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New opioid prescribing guidelines reverse course on strict restrictions

iStock/Eugeneonline(WASHINGTON) -- The Department of Health and Human Services reversed course on its opioid guidelines this week and advised doctors that cutting off pain patients' prescriptions suddenly could do more harm than good.

The new guidance, published Thursday, stressed that that abrupt changes to long-term pain patients' medication regimens could "put the patient at risk of harm," because of the significant chance that a sudden switch could throw the patient into opioid withdrawal.

In addition to withdrawal, the guide lists anxiety, depression, self-harm, suicidal ideation, ruptured trust and pain exacerbation as side effects of sudden prescription changes.

"We need to treat people with compassion," Adm. Dr. Brett Giroir, assistant secretary for health at HHS, said in a statement. Giroir noted that clinicians were tasked with the dual goals: effective pain management and reducing addiction risk. Outside of life-threatening situations, HHS does not recommend that clinicians rapidly taper or suddenly discontinue patients' prescriptions.

The new recommendations stand in contrast to those issued to primary care providers by the Centers for Disease Control and Prevention in 2016, which focused on judicious prescribing and emphasized that opioids were not a first-line treatment, nor were they an appropriate routine therapy. Many clinicians thought the guidelines went too far and resulted in unintended consequences.

In a letter to the agency earlier this year, doctors described patients in pain who were cut off from opioids and not offered alternative pain care. Some suffered. Others turned to illicit drugs for relief.

"These actions have led many health care providers to perceive a significant category of vulnerable patients as institutional and professional liabilities to be contained or eliminated, rather than as people needing care," the doctors wrote.

More than 68,000 people died of drug overdoses in 2018, according to preliminary estimates from the CDC, a count that's down slightly from 2017, when overdose deaths topped 70,000. It's the first drop in deaths since 1990, a drop that's partially attributed to doctors prescribing fewer opioids in recent years.

By 2017, prescriptions for opioids fell to 191 million prescriptions dispensed, down from a peak of 225 million prescriptions in 2012.

"What's good about this guidance is that it calls for care to be individualized and tailored for the patient," said Dr. Stefan Kertesz, lead author of the letter to the CDC and a professor of preventive medicine at the University of Alabama at Birmingham.

Doctors escalated opioid doses too quickly in years past, Kertesz said. Once prescribing opioids became frowned upon, they similarly de-escalated doses too aggressively, often without patient consent. The new guidelines move in the right direction "by demanding that care be individualized," Kertesz added.

Moving to less aggressive tapering practices won't necessarily be easy for doctors. "There is a tremendous amount of pressure on doctors from every possible agency, including the federal government itself," Kertesz explained.

That pressure can take the form of limits on opioids prescribing, or evaluating providers' quality of care based on the number of patients they treat with high opioid doses.

"The effect of all these pressures is to force doctors to reduce doses or to get rid of the patients altogether," Kertesz said.

Copyright © 2019, ABC Radio. All rights reserved.

STD cases hit record high for fifth year running, as prevention efforts hit by budget cuts

jarun011/iStock(NEW YORK) -- Sexually transmitted infections hit a record high 2.4 million cases in 2018, making it the fifth year in a row that cases of chlamydia, gonorrhea and syphilis have spiked, according to new numbers from the Centers for Disease Control and Prevention.

The agency pointed to the budget cuts that have hit sexually transmitted disease programs in recent years as a driving factor behind the disease spike. Cuts to state and local programs have translated into clinic closures, decreased staffing and ultimately fewer patient screenings and follow-ups.

Over the last five years, chlamydia cases increased 19%, gonorrhea cases increased 63% and syphilis cases increased 71%.

Human papillomavirus virus, which 79 million Americans are infected with, remains the most common sexually transmitted disease.

Most worrying of all was a spike in syphilis transmission from mothers to newborns during pregnancy, which skyrocketed 185% -- to 1,306 cases -- in 2018.

Congenital syphilis, which can lead to miscarriage, stillbirth and severe neurological problems for babies, resulted in 94 newborn deaths last year, a number Dr. Gail Bolan, director of the CDC’s Division of STD Prevention called "startling" in a statement.

The rise in congenital syphilis is especially worrisome because it indicates a breakdown in the health care system, explained Holly Hagan, director of the NYU College of Global Public Health Center for Drug Use and HIV/HCV Infection.

"Where there is good access to regular health care, screening for infectious disease and access to family planning, congenital syphilis should not occur," Hagan added.

Decreased condom use could also be contributing to the increases, experts say, a practice that might be fueled in part by advances in the prevention of HIV transmission.

Pre-exposure prophylaxis, or PrEP, for example, the once-daily pill that prevents HIV transmission, does not offer protection against the spread of other sexually transmitted diseases. In 2016, roughly 80,000 Americans filled prescriptions for the medication.

People on PrEP may take the calculated risk of contracting gonorrhea, chlamydia and syphilis when they have sex without using a condom, because they know those diseases are curable, explained Dr. David Bell, an associate professor of population and family health at Columbia University Irving Medical Center.

"They obviously don't want those infections," he added. "But they do end up taking the risk, to some degree."

The protocol for providers who have patients taking PrEP is to screen those individuals for sexually transmitted disease much more frequently than they would otherwise, at least once every three months. There's a possibility that increased screening could be capturing more individuals with sexually transmitted diseases than screenings did when PrEP use was less prevalent.

Bell pointed to the importance of treating chlamydia, gonorrhea and syphilis, in order to decrease their overall prevalence in the U.S. population, particularly in areas of the county with pockets of high STI rates, like parts of the South.

"We have put most of our eggs in the basket around the personal responsibility and personal morality of using condoms. But a major part of prevention should be testing for sexually transmitted infections and curing them," he said. "If we had decreased prevalence our rates wouldn't be going up."

Chlamydia, gonorrhea and syphilis, which can all be treated with antibiotics, can lead to infertility, ectopic pregnancy and increased HIV risk if left untreated. The CDC recommends that boys and girls between the ages of 11 and 12 get vaccinated against HPV, which can lead to cervical, vulvar, vaginal, penile and anal cancers.

Risk factors for sexually transmitted diseases include having unprotected sex, sex with multiple partners and having a previous history of STI infection, according to the Mayo Clinic.

Half of the infections occur in people between the ages of 15 and 24, although men treated for erectile dysfunction medication are also at a higher risk for STIs than the general population.

Copyright © 2019, ABC Audio. All rights reserved.

'Weed moms' are the new 'wine moms'

Nastasic/iStock(NEW YORK) -- Are weed moms the new wine moms?

Though "wine mom" culture has long been the source of many a mommy meme and largely socially acceptable, marijuana-using moms are stepping out of the shadows and proudly extolling the virtues of cannabis.

In a recent essay for Parents magazine, writer Leah Campbell claimed micro-dosing marijuana makes her a better mom.

"A small amount of pot administered as an edible allows me to be present and functional for my daughter," the article reads. "It makes me the best version of myself and I have no shame at all in admitting that it makes me a better parent."

Julia Dennison, executive editor of Parents.com told ABC News' Good Morning America that more moms are opening up about their marijuana use than ever before.

"We see mom influencers on Instagram posting about it," she said. "In line with the legalization of marijuana has come a lessening of the stigma surrounding it."

Dr. Edith Bracho-Sanchez, a primary care pediatrician and assistant professor of Pediatrics at Columbia University, agreed.

"As more states have moved to legalize cannabis for both medicinal and recreational use in recent years, there certainly has been a rise in the amount of parents who are using them to cope with the stress of parenting and daily life," she told GMA. "I'm hearing from more and more adults who use these products to 'take the edge off,' relax or ease pain."

In her piece, Campbell writes she started micro-dosing to avoid period pain. She soon discovered it also eased her anxiety.

"When I started to feel that increase in my heart rate, I found that just one 2.5mg dose of THC was typically enough to stabilize my breathing and bring me back to a steady state. Quick, easy, and effective," she wrote.

Campbell wrote she does this 5 - 10 days each month and "every once in a while, I take higher doses recreationally."

Campbell is far from an outlier. In a 2016 report from the Centers for Disease Control and Prevention, the organization found the highest usage of marijuana was among 26-34 years olds.

Despite this, Dennison said there is still some taboo tied to marijuana use among moms.

"They get flack in mom groups in a way they don't when the topic is wine," she said.

Marijuana is fully legal in at least 11 states, including Alaska where Campbell lives.

Moms who may not have a marijuana community around them can find support online.

On Facebook, The Cannavist Mom, a group for "cannabis choosing moms" has almost 35,0000 members. It's tagline: "Mommy needs a joint should be just as socially acceptable as Mommy needs a glass of wine!" There's also Moms for Marijuana International with half a million followers.

And while "wine mom" may be tempted to turn "weed mom" if only to save herself the hangover, Bracho-Sanchez warns to proceed carefully.

"Just because these products are now legal, it does not mean that they're always safe," she said. "We have no standards or process for ensuring their quality, we don't know the appropriate dosing for different conditions and we ultimately can't guarantee their safety."

"I do believe the use of these products is a valid strategy to cope with certain medical conditions and I encourage people to partner with their physicians to decide whether they can be safely introduced into the treatment plan," she said.

Copyright © 2019, ABC Audio. All rights reserved.

'Freak Shakes' are one bakery’s tool to help a woman battling breast cancer

Julie Curry, owner of Bake'n Babes(TAMPA, Fla.) -- Milkshakes are changing a Florida woman’s fight against breast cancer after a bakery owner surprised her with a fundraiser.

“It felt really good," recipient Victoria Burnham, 25, said. "I know there are ... people out there who are going through worse out there, but they chose me.”

Burnham was diagnosed with breast cancer in December 2008 and has been going through chemotherapy since June. She told ABC News' Good Morning America she is unable to work and tries to manage her daily expenses.

Burnham is exactly the type of person Julie Curry, the owner of Bake'n Babes in Tampa, wanted to help during Breast Cancer Awareness Month. To do so, the shop is selling its "Freak Shakes," which are over-the-top milkshakes, to fundraise for Burnham. This month, the eatery has sold almost 100 of them.

To get a sense of the social media-worthiness of the sweet treats, look no further than an Instagram post by singer Lizzo, who appears to love the custom-made Freak Shake she was served and even gave Bake'n Babes a shout-out in the caption.

Curry said she was inspired to sell a Freak Shake called “Think Pink” throughout October after one of her bakers, Jen Ingandela, revealed her own personal battle with breast cancer. Curry said Ingandela told her people would often say they had donated to walk-a-thons or another cause in her honor, but Curry “wished they would’ve donated the money to her.”

After this conversation, Curry wanted to get involved and went on the hunt to find a woman battling the disease she and the bakery could help directly.

“Jen was pretty adamant about find[ing] a local person,” Curry said.

Curry was soon connected by a friend to Burnham and then decided to make her the beneficiary of the fundraising effort.

“[I] wanted her to make sure she didn’t feel this was a charity case," Curry said. "I wanted her to know [there were] other women in the community who care for her.”

Beyond her own diagnosis, Burnham is no stranger to the disease.

“My mom was diagnosed and died when I was at 8," she said, noting that her sister beat stage 4 breast cancer, and that two of her aunts also had battles with cancer.

Curry told ABC affiliate WFTS-TV in Tampa that this initiative is sparking an important conversation in an unexpected place.

"I know it's not something a bakery would normally talk about," she said.

What's more, the bakery has featured a different breast cancer survivor each day in October on social media, telling their stories and encouraging others to get checked.

“People are coming in and wanted to buy," Curry told GMA. "Every day we are sharing a survivor story because I want everyone to feel that love and support."

Burnham does and said she wants those fighting breast cancer to know that “it may be hard right now, but it will get better."

"Make sure you get checked," she said. "I saw a lump before my 23rd birthday, so that’s crazy.”

Copyright © 2019, ABC Audio. All rights reserved.

Babies at higher risk of heart defects if dad drinks alcohol before conception: Study

iStock(NEW YORK) -- Does a dad's drinking matter as much as a mom's before conception?

Researchers in China believe that a father's alcohol intake may actually affect a future child more than a mother's.

They completed a meta-analysis review of thousands of cases to determine how parental alcohol use prior to conception and during the first trimester of pregnancy affects heart health in a child.

Their results, published in the European Journal of Preventive Cardiology, revealed that the risk of heart defects in infants was 44% higher if their fathers drank. They found that this risk was increased by 16% for mothers who drank.

"Binge drinking by would-be parents is a high-risk and dangerous behavior that not only may increase the chance of their baby being born with a heart defect, but also greatly damages their own health," study author Dr. Jiabi Qin, of Xiangya School of Public Health, Central South University, Changsha, China, said in a statement.

In an interview with ABC News, Qin added, "We think that everyone should know the harm of alcohol consumption." He said parents should "resolutely avoid alcohol consumption six months or one year before and during pregnancy."

Many studies have shown alcohol has negative effects on a developing fetus.

"What is of the most interest in this work is the fact that they identify a risk if the father is using alcohol. That is a somewhat novel finding," says Dr. Robert H. Pass, director of pediatric cardiology at the Mt Sinai Kravis Children's Hospital.

What does this mean for prospective parents?

"I don't think that from one study that we can definitively make recommendations," Pass said. "However, this study supports previous studies that alcohol is bad for women who are pregnant." He added that this study is also "highly suggestive of the father's effect on fetal outcomes."

However, Pass was hesitant about changing current medical practices. He said meta-analyses "can sometimes be very helpful, but there are many limitations. Sometimes the data is not 100% accurate."

Pass believes that more research is needed, especially surrounding a father's health.

Qin agreed that we need to know more. For example, he thinks we should explore how alcohol use increases heart disease in children. He also acknowledged the limitations associated with a meta-analysis and hopes that future studies will be designed differently in order to further support the results of his research.

Alcohol isn't the only thing that negatively impacts a father's impact on his child's health.

"We know that advanced paternal age is associated with a number of different risks for fetuses," Pass said.

Dr. Deidre Downs Gunn, a reproductive endocrinologist and infertility specialist and medical director of the IVF program at the University of Alabama-Birmingham Medical Center said: "In addition to alcohol use, there are a number of factors that can impact sperm quality and reproductive health in men. Smoking, marijuana use, obesity or poor nutrition, certain medications, and especially testosterone use- all of these can affect a man's ability to have children."

Overall, this study illustrates the importance of preconception counseling for mothers and fathers.

"This study is an example of why we need to have a conversation about men's preconception health, not just women's, to improve the chance of a healthy pregnancy and baby," Gunn said.

Copyright © 2019, ABC Radio. All rights reserved.

Salmonella outbreak linked to pet turtles in 13 states: CDC

iStock(NEW YORK) -- A salmonella outbreak in 13 states has been linked to pet turtles, according to the Centers for Disease Control and Prevention (CDC).

Twenty-one people have been infected with the strain of Salmonella Oranienburg, the CDC announced Wednesday. Seven of those cases required hospitalization, but no deaths have been reported.

The CDC linked the outbreak to pet turtles after 12 of the 17 people who fell ill reported contact with the reptiles, according to the CDC.

Even when appearing healthy and clean, turtles can carry salmonella germs in their droppings, which can easily spread to their bodies, tank water and habitats, according to the CDC. People can then get sick after touching a turtle or anything in their habitats.

California had the most reported cases at six, according to the CDC. Other states where multiple cases were reported were Illinois, New York and Washington.

The CDC recommended that those who own or come in contact with pet turtles to always wash their hands thoroughly with soap and water after handling a turtle or cleaning its habitat. The CDC also advised against kissing or snuggling turtles and letting turtles roam freely where food is prepared or stored, such as kitchens.

In addition, avoid cleaning a turtle's habitats, toys or pet supplies in the kitchen or any other location where food is prepared or stored -- clean it outside the house when possible, health officials advised.

Symptoms of a salmonella infection include diarrhea, fever, and stomach cramps 12 to 72 hours after being exposed to the bacteria. The illness usually lasts four to seven days, and most people recover without needing treatment, according to the CDC.

Children younger than 5 years old and adults 65 and older, as well as those with weakened immune systems, are more likely to experience severe cases of the infection.

Households with members at risk for serious illness should consider a different pet, according to the CDC.

The health agency is continuing to investigate the outbreak.

Copyright © 2019, ABC Radio. All rights reserved.

Nurse alleges colleagues misused Benadryl to put patients to sleep: Lawsuit

(WEST ORANGE, N.J.) -- A nurse in New Jersey is suing a hospital, claiming that she was taken off the schedule and eventually pushed out of her job on an adult psychiatry unit after she reported to higher-ups that some night-shift nurses were allegedly giving Benadryl to patients to make them sleep and not reporting their actions.

Patricia Moran, a registered nurse for more than 30 years at RWJ Barnabas Health, which owns Monmouth Medical Center, was hired in 1988 and worked on the adult involuntary psychiatric unit at the center.

In March 2019, her civil lawsuit claims, Moran suspected that some overnight nurses were allegedly using Benadryl to make patients drowsy or put them to sleep.

Benadryl, which has a generic name of diphenhydramine, is used to treat allergy symptoms, such as runny noses, sneezing, itchy throats and itchy and watery eyes. Common side effects include sleepiness, fatigue and headaches. Benadryl also markets itself as a sleep aid.

Moran's complaint, which was filed in Monmouth County Superior Court on Wednesday, said that "on hospital adult units, Benadryl is almost exclusively prescribed to address side effects from psychotropic medication ... such as restlessness, muscle cramping and involuntary muscle contractions."

However, Moran's complaint said that she believed the medication was allegedly being administered by staff to lighten the workload for the night-shift nurses.

According to her complaint, she learned of the alleged misuse because the machine that dispensed and tracked medications given at the hospital, was not generating reports when Benadryl was being given to the patients.

"This confirmed that nurses were not providing accurate information regarding the use of Benadryl," the complaint alleges.

Dr. Saumya Bhutani, a resident physician in psychiatry in New York who looked at Moran's complaint, per ABC News' request, said that in adult inpatient psychiatric units, however, that Benadryl is used and ordered by physicians not only for side effects of psychiatric medications but also for insomnia and agitation.

"The complaint as it stands is still vague without more information from Moran. Each Pyxis and electronic health record is uniquely different so it's hard to understand where she saw that Benadryl was being given and where she saw that it wasn't," Bhutani said Thursday. "Without hearing from the nurses, doctors and patients, it's difficult to determine the extent of the misuse. Was the Benadryl ordered for other indications beyond side effects? What were the conversations and interactions between the nurses and patients when the Benadryl was given? What was going on with the patients? Were the day nurses and doctors made aware of what was going on?"

ABC News was not able to reach Moran for comment on her lawsuit.

In a statement to ABC News on Thursday, the medical center said, "Monmouth Medical Center is fully committed to providing a safe environment for our patients, visitors and staff. Per our policy, we are unable to comment on any individual employee or patient matter."

In her complaint, Moran said that she took her allegations to the hospital's administrative director of psychiatry, who then went to her direct manager. Moran claims in court documents that her direct supervisor then "retaliated" against her.

"[Moran] was denied time on the schedule, she was provided a bogus evaluation, she was subjected to increased scrutiny, and she was otherwise ostracized from her co-workers," court papers said.

In March 2019, Moran sent the supervisor a letter, saying, "I find it surprising that I have not been asked about availability, and have no time at all scheduled, although I see other per diems do have time scheduled. I am available any evening 7-11 shift. Pat,” according to the suit.

When she heard nothing back from the supervisor, Moran claimed, she went back to the administrative director of psychiatry to report that she believed she was being "subjected to retaliation as a result of reporting the misuse of medication" and also that her supervisor was "deliberately and maliciously" creating a hostile work environment in hopes that she would either resign or get terminated.

Moran also said that after working with adults for more than 30 years, she was abruptly moved to a pediatric floor. She claims that when she asked for help with an assignment on the pediatric unit, she was given another assignment but also reported to human resources for "refusing" the initial task. She said in court papers that she did not refuse the first assignment.

"[Moran] was further advised that her conduct was a 'terminable offense' and that she was not allowed to work until ... the matter was investigated by HR. [She] was placed on unpaid leave and remains on unpaid leave as of the filing of the complaint (i.e., from July 2019 through October 2019)," court papers said.

Moran said that she met with human resources in September 2019 and was issued a final warning "with no prior verbal or written warning" despite RWJ's disciplinary process.

"Even though [Moran] had not received any discipline whatsoever in more than 31 years with the hospital, [she] suddenly found herself under investigation and slated for potential termination," the complaint said.

Moran said that although she was cleared to return to work on Oct. 7 -- after human resources had completed its investigation -- her supervisor still "refused" to schedule her for any shifts and claimed that "there was 'not a need' for her services." As of October, she'd been out of work for at least 14 weeks, the complaint said.

Moran is demanding a trial by jury, according to her complaint, which also includes RWJ Barnabas Health, her supervisor and a human resources director as defendants.

"As alleged in the complaint, the hospital turned its back on Ms. Moran and immediately retaliated in an egregious fashion, all because she exposed illicit conduct and sought to uphold the highest standard of care for patients. No employee deserves to be treated in such a manner, let alone someone who has dedicated more than 31 years at this particular hospital," said Matthew A. Luber, of McOmber & McOmber, who is representing Moran, in a statement to ABC News Thursday. "Ms. Moran looks forward to her day in court."

Copyright © 2019, ABC Radio. All rights reserved.

People in rural areas face long drives for opioid addiction treatments


(NEW YORK) -- As the U.S. grapples with the opioid epidemic -- 47,600 overdose deaths in 2017 alone, according to the Centers for Disease Control and Prevention -- access to treatments for addiction has perhaps never been so important. But for many in rural areas, those treatments are still hard to come by.

A new study by Yale University, published in the Journal of the American Medical Association, found that drive times to methadone clinics in rural counties is, on average, almost 50 minutes each way.

Dr. Kip Corrington, a physician at Novant Health Northwest Family Medicine in North Carolina, has prescribed methadone, one of the most established treatments for opioid addiction.

"As a society, we need to work on getting rid of the stigma," he said. "There is a misunderstanding that it's trading one substance for another, but, in reality, it saves lives. Some of the difficulties people in rural areas face are cost and access. You're in a difficult financial situation. I've had patients travel anywhere from 40 to 80 miles one way."

Many of these same rural counties have access to primary care health clinics within a 20-minute drive. This raises the question: Should we integrate methadone prescriptions into primary care clinics to better fight the opioid epidemic?

"Methadone is the most studied medication for opioid use disorder, but you have patients who need it tell you, 'Doc, it takes me forever to get to the office,'" said Dr. Paul Joudrey, lead author of the study and Instructor in the Department of Internal Medicine at Yale School of Medicine.

Joudrey added that he hopes this research helps "expand geographic access" to treatment.

The study, which examined counties in five states hardest hit by overdose deaths, determined that where some in urban areas could get treatment in eight minutes, in rural counties that averaged 49 minutes.

But to Joudrey, who specializes in addiction medicine, this is not the crux of the study.

"This is not a story about how urban areas have better access to methadone," he said. "This is really about solving geographic disparities in access to methadone -- using existing primary care clinics in rural counties."

In the rural counties where methadone clinics were about 49 minutes away, primary care facilities were just 17 minutes away.

Primary care clinics in underserved areas that receive federal funding must adhere to specific requirements. So, too, must clinics that dispense methadone, which must be prescribed from U.S. Substance Abuse and Mental Health Services Administration-certified opioid treatment programs.

As explained on the SAMHSA website, creating an opioid treatment program involves a certification and accreditation process at both the federal and state level. Once an opioid treatment program exists, certification must be renewed every three years. And local zoning guidelines also play a role in where methadone clinics are established.

Joudrey described these requirements as "burdensome restrictions." In other countries, including Canada and Australia, primary care clinics can be certified to dispense methadone.

"Laws need to be passed to support and incentivize the federally qualified health centers into being capable of dispensing methadone," he added.

In addition to overcoming regulatory hurdles, methadone clinics still face opposition from potential neighbors.

"There is still a public stigma toward methadone clinics," Joudrey said.

Some of those opposed to integrating methadone into primary care clinics have expressed concern over patients possibly overdosing on methadone, noting how prescriptions of buprenorphine, another treatment for opioid use disorder, already are available and with fewer restrictions.

"I don't know if DEA or regulatory agencies will allow methadone in primary care clinics," Corrington said. "Buprenorphine is a simpler and safer solution that is just as effective."

Joudrey said, "Buprenorphine is good but does not work for everyone, especially those with more severe opioid use disorder."

"Methadone overdose is possible," Joudrey added, "but overdosing on heroin and fentanyl is much more dangerous. Data has shown in other countries that methadone can be prescribed safely this way without risk of overdose."

Joudrey is passionate about making methadone more accessible. He described how in most clinics, people have to visit six days a week for the first eight weeks to obtain their methadone. After demonstrating that responsibility, people do not have to go as often, but at least once a week. Frequencies vary by state.

"When we want people to recover, we want them to have jobs and live full lives," Joudrey said. "To have to drive far for methadone while trying to get the rest of your life together is really hard."

Dr. Saumya Bhutani is a resident in psychiatry in New York working with the ABC News Medical Unit.

Copyright © 2019, ABC Radio. All rights reserved.

Sophie Turner blasts diet culture and detox teas ads

petrunjela/iStock(NEW YORK) -- Influencers who stand by their detox product compelled Sophie Turner to speak out, and she spilled the proverbial tea on the weight-loss industry.

Detox teas are somewhat of a hot-button issue with celebrities hawking them to fans. Consequently, actors like Jameela Jamil are rallying to have these products banned, claiming they are unsafe and promote body-shaming.

The Game of Thrones alum took a stand against detox teas earlier this week by mocking influencers on her Instagram story.

"Hey you guys, just kind of going for my influencer look today," Turner said Tuesday in a high-pitched American accent, "Today I just wanted to promote this new powdered stuff that you put in your tea."

Her message quickly gets dark as she continues, talking about how it makes you sick and is "totally, really, really bad for me to be promoting to young women and young people everywhere, but I don't really give a f--- 'cause I'm getting paid money for it."

One of Turner's fans reposted the video to Twitter.

This isn't the first time the Dark Phoenix star criticized the diet industry.

In a May interview with Marie Claire Australia, the actress opened up about her personal struggles with her body image. She claimed to have been pressured to lose weight and, instead, turned to therapy to cope with her feelings of inadequacy.

"Everyone needs a therapist," she advocated during the interview, "especially when people are constantly telling you you're not good enough and you don't look good enough. I think it's necessary to have someone to talk to, and to help you through that."

Copyright © 2019, ABC Audio. All rights reserved.

How life changes like childbirth, menstruation affect women's mental health

MangoStar_Studio/iStock(NEW YORK) -- Women know the drill: They start menstruating as teenagers, or earlier, and have the ability to become pregnant, and then as they age they lose both their period and childbearing abilities through menopause.

These life changes unique to women are one reason why there is a gender gap when it comes to depression, experts said.

About one in 10 U.S. women experience depression. Women are also almost twice as likely as men to have symptoms of depression, according to data shared by the U.S. Office on Women's Health.

Rates of depression between boys and girls stay roughly the same until puberty, at which point females show higher rates of symptoms that lead to depression, according to Dr. Cynthia Elise Rogers, director of perinatal behavior health service at Washington University in St. Louis.

The exact role hormones play in women's mental health is still an area of active research, Rogers pointed out. That research is centered on the role environmental stressors play on a woman's mental health.

Some of the stress unique to women is a symptom of just being a woman in today's world, according to Jeff Temple, a professor and psychologist in the department of obstetrics and gynecology at the University of Texas Medical Branch.

"Women are more likely to experience negative events like sexual assaults, are more likely at home to be victims of gender-based violence, are more likely to be caregivers, and at work they're paid less and expected to do more, all while experiencing things like sexual harassment at higher rates," he said. "I think if men had to experience the stress that women have to experience, we would definitely have higher rates of depression."

On World Mental Health Day, Oct. 10, here are five things every woman should know about her mental health:

1. How hormones can affect mental health

One theory long held by researchers is that fluctuations in female hormones may make women more vulnerable to depression.

The hormones that may affect women's health are estrogen, progesterone -- made in the body after ovulation and during pregnancy -- and weaker androgen, or male-type hormones like testosterone, according to Shruthi Mahalingaiah, an assistant professor of environmental reproductive and women's health at Harvard University.

In one example, studies have shown that during an estrogen decline in a woman's body, like after childbirth or ovulation, the metabolism of neurotransmitters in the brain speeds up, which can cause mood swings, Mahalingaiah said.

"There is individuality in this, so each women is different in how they experience their hormone fluctuations," she said. "Some might experience [mood swings] and seek help, others may experience and suffer it alone or some may have much more mild experiences."

2. How stress affects mental health

Temple also noted that women experience more environmental stress than men -- lower pay and sexual harassment among them -- in addition to the stress placed naturally on their bodies by their monthly cycles.

"We are all born with a certain amount of an ability to cope with stress, and the more stress we experience, the harder it is for our bodies to cope," he said. "So when women have these everyday stressors compounded with big life events, it wears away their body's ability to cope."

Women tend to manifest stress inward, which can lead to depression, Temple said.

He added that women are often formally diagnosed with depression more often than men, even when they present the same symptoms.

"We often put the onus on women, and I really think that we need some societal change too," he said. "As health care providers, we can do a better job of recognizing and treating the mental health consequences of things like sexual abuse and gender-based violence and the stressors that women experience more than men."

3. Depression as a medical condition

Depression can be caused by physiological processes in the body, which is way a psychologist like Temple is embedded in a medical unit and why an OBGYN like Stanley is trained to deliver mental health care.

"One thing I'm always telling my patients is that there is a stigma against mood disorders and depression but they are medical conditions," Stanley said. "Just like you would treat cancer, we need to treat depression, and just like with an untreated medical condition, you can also have a very bad medical outcome from untreated depression."

4. Perinatal depression is not a 'character flaw'

One of the most common times of depression for women comes around childbirth.

Perinatal depression is an umbrella term for depression experienced by women during pregnancy and up to a year after delivery. Postpartum depression occurs after having a baby and goes beyond the "baby blues" symptoms that typically last a few days.

About one in nine women in the U.S. experience symptoms of postpartum depression, according to the Centers for Disease Control and Prevention, but studies show that half of all women in the U.S. remain undiagnosed and untreated.

"It is important for us to continue to educate women that depression is a complication of pregnancy, one of the most common complications," Rogers said. "It is not a character flaw but representative of a brain dysfunction, and there are many ways to receive treatment."

Postpartum depression can be triggered by both biological and environmental factors, starting with the new mom's levels of hormones -- estrogen and progesterone -- quickly dropping when she gives birth, which can lead to chemical changes in her brain.

New moms are also often sleep deprived, which can lead to changes in mood, and they face the societal pressure of being a mom.

"The expectation is moms are supposed to want to have kids and love their kids every second of the day," Temple said. "Often the best moment I have with a patient with postpartum depression is telling her that my two favorite times of the day are when I see my kids and when I leave my kids."

"It's important to normalize those feelings and make them OK," he said.

5. Red flags to spot

During life transitions, women should be particularly attuned to signs of depression, experts agree.

In addition to changes like childbirth and menopause, other changes such as the death of a spouse or the marriage of a child also tend to hit women harder than men.

The Centers for Disease Control and Prevention outlined symptoms of depression to look for: unexplained tears, having no will to get out of bed, not enjoying things you know you should or used to, significant changes in sleep habits or appetite, and increased fatigue. Depression can interfere with daily life and may last for weeks or months at a time, according to the CDC.

"All of those are things women may just blow off, but they are signs of depression," Stanley said. "Don't be afraid to talk to your provider."

Copyright © 2019, ABC Audio. All rights reserved.

Children's hospital creates custom glasses system for child with ear deformity

Gillette Childrens Specialty Healthcare(ST. PAUL, Minn.) -- A Minnesota boy who received custom made glasses with a specialty strap system to fit his disabilities can now see with ease.

Eight-year-old Bentley Erikson was born with a birth defect called microtia, which prohibits the ear from fully forming properly, and his mom told ABC News affiliate KSET-TV that along with other complex medical conditions and vision problems, her son struggled to find glasses that stayed on his head.

"I did what all moms do, I thought I could fix this, and I bought $250 worth of crafting supplies and tried to 'mom engineer' something," Kris Erikson said.

So Erikson turned to Gillette Children's Specialty Healthcare in St. Paul that specializes in designing and building orthotic and prosthetic devices in a wide range of sizes for children.

Gillette crafted an orthotics piece that fit seamlessly around Bentley's shunt and hearing aid that could sit comfortably over his head.

"They dream it up," Erikson said.

"Although we see many patients with similar diagnoses such as cerebral palsy, each product we deliver is customized to the needs of each individual patient," Bradley Fisher, manager of the OPS department for Gillette Children's Specialty Healthcare, told ABC News. "It’s great to help a kid like Bentley achieve something as simple as wearing glasses, an ability many of us take for granted.”

Gillette's Orthotics, Prosthetics and Seating Department has 18 locations throughout Minnesota and books 2,500 appointments a month.

Fisher added that Gillette Children's "believe in patient centered care" and do their best "to find creative solutions" for each unique patient.

Copyright © 2019, ABC Audio. All rights reserved.

Owning a dog could provide long-term health benefits, study says

alexei_tm/iStock(UPPSALA, Sweden) -- A dog is known as "man's best friend," but owning a dog may literally save your life, according to new research from Uppsala University.

"There is a lot of anecdotal evidence that people feel increased well-being with their dog; we wanted to investigate this," said Dr. Tove Fall, one of the authors of the study and professor of molecular epidemiology at Sweden's Uppsala University.

The study set out to determine whether dog ownership affected survival rates after a heart attack or stroke. Data was collected over an 11-year period and examined dog owners versus non-dog owners and their overall cardiac health outcomes.

Heart attack survivors in the study who were living alone, but owned a dog, had a 33 percent lower risk of death, while stroke survivors who lived alone and had a dog had a 27 percent reduced risk of death, compared to people who did not own a dog and lived in a single household group.

"We found the dog owners had lower mortality than non-owners with the largest difference seen in the subgroup of people that lived in a single household," Fall said. "This group is especially vulnerable. It seems that dogs can alleviate the impact of living alone; they can increase social interaction."

Dr. Eugenia Gianos, system director of cardiovascular prevention at Northwell Health, added, "It is very likely that people who own pets have many other positive behaviors, including exercise, healthy eating and social connectivity, which are likely to be leading to better outcomes in health. However, it is also positive that emotional connection to a pet can have positive effects on various parameters that could improve outcomes for people."

The significant results were seen in people who live alone.

"Whether being single or married, it is about having positive social interaction that is associated with better health outcomes," Gianos said. "It could be that in a marriage, if you have challenges then you could have more stress that is related to high blood pressure and worse outcomes. With being single, it could be that the pet is providing companionship and preventing loneliness that is leading to improved benefit."

The study even compared several dog breeds to see if there were different cardiac outcomes.

"We found that many of the larger breeds and smaller breeds that are active such as terriers have better outcomes – survival outcomes," Fall said. "Those that did not show as much are the companion toy group and mixed breeds. The physical activity might be less."

However, she cautioned, "It is also a personal choice; you might choose a dog that fits your lifestyle. Part of the association might be seen by people who are more active getting a more active dog and have better cardiac outcomes."

"Dogs might be beneficial for human health, however, we do not know if unmeasured factors affect the results. In the national register, they do not measure behavior such as smoking or food intake. In this study we cannot account for smoking. The factor of smoking might play into this relationship when the cause was something else," Fall added.

Gianos agreed, saying, "Those two behaviors happen to be most linked with heart disease in research, which are extremely important to control. We would want to make sure that those two factors were not contributing to the improved outcomes that we are seeing."

Regardless of these shortcomings, the author maintained dogs are "a fantastic motivator."

Copyright © 2019, ABC Audio. All rights reserved.

CDC warns that more pregnant women should get the flu shot: What to know

Jovanmandic/iStock(ATLANTA) -- Not enough pregnant women are getting the flu vaccine and it's putting themselves, their babies and the public at risk, according to a new report from the Centers for Disease Control and Prevention (CDC).

Pregnant women have more than double the risk of hospitalization compared to non-pregnant women of childbearing age if they get influenza, but getting a flu shot reduces a pregnant woman's risk of being hospitalized due to influenza by an average of 40 percent, according to data shared by the CDC.

In addition to the flu vaccine helping pregnant women, it can also help their babies because the vaccine passes on antibodies to the fetus that provide protection after birth, when babies are too young to be vaccinated themselves, according to the CDC.

"It is the best way for that woman to protect not just herself, but her unborn baby because that baby cannot get vaccinated for six months," ABC News chief medical correspondent Dr. Jennifer Ashton said Wednesday on Good Morning America. "So she will be able to protect her baby by passing those antibodies while she’s pregnant."

Children under 5 years old have the highest likelihood of being hospitalized for the flu. A total of 186 pediatric deaths were reported to CDC during the 2017-2018 flu season, the most recent available data.

Flu rates typically peak in the U.S. between December and February. People who are at most risk for flu complications include children, pregnant women, people over 65, those with chronic medical conditions and nursing home residents, according to Dr. Naomi Kaplan, a resident physician in physical medicine and rehabilitation and a member of the ABC News Medical Unit.

With the 2018-2019 flu season already well underway, here are four things pregnant women need to know about the vaccine.

1. Vaccination during pregnancy is safe: “Vaccination during pregnancy is safe and we have a lot of reassuring data to back that up,” Dr. Christopher Zahn, vice president of practice activities for the American College of Obstetrics and Gynecology (ACOG), told GMA in a statement.

2. Flu vaccines are safe during any trimester: The CDC recommends that all pregnant women should get a flu vaccine during any trimester of each pregnancy.

3. Pregnant women need the whooping cough vaccine too: The CDC recommends that all pregnant women get the whooping cough vaccine (Tdap) during the early part of the third trimester of each pregnancy as part of routine prenatal care.

4. Flu vaccines are available outside the doctor's office: The flu shot is available in both doctors' offices and in drug stores. Women whose health care providers offered or referred them for vaccination had the highest vaccination rates, according to the CDC.

Copyright © 2019, ABC Audio. All rights reserved.

Next chapter in ‘Screenagers’ documentary tackles depression in teens due to social media

monkeybusinessimages/iStock(SEATTLE) -- The 2016 documentary Screenagers hit a nerve.

More than 4 million people trekked to schools and community centers to watch a screening of the documentary that chronicled the rise of kids’ addictive behavior with digital devices.

The maker of the film, Dr. Delaney Ruston, thought she had this issue under control in her family, but her teen daughter’s battle with depression forced her to look harder at screens and other forces in modern childhood that are factoring into troubling mental health issues.

Now she’s made a second film on that related topic, called Screenagers: The Next Chapter.

The documentary premiered at Eckstein Middle School in Seattle Tuesday night in front of more than 500 concerned parents and educators. It starts a run of showings this week in community screenings nationwide highlighting the rise of teen anxiety and depression.

Parents in Seattle seemed perplexed about how to help their children look away from devices and towards other people as a way to combat isolation and social anxiety.

One mother told ABC News, “It’s a normal part of being a middle-schooler, they talk about panic attacks and being anxious.”

Another father who was also worried said of technology, “Their faces are always in front of that stuff, and it’s informing how they view themselves and what is normal and around them.”

With headlines of the teen suicide rate doubling since 1999, and sky-rocketing anxiety and depression rates, parents are concerned.

The film does not tackle the issue of what’s causing this crisis, but it does look at the many forms of mental health challenges that face families, such as anxiety, stress and unresolved trauma.

The central story of the film, however, focuses on Ruston’s 16 year-old daughter Tessa, who suddenly dipped into depression.

While Ruston did see the signs of depression, she says even as a practicing physician, she didn’t know what to do.

“I had no idea when to step in, what to say, and often it felt like anything I said made it worse,” she said. “It felt like I was just tiptoeing. If I say the wrong thing, it’ll make her never talk to me again. It’s emotional just thinking about it, just how stuck I was.”

Meanwhile, Tessa found little comfort in social media, the medium for much of her communication with friends. She posted what she thought was a raw assessment of her deep sadness, but it didn’t evoke the response she needed and wanted from her friends.

She said, “I said this year has been really hard and I’ve learned a lot and I’ve grown a lot, (but) I felt like the response wasn’t acknowledging the truth that I was really trying to put out there … crickets was almost how it felt to me. I tried so hard to say look I'm not perfect at all and they're like, 'Oh, we love you, we're here for you, and it almost hurt to feel not understood in that sense."

And when Ruston realized how serious her daughter's depression was, this isolation scared her. “I was amazed how many months into her depression she was, and I assumed she was talking to a friend or something, and she said, ‘No, I haven't told anyone.’”

At that point, Ruston realized she and her husband, along with mental help professionals, would need to be there to talk to Tessa, but that talking and support needed some work. Ruston says, “I needed to learn how to be comfortable with my feelings, but not over-respond. [I needed to] let her know that I could handle it.”

Through trial and error, Tessa's parents found some ways to communicate that can work for all parents and teens.

Tessa says, “Some of the things my parents said that really helped in the moments of hardship were you’re doing the best you can for where you’re at and what tools you have, especially when I felt really low and incapable. My favorite quote that my dad said that actually really got me through the hard times that felt like forever is ‘this too shall pass.’”

She added that a huge barrier to talking with her parents was guilt and shame, that it was her fault that she felt so depressed. But something Ruston said really helped. “My mom especially reiterated that I wouldn’t be feeling this way if I had the choice.”

The documentary offers specific advice for parents who feel stonewalled from teens who won’t talk. Here are some of them:

Validate their feelings, accept that they truly do feel the way they say, that it’s not just teen drama. Ruston adds, “the most important words you may say are ‘that sounds really hard.”

Take advantage of the moments when teens do want to talk. These sometimes rare occasions are opportunities to prove you won’t judge them or scold them.

When you don’t know what to say, ask more questions. Noted therapist John Gottman, who is featured in the documentary, offers some prompts like, “What did your friends say? Were you mad? What do you want to do now?”

Avoid offering fixes or solutions. Tessa said, “All the problem solving, solutions, and enforcements feel so judgmental and stabbing because sometimes I don't even think it’s a problem I just want to share it and the problem solving itself makes it into a negative thing, right away it’s like ‘this is wrong and you need to make it right.’”

Praise kids with specifics -- hold a mirror up to them so they can’t refute what you say and just like we do with toddlers, catch them doing something right, and then praise the work.

Don’t give up on finding ways to limit screen time -- even if you think that ship has sailed. Sleep and limiting exposure to social media can help kids find their resilience.

Learn how to tolerate a teen’s explosive reaction over screen limits -- you are giving them the gift of boundaries that adults even struggle with.

Screenagers: The Next Chapter will be screened in schools and community settings across the country. For information on how to have it seen in your town, go to their site here.

Copyright © 2019, ABC Audio. All rights reserved.

Teen role-plays as the perfect boyfriend in ASMR videos to help people fall asleep

Owen Riley(NEW YORK) -- Having trouble sleeping?

Well, maybe an ASMR video from Owen Dennis Riley can help.

But these aren’t just your regular ASMR videos that you find on YouTube. Riley, better known as DennisASMR on YouTube, produces soothing ASMR videos to help people fall asleep while role-playing as the perfect boyfriend.

In a story first reported by the New York Times, Riley's videos are part of a growing trend of autonomous sensory meridian response, or ASMR, videos online, where certain audio-visuals like people speaking softly or someone eating closely to a microphone can cause some people to experience a tingling, static-like sensation on the skin.

Now, a new category of ASMR videos called “ASMR Boyfriend Role-Play,” where individuals pretend to be someone’s boyfriend, are becoming popular videos online and are supposed to be relaxing or sleep-inducing. Riley’s videos are an example of the trend.

“A lot of people find it difficult to go to sleep sometimes and so my videos kind of work as a sound machine for the people who struggle with sleeping,” he told ABC News' Good Morning America.

In past videos produced in his makeshift studio under his bunk bed, the 17-year-old has sung in whispers to his over half a million subscribers, spoken soft sweet nothings to help people fall asleep and has even role-played as different characters, such as Harry Potter and Spider-Man.

Even though Riley has thousands of views in dozens of his videos, does his method work?

Some experts are warning that this type of role-playing can be problematic.

Even though Riley does have that ASMR-sensory-aspect to his videos, Dr. Caroline Fleck, a clinical psychologist and an adjunct instructor at the Stanford University School of Medicine said that some of his content could be “distracting” and “could potentially counter balance” what ASMR is supposed to be for.

Dr. Caroline Fleck said, “There is no data to suggest that what he’s doing is effective in any way and/or conductive to sleep.”

In one video, some may argue that the teen goes too far, with his role-playing coming off as too intense as he pretends to be a jealous boyfriend.

“He’s perpetuating this message that you need someone to take care of you in order to self-soothe, and that’s not accurate,” said Fleck. “In fact, it’s very problematic, especially if you’re reaching a younger audience who maybe doesn’t have expectations for a relationship or hasn’t had them, the idea that a relationship is defined as somebody stepping in and soothing you and taking care of you.”

Despite what some experts think, Riley argues that he’s not trying to be unrealistic in his role-play.

“My videos aren’t saying that every relationship is perfect and I’m not trying to be unrealistic with it,” Riley said. “I’m just trying to take the positive elements from that and put it up there because nobody wants to see a video arguing role-play with your boyfriend, that would be terrible.”

Riley’s mother, Kathy Riley, who keeps a close eye with everything that her son produces online, is aware of what kind of messages can be perceived in videos like his.

She said, “We always want him to have integrity with what he does, we always want him to not make his fans feel uncomfortable.”

While Riley may have his skeptics, he certainly has his fans.

His mother, who goes through comments from his YouTube audience, is positive about people who turn to her son for help falling asleep, “I go through the comments but for the most part they seem to be a great community.”

Owen said, “It just seems to me like a lot of fun and if it’s helping people, I think people should not look so deeply and enjoy it for what it is.”

Copyright © 2019, ABC Audio. All rights reserved.

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