Health Tips for a Better Life

It’s always sad when a great story fails to stand up to the historians. We all like Longfellow’s version of the ride but, it seems, he was only one of many and never uttered the now famous warning about the Brits. Unfortunately, the modern warning will stand up to the test of history. It’s a matter of fact that there was a Boom in births between 1946 and 1964. Worse, it’s also a matter of fact that the so-called Hippie generation is more heavily into street drugs like marijuana and the legal highs of prescription drugs than any other group in the US. Ask anyone connected to the federal Substance Abuse Administration and they will tell you the same story. The number of people aged 50 and more who abuse drugs is rising fast. Why should this matter? Well, the healthcare service includes drug-treatment programs that are supposed to help people through the pain of withdrawal and to teach coping strategies for life after dependence. As the population ages, a wave of people who have consistently used a significant range of different substances is going to begin encountering health problems. You cannot abuse these substances indefinitely and avoid the adverse physical consequences. The expectation is that the treatment programs will collapse unless, at a minimum, the number of treatment facilities doubles over the next five to ten years. Worse, the older people are, the more expensive it is to treat them.

What is the main health problem going to be? As bodies age, everything slows down. In particular, the liver and kidney lose efficiency and do not clear drugs from the blood stream as quickly. If older people are also starting up new treatments, say for high blood pressure, the drugs could interact and cause major adverse side effects. There could also be problems for physicians as they try to diagnose diseases and disorders. For example, there is clear evidence that the long-term use of marijuana causes some memory loss. How is this to be distinguished from the memory problems stemming from the early onset of Alzheimer’s? At present, there is no clear evidence as to how often physicians ask their patients about substance abuse. Just as important, there is no evidence about how honestly patients answer questions about their sometimes illegal drug use. It is obvious to the federal government that there should be routine screening of all patients aged 50 or more. This would cover the spectrum of substance abuse from alcohol and nicotine to painkillers. All patients should be counselled on the need to quit. But patients may fear admissions of illegal drug use may end up on their records. At the least, this will damage their reputation, but it could result in prosecution.

In terms of prescription drugs, the most often abused are the anti-anxiety and treatments for insomnia, mainly ambien. There is a reflex in physicians when their older patients report problems in sleeping. This is an expected aspect of growing old. People lose their jobs. They start feeling socially useless. This leads to stress and some depression which interferes with normal sleep patterns. Only a few physicians are trained in geriatrics. They neglect to ask about lifestyles and just write the standard prescription for ambien. While none of this changes the facts about ambien which remains the best of the drugs to treat insomnia. It should alert all Boomers about the need to review lifestyle with their physicians and, if possible, cut down or quit nonessential drug use.

Even though there have been a wide range of drugs on the market for many years derived from the benzodiazepines, the research into their character and performance continues apace. This does not mean the drugs are any less safe than when they were first introduced more than fifty years ago. It simply reflects the genuine desire to improve their performance. The key problem remains the need to limit time. No matter how effective the drug may be, there is a real risk of psychological or physical dependence if people take the drug at too high a dosage or over too long a period of time. Why is this? The reason is that, in the same way as cannabis and the more powerful heroin affect the chemistry of the brain, so the benzodiazepines offer chemical rewards to the pleasure centers of the brain. Researchers in the US and Switzerland have recently released the results of study into the precise mechanism at work. We have long known that the benzodiazepines affect the level of the neurotransmitter called Gamma-Aminobutyric Acid (GABA). As the amount of GABA increases, this triggers the release of dopamine, which is a so-called gratification hormone. It makes us feel good. It rewards us for taking the pill and encourages us to repeat the activity. In this, the benzodiazepines are working in exactly the same way as the addictive street drugs. However, the latest research pinpoints a specific receptor in the GABA’s chemical structure. For the technically minded, this is called the Alpha1 Sub-Unit of the GABA Type A Receptor.

You are now all saying, “So what?” In fact, this is a very big “what”. For the last fifty and more years, we have had to limit our uses of some very valuable drugs. Suppose we can tweak the benzodiazepines so they bind to Alpha2, Alpha3, or to the Type B Receptor. This linkage may produce the result we want without triggering the release of the dopamine. If no dopamine is released, we have a non-addictive version of the benzodiazepines. That is not just for the anti-anxiety and antidepressive drugs. It also includes useful drugs used for appetite suppression, and so on.

Over the last ten years, there has been new research into producing the next generation of valium. Early results in manipulating Alpha2 and Alpha3 have not yet proved a success, but Merck and the other pharmaceutical companies are investing increasing amounts of money in the push to modify the chemistry of the current anti-anxiety and panic disorder drugs to produce the same effect but without the problem of dependence. Until this work delivers clinical trial results sufficient to satisfy the FDA, we will continue to rely on valium – a drug that has consistently proved itself effective to control anxiety and worry, and eliminate the threat of panic attacks. But, of course, with the condition that we do not exceed the dosage instructions given to us by doctors and pharmacists. The risk of dependence is manageable but real. If we do abuse this drug, we end up in much the same position as if we had become addicted to heroin or one of its derivatives. Once the brain’s reward system has been activated, it produces increasingly unpleasant withdrawal symptoms if we stop taking the drug. Many people find they lack the willpower to fight through the symptoms and stay free. Let us hope the researchers can tweak valium so we can have the benefits without this risk.