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Category Archives: Health

The Health Benefits of Hypnosis

What is hypnosis, anyway? According to the American Society of Clinical Hypnosis, it is a tool that allows the mind to focus — similar to how a magnifying glass focuses and intensifies the sun’s rays. Unlike the popular myths, you’re not actually unconscious while in a hypnotic state, but fully awake and in a heightened state of concentration. There are several different ways that practitioners can help individuals who are under hypnosis: They may present ideas or suggestions, encourage patients to come up with mental images that illustrate positive change, or help them better understand their underlying motivations.

Need more convincing? Hypnosis is also recognized as a valid medical procedure by the American Medical Association and the American Psychological Association. If you’re curious, here are just a few of the ways hypnosis can help your health:

Hypnosis for weight loss: Hypnosis can help people change their eating behaviors and drop the pounds. According to a Vanderbilt University review of the scientific literature, hypnosis works best for weight-loss when combined with a behavioral weight -management plan.

Hypnosis to quit smoking: At the 2011 annual meeting of the American Psychiatric Association, Jose Maldonado, MD, associate professor of psychiatry at Stanford University, reported that the success rate of hypnosis for smoking cessation may be as high as 64 percent.

Hypnosis for depression: Cognitive hypnotherapy, which combines hypnosis with cognitive-behavioral therapy, helps change unwanted patterns and behaviors by connecting with the subconscious mind. Experts say this treatment can help the “stuck” thought patterns that go along with depression, anxiety, OCD, and other mood disorders.

Hypnosis for pain management: Hypnosis has been used to treat both chronic types of pain (arthritis, fibromyalgia, irritable bowel syndrome) and pain resulting from serious injury. A study published in the International Journal of Clinical and Experimental Hypnotism found that hypnosis using virtual reality software reduced the intensity of pain in hospitalized trauma patients more than standard treatment alone.

8 Little Ways to Cut Your Cell Phone Cancer Risk

Does the World Health Organization’s statement that cell phones may cause cancerhave you thinking twice about making that phone call?

Of course it’s alarming to think that something that’s become such a can’t-live-without can be linked to brain cancer, but there’s a lot even the most cell phone-addicted people can do to minimize health risks.

Any potential links to cancer stem from the low levels of radiation cell phones emit. Lower your exposure to the radiation, and you’ll reduce the potential links to cancer or other health problems:

  1. Use a headset. Sounds obvious, but headsets emit much less radiation than cell phones do, according to the Environmental Working Group (EWG), and they keep your cell phone away from your head. The farther away you are from a source of radiation, the less damage it can do.
  2. Text when you can. Your constantly texting teens are onto something: Cell phones use less energy (and emit less radiation) when you text than when you talk, says the EWG. Texting also keeps the radiation source farther away from your brain.
  3. Use cell phones for FYI-only calls. Don’t use your cell phone for that long overdue, hour-long catch-up with your sister. Keep calls as short as possible —Do you need me to get the dry cleaning, honey? — and switch to a landline if they’re veering off into chitchat territory.
  4. Watch the bars. Can you hear me now? If you’re struggling to maintain a connection, ditch the call and wait until you have better service. When your phone has fewer signal bars, it has to work harder (and, therefore, emit more radiation) to connect.
  5. Keep the phone away from your ear when you can. EMF-Health.comrecommends waiting for the call to connect before you bring the phone to your ear, which minimizes radiation exposure. And when you talk, tilt the phone away from your ear and bring it in close when you’re listening. That’s because the radiation levels are “significantly less when a cell phone is receiving signals than when it is transmitting,” Lin Zhong, assistant professor of electrical and computer engineering at Rice University in Houston, told The New York Times.
  6. Don’t make calls in elevators or cars. You already it’s dangerous to talk and drive; EMF-Health.com says that cell phones use more power to establish a connection in enclosed metal spaces like cars and elevators.
  7. Make sure your kids use the landline. It seems like even toddlers are using cell phones today, but experts say kids are the most vulnerable to potential radiation dangers. The EWG says children’s brains absorb twice as much cell phone radiation as adults. According to The New York Times, health authorities in Britain, France, Germany, and Russia all have warnings against letting children use cell phones.
  8. Buy a low-radiation phone. Some cell phones emit more radiation than others; if you’re in the market for a new phone, EMF-Health.com recommends that you consider the phone’s SAR (specific absorption rate), a way of measuring the radiation absorbed by the body. It’s usually listed in the phone’s instruction manual. You can also look at the EWG’s report of cell phone SARs here — from the LG Quantum’s 0.35 W/kg on the low end to the Motorala Bravo’s 1.59 W/kg on the high end.

Cell Phones May Cause Brain Cancer

Cell phones may cause brain cancer, a panel of experts reporting to the World Health Organization (WHO) announced Tuesday.

After reviewing dozens of studies that explored a possible link between cancer and the ubiquitous hand-held phones, the experts classified cell phones as “possibly carcinogenic to humans” and placed them in the same category as the pesticide DDT and gasoline engine exhaust.

The panel determined that an increased risk for glioma, a malignant form of brain cancer, appears associated with wireless phone use.

Globally, it’s estimated that 5 billion cell phones are in use. “The number of users is large and growing, particularly among young adults and children,” the International Agency for Research on Cancer said in a news release issued Tuesday.

The IARC made the announcement in Lyons, France, based on the work of 31 scientists from 14 countries. It will present its findings to the WHO, which may then issue its recommendations on safe cell phone use.

Experts said children are especially vulnerable.

“Children’s skulls and scalps are thinner. So the radiation can penetrate deeper into the brain of children and young adults. Their cells are dividing at a faster rate, so the impact of radiation can be much larger,” Dr. Keith Black, chairman of neurology at Cedars-Sinai Medical Center in Los Angeles, told CNN.

Until Tuesday’s announcement, the WHO had said that cell phones were safe to use.

The international experts behind Tuesday’s announcement met for eight days to review exposure data, studies of cancer in humans and in experimental animals, and other relevant data, looking for associations between cancer and the type of electromagnetic radiation found in cell phones, televisions and microwaves.

Dr. Christopher Wild, director of the International Agency for Research on Cancer, said this new paper is important “first and foremost just because of the large number of users worldwide that have access now to this technology.”

Also, the scientists found notable gaps in the existing research, he said, which “suggest interesting areas of future research that will improve the evidence base which we have in order to make decisions about the usage of mobile phones in the future.”

Responding to Tuesday’s announcement, John Walls, vice president of public affairs for CTIA-The Wireless Association, a trade group representing the wireless industry said: “Today, an International Agency for Research on Cancer (IARC) working group in Lyon, France categorized radiofrequency fields from cellphones as possibly carcinogenic based on ‘limited evidence.’ IARC conducts numerous reviews and in the past has given the same score to, for example, pickled vegetables and coffee. This IARC classification does not mean cell phones cause cancer. Under IARC rules, limited evidence from statistical studies can be found even though bias and other data flaws may be the basis for the results.

“The IARC working group did not conduct any new research, but rather reviewed published studies,” Walls added in a news release. “Based on previous assessments of the scientific evidence, the Federal Communications Commission has concluded that ‘[t]heres no scientific evidence that proves that wireless phone usage can lead to cancer.’ The Food and Drug Administration has also stated that ‘[t]he weight of scientific evidence has not linked cell phones with any health problems.'”

There has been conflicting research in recent years on the health hazards posed by cell phones. As recently as February, British researchers reported that cell phones do not increase the risk of brain cancer.

Their analysis of data on newly diagnosed cases of brain cancer in England between 1998 and 2007 — when cell phone use was climbing — revealed no statistically significant change in the incidence of brain cancers in men or women, said the University of Manchester researchers.

There was a very small increase (0.6 more cases per 100,000 people) in the incidence of cancers of the brain’s temporal lobe. That works out to 31 extra cases per year in England’s population of nearly 52 million people, the researchers said.

But the study authors also noted that cancers of the brain’s parietal lobe, cerebrum and cerebellum in English men fell slightly during the study period.

7 Foolish Health Rumors You Should Ignore

Urban legends and health myths are certainly nothing new — we’re pretty sure even our Neanderthal ancestors passed some version of them around their cave fires. But the Internet has certainly helped outdated advice die hard, so it’s no wonder these fake facts keep popping up in our inboxes. We picked our favorites from such myth-busting sites as Snopes, the authors of Don’t Swallow Your Gum!: Myths, Half-Truths, and Outright Lies About Your Body and Health, and more. Here’s why you should stop falling for these, once and for all:

Plucking a gray hair causes two to grow back.

The truth: It’s fine to tweeze that errant hair. Genetics plays a key role in when you go gray, regardless of how often you pluck. It can take six months from the time a hair falls out until it grows back long enough for you to notice it; during that time, you’ll automatically see more gray hair as part of the aging process, explains Snopes.com.

Antiperspirant deodorants cause breast cancer.

The truth: Going au naturel won’t protect your breasts from cancer. This mythprobably came about because some antiperspirants contain aluminum, which can show up as a false-positive finding on a mammogram. All this means is you should skip the white stuff before a breast cancer screening. Though concerns have been raised about parabens in deodorant raising estrogen levels — and thus possibly increasing cancer risk — there’s never been any conclusive evidence to prove a link, according to the National Cancer Institute and FDA.

Cats can steal the air from a baby’s mouth.

The truth: There’s no need to send Fluffy away when baby moves in. This myth dates back hundreds of years to an era when cats were associated with evil spirits and witchcraft, but KidsHealth.org notes that it’s anatomically impossible for a cat or other animal to suffocate a baby by sealing the infant’s mouth with its own. Still, it’s a good idea to supervise pets around babies and small children — for the kitty’s safety just as much as the child’s.

Mountain Dew can shrink a man’s testicles.

The truth: Mountain Dew-drinking guys everywhere can breathe a sigh of relief. The gist of this ridiculous rumor, according to Snopes.com, is that drinking Mountain Dew can lower a man’s sperm count or cause his penis to shrink. The alleged culprit is food coloring Yellow No. 5, and the myth that it has a harmful effect on the male reproductive system is unfounded, the site says.

You can catch a cold from being outside too long.

The truth: It’s actually a good idea to let your kids spend plenty of time outdoors. “Going outside — with or without a wet head — is one of the best things you can do toprevent catching a cold,” D.J. Verret, MD, a Dallas otolaryngologist, toldWomansDay.com. “Colds are caused by viruses or bacteria, which are more often spread in the winter because of close contact from everyone being indoors.” So spending time al fresco can actually make you less likely to catch a cold.

Cracking your knuckles causes arthritis.

Truth: The sound can be extremely grating, but this uncouth habit won’t harm your joints. Researchers found no difference in instances of arthritis when they compared a group of longtime knuckle crackers with those who left their hands alone, according to Prevention.com. However, the study did find that people who cracked their knuckles had weaker grips and more hand swelling — good reasons to kick the habit.

Drinking cold water after meals can lead to cancer.

Truth: Water is one of the healthiest things you can drink with any meal — hot, cold, or tepid. This rumor first surfaced in early 2006, according to Snopes.com, and still makes its way into various email chains. It posits that cold water helps solidify oily fats from your meal into a “sludge” that lines the intestines and can lead to cancer. But there’s zero evidence from medical literature to support this theory.

 

 

Global Warming May Pose Health Risks

Medical and public health groups are banding together to explain how global warming has taken a toll on human health and will continue to cause food-borne illnesses, respiratory problems, and deaths unless policy changes are enacted.

In a conference call with reporters, the heads of the American Medical Association (AMA) and the American Public Health Association (APHA) joined with a pediatrician and a scientist to lay out what they say is a major public health issue: climate change caused by global warming.

The “evidence has only grown stronger” that climate change is responsible for an increasing number of health ills, including asthma, diarrheal disease, and even deaths from extreme weather such as heat waves, said Dr. Georges Benjamin, executive director of the APHA.

For one, rising temperatures can mean more smog, which makes children with asthma sicker, explained pediatrician Dr. Perry Sheffield, assistant professor in the Department of Pediatrics and the Department of Preventive Medicine at the Mount Sinai School of Medicine, in New York.

There is also evidence that pollen season is also getting longer, she said, which could lead to an increase in the number of people with asthma.

Climate change also is thought to lead to increased concentrations of ozone, a pollutant formed on clear, cloudless days. Ozone is a lung irritant which can affect asthmatics, those with chronic obstructive pulmonary disease, and those with heart disease, said Dr. Kristie Ebi, who is a member of the Intergovernmental Panel on Climate Change.

More ozone can mean more health problems and more hospital visits, she said.

Aside from air-related ailments and illnesses, extreme weather can have a devastating effect on health, Sheffield said.

“As a result of global warming, extreme storms including hurricanes, heavy rainfall, and even snowstorms are expected to increase,” Sheffield said. “And these events pose risk of injury and disruption of special medical services, which are particularly important to children with special medical needs.”

Extreme heat waves and droughts are responsible for more deaths than any other weather-related event, Sheffield said.

The 2006 heat wave that spread through most of the U.S. and Canada saw temperatures that topped 100 degrees. In all, 450 people died, 16,000 visited the emergency room, and 1,000 were hospitalized, said Dr. Cecil Wilson, president of the AMA.

Climate change has already caused temperatures to rise and precipitation to increase, which, in turn, can cause diseases carried by tics, mosquitoes, and other animals to spread past their normal geographical range, explained Ebi.

For instance, Lyme disease is increasing in some areas, she said, including in Canada, where scientists are tracking the spread of Lyme disease north.

Ebi also recounted the 2004 outbreak of the leading seafood-related cause of gastroenteritis, Vibrio parahaemolyticus, from Alaskan seafood, which was attributed to increased ocean temperatures causing infected sea creatures to travel 600 miles north.

Salmonella outbreaks also increase when temperatures are very warm, Sheffield said.

A 2008 study also projected that global warming will lead to a possible increase in the prevalence of kidney stones due to increased dehydration, although the link hasn’t been proven.

Wilson said the AMA wants to make doctors aware of the projected rise in climate-related illnesses. To combat climate change, Wilson says physicians and public health groups can advocate for policies that improve public health, and should also serve as role models by adopting environmentally-friendly policies such as eliminating paper waste and using energy-efficient lighting in their practices.

“Climate instability threatens our health and life-supporting system, and the risk to our health and well-being will continue to mount unless we all do our part to stabilize the climate and protect the nation’s health,” said Wilson.

Benjamin added that doctors should pay attention to the Air Quality Index. For instance, if there’s a “Code Red” day, which indicates the air is unhealthy, physicians should advise patients (particularly those with cardiac or respiratory conditions) that it’s not the day to try and mow the grass.

“ER docs are quite aware of Code Red days because we know that when those occur, we’re going to see lots of patients in the emergency room,” Benjamin said.

The conference call came as Congress is considering what role the Environmental Protection Agency (EPA) should have in updating its safeguards against carbon dioxide and other pollutants.

While the EPA has the authority to regulate levels of CO2, a budget bill passed by the House of Representatives last the weekend prohibited the EPA from exercising that authority. Meanwhile, other bills are pending in Congress that would significantly delay the agency’s ability to regulate air pollutants.

AMA has a number of policies on the books regarding climate change, including a resolution supporting the EPA’s authority to regulate the control of greenhouse gases, and a statement endorsing findings from the most recent Intergovernmental Panel on Climate Change report that concludes the Earth is undergoing adverse climate changes, and that humans are a significant contributor to the changing weather.

In that statement, the AMA said it supports educating the medical community about climate change and its health implications through medical education on topics such as “population displacement, heat waves and drought, flooding, infectious and vector-borne diseases, and potable water supplies.”

The statement also said the AMA supports physician involvement in policymaking to “search for novel, comprehensive, and economically sensitive approaches to mitigating climate change to protect the health of the public.”

Cell Phones Affect Brain Activity

Holding a cell phone to your ear for a long period of time increases activity in parts of the brain close to the antenna, researchers have found.

Glucose metabolism — that’s a measurement of how the brain uses energy — in these areas increased significantly when the phone was turned on and muted, compared with when it was off, Dr. Nora Volkow, director of the National Institute on Drug Abuse, and colleagues reported in the Journal of the American Medical Association.

“Although we cannot determine the clinical significance, our results give evidence that the human brain is sensitive to the effects of radiofrequency-electromagnetic fields from acute cell phone exposures,” co-author Dr. Gene-Jack Wang of Brookhaven National Laboratory in Long Island, where the study was conducted, told MedPage Today.

What We Know About Cell Phones and Cancer

Although the study can’t draw conclusions about long-term implications, other researchers are calling the findings significant.

“Clearly there is an acute effect, and the important question is whether this acute effect is associated with events that may be damaging to the brain or predispose to the development of future problems such as cancer as suggested by recent epidemiological studies,” Dr. Santosh Kesari, director of neuro-oncology at the University of California San Diego, said in an e-mail to MedPage Today and ABC News.

There have been many population-based studies evaluating the potential links between brain cancer and cellphone use, and the results have often been inconsistent or inconclusive.

Most recently, the anticipated Interphone study was interpreted as “implausible” because some of its statistics revealed a significant protective effect for cell phone use. On the other hand, the most intense users had an increased risk of glioma — but the researchers called their level of use “unrealistic.”

But few researchers have looked at the actual physiological effects that radiofrequency and electromagnetic fields from the devices can have on brain tissue. Some have shown that blood flow can be increased in specific brain regions during cell phone use, but there’s been little work on effects at the level of the brain’s neurons.

So Dr. Volkow and colleagues conducted a crossover study at Brookhaven National Laboratory, enrolling 47 patients who had one cell phone placed on each ear while they lay in a PET scanner for 50 minutes.

The researchers scanned patients’ brain glucose metabolism twice — once with the right cell phone turned on but muted, and once with both phones turned off.

There was no difference in whole-brain metabolism whether the phone was on or off.

Are Cell Phones Dangerous for Kids?

But glucose metabolism in the regions closest to the antenna — the orbitofrontal cortex and the temporal pole — was significantly higher when the phone was turned on.

Further analyses confirmed that the regions expected to have the greatest absorption of radiofrequency and electromagnetic fields from cell phone use were indeed the ones that showed the larger increases in glucose metabolism.

“Even though the radio frequencies that are emitted from current cell phone technologies are very weak, they are able to activate the human brain to have an effect,” Dr. Volkow said in a JAMA video report.

The effects on neuronal activity could be due to changes in neurotransmitter release, cell membrane permeability, cell excitability, or calcium efflux.

It’s also been theorized that heat from cell phones can contribute to functional brain changes, but that is probably less likely to be the case, the researchers said.

Dr. Wang noted that the implications remain unclear — “further studies are needed to assess if the effects we observed could have potential long-term consequences,” he said — but the researchers have not yet devised a follow-up study.

“The take-home message,” Dr. Kesair said, “is that we still don’t know, more studies are needed, and in the meantime users should try to use headsets and reduce cell phone use if at all possible. Restricting cell phone use in young children certainly is not unreasonable.”

Chemical Found in Blood Holds

Even within the normal range, higher bilirubin levels appear to be associated with reduced risks of lung cancer, chronic obstructive pulmonary disease (COPD), and death, a longitudinal, prospective analysis of a large database showed.

For every 0.1-mg/dL increase in bilirubin level, the rate of lung cancer dropped by 8 percent in men and 11 percent in women, according to Laura Horsfall, MSc, of University College London, and colleagues.

In addition, the same incremental increase in bilirubin was associated with a 6 percent decline in the rate of COPD and a 3 percent decline in mortality for both sexes, the researchers reported in the Feb. 16 issue of the Journal of the American Medical Association.

“Based on our findings, bilirubin levels within the normal range appear to capture information about patients that may reflect a combination of environmental and genetically determined susceptibility to respiratory diseases,” they wrote.

Most people are familiar with bilirubin because of its role in jaundice — the yellowing of the skin that is sometimes seen in newborns but is also associated with liver disease.

Bilirubin is actually a byproduct of the turn over of red blood cells — the cells that carry oxygen throughout the body. Healthy individuals constantly replace old red blood cells with new ones. As the old cells are broken down they produce bilirubin, a chemical characterized by a distinctive yellow color.

The spleen and the liver taking in bilirubin and use it to break down or metabolize other substances into bile, which is used to aid digestion.

Although the study cannot establish causality for any of the relationships, there is some experimental evidence that bilirubin has benefits for respiratory health because of its cytoprotective properties, including antioxidant, anti-inflammatory, and antiproliferative effects, according to the researchers.

They noted that a better understanding of the possible mechanisms linking bilirubin levels to lung cancer, COPD, and death may lead to potential therapies that target the activity of UGT1A1, a liver enzyme responsible for converting insoluble bilirubin to an excretable form.

Horsfall and her colleagues examined data from the Health Improvement Network, a U.K. primary care research database.

Their analysis included 504,206 patients ages 20 and older from 371 practices. All of the patients had recorded serum bilirubin levels but no evidence of hepatobiliary or hemolytic disease.

Median bilirubin levels were 0.64 mg/dL in men and 0.53 mg/dL in women.

Through a median follow-up of eight years, there were 1,341 incident cases of lung cancer, 5,863 incident cases of COPD, and 23,103 all-cause deaths. The corresponding rates per 10,000 person-years were 2.5, 11.9, and 42.5.

For men, the rate of lung cancer per 10,000 person-years dropped from 5.0 in the lowest decile of bilirubin levels to 3.0 in the fifth decile. Similar declines were seen for COPD (19.5 to 14.4) and death (51.3 to 38.1).

The findings were similar for all outcomes in women, and the declines in both sexes remained significant after adjustment for age, body mass index, systolic blood pressure, smoking, alcohol intake, and a measure of social deprivation.

The authors acknowledged some limitations of the study, including possible residual confounding by unmeasured environmental exposures or race/ethnicity and the inability to establish causality for the observed relationships.

Marijuana Users at Risk for Early Psychosis

Psychotic illness occurs significantly earlier among marijuana users, results of a meta-analysis suggest.

Data on more than 22,000 patients with psychosis showed an onset of symptoms almost three years earlier among users of cannabis compared with patients who had no history of substance use.

The age of onset also was earlier in cannabis users compared with patients in the more broadly characterized category of substance use, investigators reported online in Archives of General Psychiatry.

“The results of this study provide strong evidence that reducing cannabis use could delay or even prevent some cases of psychosis,” Dr. Matthew Large, of the University of New South Wales in Sydney, Australia, and co-authors wrote in conclusion.

“Reducing the use of cannabis could be one of the few ways of altering the outcome of the illness because earlier onset of schizophrenia is associated with a worse prognosis and because other factors associated with age at onset, such as family history and sex, cannot be changed.”

Psychosis has a strong association with substance use. Patients of mental health facilities have a high prevalence of substance use, which also is more common in patients with schizophrenia compared with the general population, the authors wrote.

Several birth cohort and population studies have suggested a potentially causal association between cannabis use and psychosis, and cannabis use has been linked to earlier onset of schizophrenia. However, researchers in the field remain divided over the issue of a causal association, the authors continued.

Attempts to confirm an earlier onset of psychosis among cannabis users have been complicated by individual studies’ variation in methods used to examine the association. The authors sought to resolve some of the uncertainty by means of meta-analysis.

A systematic search of multiple electronic databases yielded 443 potentially relevant publications. The authors whittled the list down to 83 that met their inclusion criteria: All the studies reported age at onset of psychosis among substance users and nonusers.

The studies comprised 8,167 substance-using patients and 14,352 patients who had no history of substance use. Although the studies had a wide range of definitions of substance use, the use was considered “clinically significant” in all 83 studies. None of the studies included tobacco in the definition of substance use.

The studies included a total of 131 patient samples.

Substance use included alcohol in 22 samples, cannabis in 41, and was simply defined as “substance use” in 68 samples.

Alcohol use was not significantly associated with earlier age at onset of psychosis.

On average, substance users were about 2 years younger than nonusers were. The effect of substance use on age at onset was greater in women than in men, but not significantly so. Heavy use was associated with earlier age at onset compared with light use and former use, but also not significantly different, the authors reported.

Substance users were two years younger at the onset of psychosis compared with nonusers. Age at onset was 2.7 years earlier among cannabis users compared with nonusers.

Acknowledging limitations of the study, the authors cited the lack of information on tobacco use and its association with earlier age at onset of psychosis, and the lack of data on individual patients inherent in all meta-analyses.

Despite the limitations, the authors said the findings have potentially major clinical and policy implications.

“This finding is an important breakthrough in our understanding of the relationship between cannabis use and psychosis,” they wrote in conclusion. “It raises the question of whether those substance users would still have gone on to develop psychosis a few years later.”

“The results of this study confirm the need for a renewed public health warning about the potential for cannabis use to bring on psychotic illness,” they added.

Painkiller Use Common Among NFL Players

Retired National Football League players who abused opioid painkillers while active were most likely to use and abuse the same drugs after leaving the sport, the results of a telephone survey and analysis found.

The survey found more than half of the retired NFL players interviewed used opioidpainkillers during their career. Of those, 71 percent reported misusing the drugs while playing, and 15 percent said they still abuse the prescription medication, Dr. Linda B. Cottler, of Washington University School of Medicine, and colleagues reported online in Drug and Alcohol Dependence.

The former broadcaster and NY Giants great, Frank Gifford, said, “pro football is like nuclear warfare. There are no winners, only survivors.”

The findings from Cottler’s survey support Gifford’s assessment.

An analysis of survey data showed the rate of opioid misuse while the retired players were active in the NFL was roughly three times greater than the lifetime rate of nonmedical use of opioids in the general population of approximately the same age.

Misuse in the past 30 days in retired players was seven percent, versus less than two percent in adults 26 and older in the general population. Looking only at men in the general population, the abuse rate is about two and half percent.

The final sample included 644 former players listed in the 2009 Retired NFL Football Players Association Directory who had retired from 1979 to 2006 and had at least one phone number listed.

They completed a phone interview that discussed general demographic data, health status, pain, impairment, alcohol use, prescription opioid use, and illicit drug use. Prescription opioid use was measured for while a player was active as well as over the past 30 days. Participants were categorized into users and nonusers. Users were subcategorized as having used the drugs as prescribed, or having misused them.

Misuse was defined as taking more of the drug than prescribed, using it in a way other than prescribed, using it after a prescription ended, using it for a different reason, or using it without a prescription.

When compared against players prescribed opioids while in the NFL and with those who were non-users during their NFL careers, 17 percent of those who misused while playing used as prescribed in the past 30 days, 15 percent misused in the past 30 days, and 68 percent reported no use.

In a multivariate analysis, moderate to severe pain, undiagnosed concussions, and drinking 20 or more alcoholic drinks a week were the strongest predictors of misuse. Undiagnosed concussions were reported by 81 percent of misusers.

“This association might have been due to the fact that those who choose not to report concussions are the same players who choose not to reveal their pain to a physician, thus managing their pain on their own,” the researchers wrote. “They may believe that if they report a concussion, they will be pulled from active play.”

The researchers noted the study may have been limited by lack of detailed pain information from while a player was active, a small sample size, a more inclusive definition of misuse that included abuse of opioids a player was prescribed, and a sample that included potentially more-healthy-than-average retired footballers — the researchers noted interviews with former players not in the Retired Players Association uncovered “multiple examples of serious and heavy opioid abuse.”

Head Injuries Carry Long Term Death Risk

The risk of death after head injury remained significantly increased for as long as 13 years, irrespective of the severity of the injury, results of a case-control study showed.

Overall, patients with a history of head injury had more than a twofold greater risk of death than did two control groups of individuals without head injury.

Among young adults, the risk disparity ballooned to more than a fivefold difference, Scottish investigators reported online in the Journal of Neurology, Neurosurgery and Psychiatry.

“More than 40% of young people and adults admitted to hospital in Glasgow after a head injury were dead 13 years later,” Dr. Thomas M. McMillan, of the University of Glasgow, and coauthors wrote in the discussion of their findings. “This stark finding is not explained by age, gender, or deprivation characteristics.”

“As might be expected following an injury, the highest rate of death occurred in the first year after head injury,” they continued. “However, risk of death remained high for at least a further 12 years when, for example, death was 2.8 times more likely after head injury than for community controls.”

Previous studies of mortality after head injury have focused primarily on early death, either during hospitalization or in the first year after the injury. Whether the excess mortality risk persists over time has remained unclear, the authors noted.

Few studies have compared mortality after head injury with expected mortality in the community. To provide that missing context, McMillan and coauthors conducted a case-control study involving 757 patients who incurred head injuries of varying severity from February 1995 to February 1996 and were admitted to a Glasgow-area hospital.

For comparison, the investigators assembled two control groups, both matched with the cases for age, sex, and socioeconomic status and one matched for duration of hospitalization after injury not involving the head.

One control group was comprised of persons hospitalized for other injured and other comparison group included healthy non-hospitalized adults.

The cases comprised 602 men and 155 women who had a mean age of 43, and almost 70 percent were in the lowest socioeconomic quintile.

At the end of follow-up, 305 of the head-injured patients had died, compared with 215 of the hospitalized control group, and 135 of healthy, non-hospitalized adults.

Mortality after one year remained significantly higher in the head-injury group—34 percent versus 24 percent among the hospitalized comparison group and 16 percent for the healthy non-hospitalized adults.

Overall, the head-injury group had a death rate of 30.99/1,000/ year versus 13.72/1,000/year in the community controls and 21.85/1,000/year in the hospitalized-other injury control group.

The disparity was greater among younger adults (15 to 54), who had a rate of 17.36/1,000/year versus 2.21/1,000/year in the community controls. Older adults in the head injury group had a death rate of 61.47/1,000/year compared with 39.45/1,000/year in the community controls.

“Demographic factors do not explain the risk of death late after head injury, and there is a need to further consider factors that might lead to health vulnerability after head injury and in this way explain the range of causes of death,” the authors wrote in conclusion. “The elevated risk of mortality after mild head injury and in younger adults makes further study in this area a priority.”