for all ages from infant to the elderly.
The name “Getha” is derived from “getah”, which means rubber in the Malay language, mirroring the brand perfectly for its signature products made with only 100% natural Malaysian rubber latex.
A homegrown Malaysian brand, which is also acclaimed internationally, Getha takes pride in producing top-notch products to promote quality sleep, and is always committed to serve consumers’ needs.
It has received accreditations from ECO Umweltinstitute, Germany; Oeko Tex, Switzerland; and the world-renowned Malaysian Rubber Board.
Getha believes in serving the needs of nature too – to ensure the eco-system is properly maintained, Getha complies with all regulations set forth by the authorities and also strives to promote a greener lifestyle among its consumers.
For more information on Getha 100% Natural Latex bedding products, visit www.getha.com.my or drop by one of 16 Getha Sleep Therapy Centre nationwide for a consultation customised to your needs.
My husband and I share the love of travel. We make it a goal to experiment with different locations and resorts but there is one that keeps drawing us back – The Four Seasons Maui in Wailea.
We recently made our way back to try out their Wellness Your Way Program and it was EXACTLY what we needed to relax, connect with each other, and to leave the outside world behind.
Upon arrival, our FIRST stop was the GORGEOUS Serenity Pool. I could get LOST staring at the view from the pool all day!I would have been fully complete with daily visits here 🙂
BUT, there was more…
The Four Seasons Maui is located along the beautiful Wailea cost of Maui (shhhh…don’t tell anybody, but they get the best weather!).
A gorgeous scenic walk is just footsteps away. Each morning and afternoon we went for a stroll along the coast.
There are so many areas to walk, run, climb around, take photographs, or simply just sit and watch and think.
It was time to dive into “Wellness Your Way” the Four Seasons Resort carefully curated a program that includes energy-focused spa treatments, culinary dishes and fitness classes – available on an a la carte basis and recommended under the guidance of the Resort’s wellness expert.
They offer several options (descriptions taken direct from their wellness your website HERE)
DETOX YOUR WAY
Each day, we are exposed to harmful toxins. The air we breathe, the food we consume, and the products we use, build up and impact our overall health.
In this program, their wellness experts craft an itinerary to assist you in hitting the “reset” button to increase energy, reduce cravings and lower stress
WEIGHT LOSS YOUR WAY
In this program, regardless of where you are on your path, their wellness experts will craft an itinerary of treatments and activities that will lead you to a new lifestyle that promises long-lasting effects.
VITALITY YOUR WAY
Whether you are a seasoned athlete, weekend warrior or are just beginning to explore your potential, their wellness experts will help you achieve your greatest self.
INNER PEACE YOUR WAY
In this package, their wellness experts lead you on a path to calm and stillness of mind by customizing a program that will connect you to a deep sense of tranquility.
I chose, with the nudge of my husband “inner peace your way”
My first day started with a two hour inner clarity session with Dr. Deborah Greene, PHD- Mind Body Medicine Specialist. I was told this session would calm my emotions and clear my mind.
I was a little nervous entering our session but as we sat in a hut hearing the waves crash. Her entire sense of being was so calming. Just being WITH her instantly put any fear I had to ease.
We set an intention (mine was to be able to stop my thoughts from always spinning).
Through muscle testing, holistic techniques, tapping acupressure and coaching we dialed in my intention and we went to work!
Everything was done via closed eye mediation and I left our session feeling very clear, calm and focused. My energy and clarity soared for the next few days.
According to Dr. Greene, “The role of the mind in health and wellness cannot be overestimated,” she says.
“The new biology tells us that, ultimately, our thoughts control our bodies and control our lives. Yet many people struggle to get a grip on what goes on inside their heads, so providing guests with proven tools, tips and techniques that can help them clear their mind is very empowering.
You can either learn to control your mind, or your mind is going to control you.”
She continues on to share that “Many people vacation in order to relax and get away from it all, but find that they take their stresses with them,” she says. “By focusing on the mental and emotional levels, my sessions can provide inner peace and help give the mind a much-needed break.”
Day Two we met with Dr. Mark Emerson – Clinical Nutritionist and Doctor of Chiropractic
Dr. Mark D. Emerson is a chiropractic physician, author, and internationally recognized professional speaker who specializes in Nutrition Based Lifestyle Medicine and natural treatment methods for patients of all ages.
His successful, clinically-proven protocols help to empower people to live healthier by preventing, reducing and resolving chronic progressive health issues and diseases. We had a great chat with him and even decided to try some of his
The afternoon continued with seriously the BEST MASSAGE I HAVE EVER HAD. Seriously, I had an Ayurvedic massage that was AMAZING!
Our food during our trip was outstanding! We ate so much yummy and healthy food throughout our stay. The highlight of the trip was a dinner with CRAIG DRYHURST.
EXECUTIVE CHEF . Dryhurst was Trained in a classical fashion, Dryhurst worked in a number of five-star kitchens in London, France, the East Coast and Vancouver before coming to Four Seasons Resort Maui in 2014 as Executive Sous Chef.
A supporter of the farm-to-table movement, Dryhurst recently put his creative skills to work in a rollout of the Resort’s Wellness menu, launched as part of the Wellness Your Way spa and nutrition program, offering coordinated menus in each restaurant.
Born in Edmonton, London, UK, Dryhurst grew up in a small town called Stevenage. As a child, he worked alongside his father who was a keen gardener growing vegetables and assorted berries. Visits to family in Northern Ireland also cemented his appreciation for recreating locally-flavoured dishes and globally-inspired food.
Dryhurst has had a long culinary career, starting with his work in a series of celebrated London hotels including The Langham, Claridges, The Lanesborough and The Goring. On the French Riviera, he practiced his craft at the famed Grand-Hôtel du Cap-Ferrat (now a Four Seasons hotel).
In 2002, he joined Four Seasons Hotel Boston as Chef de Partie, and spent time in its restaurants and banquet operation. He returned to his homeland in 2006, where he worked at Four Seasons Hotel Vancouver, where he re-branded its restaurant, YEW, as a sustainable seafood concept alongside Chef Ned Bell.
Just over a year ago, he joined Four Seasons Resort Maui, where he has made a strong positive impact in its restaurants – DUO Steak and Seafood and Ferraro’s Bar e Ristorante – and his creativity, hands-on approach, humor and never-ending enthusiasm are inspiring his culinary team to new levels.
“I’m most passionate about the desire to create beautiful food from great ingredients. Knowing where your food comes from is as important as putting it on the plate.”
Our meal was SO amazing. Even more amazing was listening to how he described the items we were testing out! It was evident the passion and love that goes into his creations. Below are some of the amazing foods we experienced including recipes for two of our FAVORITES
Chickpea Socca Flatbread
Sweet Tomatoes, Maui Onion, Thyme, Herb Salad, White Balsamic
Garbanzo Socca Dough
1 cup garbanzo flour
1 cup water
1 ½ tbsp EVOO
- Mix together the flour, water and olive oil and mix well knocking out any lumps. Leave to rest for 30 mins.
- Heat a nonstick pan to a medium high heat and spray lightly with pan spray. Cook the chick pea batter into desired thickness until golden on both sides.
- Remove from the pan and chill.
Cashew Sour Cream
1 1/2 cups (225 g) raw cashews, soaked
3/4 cup (190 mL) water
2 tablespoons fresh lemon juice
2 teaspoons apple cider vinegar
Scant 1/2 tsp fine sea salt
- Place cashews in a bowl and cover with water. Soak overnight or for 8 hours if you have the time. For a quick-soak method, pour boiling water over the cashews and soak for 1 hour. Rinse and drain.
- Place the drained cashews in a high-speed blender.
- Add the water, lemon, vinegar, and salt. Blend on high until super smooth. You might have to stop to scrape down the blender now and then or add a touch more water to get it going.
- Transfer into a small, air-tight container and chill in the fridge. The cream will thicken up as it chills. The cream will keep in the fridge for about 1 week. You can also freeze it for up to 1 month.
Caramelized Maui Onions
5 large Maui onion
3 thyme branch, leaves removed and chopped
Peel and slice the onions removing the root. Slice very finely and place into a heavy bottomed pan. Add the salt and the chopped thyme leaves. Bring up to a medium high heat. The onions will start to release water. Cook them until the water has cooked out and they start to caramelize. Keep de glazing the pan with water until the onions are fully cooked golden brown. Remove from the heat, adjust the seasoning and chill.
Semi dried Baby heirloom tomatoes
1lb heirloom cherry tomatoes, cut in half
1 clove garlic, chopped
1 ea shallot, chopped
1oz olive oil
Mix all ingredients together and place under heat lamp until dried halfway.
Cauliflower Rice Biriyani /portion size 225g/ serves 4
Pepper, Peas, Zucchini, Smoked Cinnamon, Cashew Raita
2 ea white cauliflower
20 ea cashew nuts
2 ea bay leaf
2 ea cinnamon sticks
7 cardomom pods
1 onion finely sliced
50g yellow squash
50g green zucchini
50g French beans, trimmed
½ red pepper deseeded and cut into strips
6g garlic clove, finely minced
12g ginger, finely minced
80g chopped tomato
1 tbsp tomato paste
1 tsp chili powder
½ tsp turmeric powder
1 tsp garam masala
1 tsp coriander powder
8g cilantro leaves
8g mint leaves
2 tbsp veg oil
1 tsp salt
- Cut the cauliflower and place in the robot cope and run until resembles the size of rice.
- Add veg oil to a pan and place over medium heat. Once hot add the cardamom, cinnamon sticks and bay leaf and cook for two mins. Then add the cashew nuts and start to toast for another minute.
- Stir in the onions and cook until golden brown. Add the beans, pepper, zucchini, squash, chili, garlic, ginger, turmeric and salt. Place a lid on the pan, and cook on a gentle heat for 20 mins, stirring often to avoid burning.
- Stir in the cauliflower, tomato and peas and cook for 5 mins.
- Remove the bay leaf and cinnamon.
- On pick up stir in the fresh herbs and adjust the seasoning.
Cashew Raita (1 portion)
40g cashew puree
1 pinch turmeric
1 pinch curry powder
1 pinch chili powder
1 pinch salt
½ cup lemon juice
Mix ingredients together
Papaya and Banana compote
1 ea papaya
1 ea banana
2 cup water
1/2 cup sugar
1 ea lime juice and zest
2 ea cinnamon sticks
3 ea star anise
1 pinch chili powder
Put water, sugar, lime, cinnamon, anise and chili in a heavy bottomed pan. Start to heat the liquid to a low simmer.
Peel, de seed and dice the papaya and add to the pan. Cover the pan with parchment and cook on a low heat for 20 mins.
Dice the banana and add to the pan. Try not to stir too much whilst cooking. Keep cooking slowly until the papaya is tender. Remove from the heat and season with more lime juice if needed.
So there you have it! As amazing as the recipes are, I think the best thing to do is let Chef Craig and his team prepare them for you while you relax, and enjoy everything Maui has to offer….Four Seasons Style!
Until next time! Aloha!
– Natalie Jill
- REUTERS/Lucy Nicholson
- The death toll from the opioids epidemic continues to soar.
- Experts say we already have a science-backed treatment that works: medication-assisted treatment, or MAT.
- The problem, however, is that very few people can get it.
The death toll from the opioids epidemic continues to soar – nearly 64,000 people died in 2016 alone. Scientists are working to find creative tools to fight it, and President Donald Trump has called the overdose crisis a public health emergency. But he has not yet outlined any targeted solutions aside from calling for drug dealers to be given the death penalty.
A growing cadre of health professionals say we already have a science-backed treatment that works. It’s called medication-assisted treatment, or MAT, and it involves administering FDA-approved medications that help curb cravings and reduce the excruciating symptoms of withdrawal.
“Medications are an effective treatment for opioid addiction,” Kelly J. Clark, president of the American Society of Addiction Medicine, told Business Insider.
The problem is that very few people can get those medications.
Only about half of private-sector treatment programs for opioid use disorder currently offer access to MAT, and of those that offer it, only one third of patients actually receive the medication, according to a study published in the Journal of Addiction Medicine.
There are many reasons for this lack of access to medication. Some stem from a misconception about how the treatments – which can include buprenorphine, methadone, or naltrexone – work. The stigma surrounding drug use and addiction plays a role, too. Still other issues include federal and state laws that restrict the availability of the medications.
“It’s more of an implementation problem than a basic science problem,” Clark said, “because we know what works.”
Medications do not ‘substitute one drug for another’
In someone with opioid use disorder, using the drugs is often not a pleasurable experience, but rather a practice that has become a necessary fact of life. Being without the drugs leads to painful symptoms that can include severe nausea, shaking, diarrhea, and depression. The need to use is simultaneously a physical and emotional compulsion – the lines between those kinds of pain are blurred.
One of the main misconceptions about medication-assisted treatment is that medications simply replace the drugs that hooked users – leading to more highs and fueling a pattern of repeated use.
But that view is outdated and ill-informed, experts say. Instead, the drugs work by staunching cravings and reducing or preventing withdrawal and relapse. Buprenorphine and methadone help suppress cravings, while naltrexone blocks the euphoric and sedative effects of opioids so users don’t experience a high.
“People ask me all the time, ‘well, aren’t they just substituting one drug for another?’ The answer is no. These are evidence-based treatments and they work,” Patrice A. Harris, the former president of the American Medical Association and a board certified psychiatrist, told Business Insider.
Several large studies suggest that as access to MAT rises, drug overdose deaths fall. A study of heroin overdose deaths in Baltimore between 1995 and 2009 published in the American Journal of Public Health, for example, found a link between the increasing availability of methadone and buprenorphine and a roughly 50% decrease in the number of fatal overdoses.
“These treatments are life saving and they work,” Sarah Wakeman, the medical director of the substance use disorder initiative at Massachusetts General Hospital and an assistant professor at Harvard, told Business Insider.
From jail to court to rehab, medication-assisted treatment is hard to find
Despite the evidence demonstrating MAT’s effectiveness, it is surprisingly difficult to obtain.
One of the hardest-to-access forms of medication for recovery is methadone. In the US, the medication can only be accessed in specialized clinics; because of the way the treatment works, people on MAT must come to a facility to be injected daily. But those facilities typically have negative reputations because of policies that restrict them to locations considered seedy or run-down. And patients who come for treatment often have to push past active drug users – a big trigger for someone with substance use disorder – on their way to and from the clinic.
“You can access heroin pretty easily, yet we make it really hard to get a treatment that’s life-saving and allows you to live healthily,” Wakeman said.
On Friday, the US Food and Drug Adminstration issued a new set of guidelines aimed at underlining the important role MAT should play treating opioid use disorder.
“Unfortunately, far too few people who suffer from opioid use disorder are offered an adequate chance for treatment that uses safe and effective medications,”commissioner Scott Gottlieb said.
Other countries take a very different approach to medication-assisted treatment that makes the treatments easier to obtain. In Canada, for example, methadone is distributed in pharmacies.
Rehabilitation facilities and courts in the US often don’t offer medication-assisted treatment either. Instead, most operate on an abstinence-based model, in which patients must detox and then are offered counseling. They’re encouraged to attend 12-step meetings like Narcotics Anonymous, which remains opposed to MAT despite the growing body of evidence behind it.
Among staff at rehab centers across the US, many workers maintain the belief that the medication doesn’t work and say clients will “abuse” medications. Stephanie Rogers, an intake coordinator at Talbott Recovery, an Atlanta-based addiction treatment center, told Business Insider that she “honestly believed” that MAT was “just substituting one drug for another.”
This trend runs in sharp contrast to the way treatment for other conditions has changed based on new research. When it comes to type 2 diabetes, for example, a large body of scientific evidence demonstrated that the medication insulin helped curb the symptoms of the illness. Those findings prompted medical professionals across the country to uniformly endorse and offer it.
Even among rehab center workers who do understand the potential of medication-assisted treatment, many told Business Insider that their facilities aren’t licensed to provide MAT in the first place. San Diego-based drug treatment center AToN, for example, lacks the proper licensing to provide methadone to patients, according to its program director.
Turning the tide requires buy-in from officials and medical providers
Some officials, including judges who preside over courts that see people brought in on drug offenses, are trying to update their policies to incorporate the most recent research on addiction treatment.
Judge Desiree Bruce-Lyle presides over several such courts at the Superior Court of San Diego County. She told Business Insider that she became convinced of the efficacy of MAT after attending an American Society of Addiction Medicine conference and speaking to some of its leaders, including Kelly Clark and vice president Penny S. Mills.
“I didn’t believe in [MAT] until I met Penny and Kelly last year and they convinced me why it was a good thing and then I heard from a lot of the speakers that were attending that we needed to take a look at it,” Bruce-Lyle said.
Still, out of roughly 50 participants in the reentry court that Bruce-Lyle helps oversees, only one or two are on MAT, she said. In their veterans court, which includes roughly 60 people, three or four are on MAT.
“I’d like to see more of it,” Bruce-Lyle said, but added that she felt she’d need to convince key players at the court – including the Sheriff and other leaders – of the treatment’s efficacy.
A handful of physicians and social workers are also helping to lead the charge by calling attention to the scientific evidence that shows MAT is more effective than an abstinence-only model. Wakeman, the assistant professor at Harvard, travels around the country giving presentations at conferences like the one that helped change Bruce-Lyle’s mind.
“Medication-assisted treatment saves lives,” Wakeman said. “You can also just call it ‘treatment’ and drop the two words in front of it.”
Falling is the leading cause of injury-related death among people over age 65, and seniors who want to avoid falls should exercise, not rely on supplements like vitamin D, US guidelines revealed recently.
The new recommendations from the US Preventive Services Task Force (USPSTF) update those last issued in 2012, when the independent medical advisory group was favourable to taking supplements containing vitamin D as a way of preventing fall-related injury.
But unless a person has vitamin D deficiency or a frail bone condition known as osteoporosis, the task force’s latest review of clinical trials on the topic found no benefit for average seniors, and even an increased risk of kidney stones for those who take vitamin D and calcium supplements.
“The USPSTF found adequate evidence that vitamin D supplementation has no benefit in preventing falls in older adults,” said the guidelines published in the Journal of the American Medical Association.
Instead, the USPSTF “recommends exercise interventions to prevent falls” in those 65 years or older who are at increased risk of falling. Such exercise may include “supervised individual and group classes and physical therapy”, said the guidelines.
The update was based on a review of 11 randomised, clinical trials involving more than 51,000 people.
“Vitamin D supplementation alone or with calcium was not associated with reduced fracture incidence” among adults without vitamin D deficiency, osteoporosis, or prior fracture, said the report.
According to the most recent data from 2014, nearly 29% of US adults 65 years or older reported falling. Nearly 38% “needed medical treatment or restricted activity for a day or longer”, said the JAMA report. Some 33,000 people in the US died due to falls in 2015.
An accompanying editorial in JAMA said the new recommendation, with its “increased emphasis on exercise, warrants adoption and should prove helpful, especially because exercise interventions reduce injurious falls”.
Getting more exercise can also improve health by lowering the risk of heart disease, stroke, type 2 diabetes, dementia and cancer, it said.
However, for elders “at increased risk for osteoporosis, those with vitamin D deficiency, or both, it remains reasonable to consider vitamin D supplementation (800-1000 IU/d or more), consistent with recommendations of other professional societies such as the US Endocrine Society and National Osteoporosis Foundation,” the editorial said. – AFP Relaxnews