Nobody came for Prince: The death of The Artist and the criminalization of addiction

HuffPo

This op-ed originally appeared on The Huffington Post on June 6, 2016.

Last Thursday the Midwest Medical Examiner’s Office released the report that declared “accidental opioid overdose” as the cause of Prince’s death. The first rumor I heard along those lines – hours or days after his death – I felt that plunging sensation in my chest. That “Please make it not be true” that the heart knows how to scream. I wished for Prince that it could’ve been almost anything but that. Even the conspiracy theorists who cried “murder by the Illuminati” sounded to me like they had dreamed up a better end for him than accidental opioid overdose. Presumably, murder would have put a swifter end to his suffering. Opioid addiction owns you, holds you as its powerless prisoner, for years before it finally lets you go.

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Growing a family tree

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This article received a 2015 Award for Excellence in Health Care Journalism from the Association of Health Care Journalists and honorable mention in the 2016 Folio Eddie Awards.

Sonny Varela comes from a Hispanic neighborhood in East Bakersfield, California. The only son of a single mother of mixed Native American and Hispanic heritage, Varela says his numerous first cousins were the brothers and sisters he never had.

Compared to him, Varela’s cousins were short with dark skin. In that part of town, that’s what his friends and classmates looked like, too. Nothing like him. Light-skinned and taller than his relatives, Varela eventually grew a thick, dark beard that reaches down his neck.

“I always thought I looked just like everybody else until I looked in the mirror,” Varela says.

He didn’t look much like his mother or the Hispanic man named as his father on his birth certificate. His so-called father, whom Varela saw infrequently, was short, dark-skinned, and not very hairy. So, Varela wasn’t surprised when he was 12 years old and his mother told him the man wasn’t his father. But she wouldn’t tell him much more.

“I’d say, ‘Just tell me something, anything, about my father,’ and she’d shut down.” All he learned was that his father was a Jewish doctor from Los Angeles with whom she’d had a one-time encounter. At 18 years old, an optimistic Varela showed up at human resources at UCLA Medical Center and asked about doctors who might fit the bill.

“How many Jewish doctors could there be in L.A.?” he wondered.

Almost 20 years later, direct-to-consumer (DTC) DNA tests and social media proved to be just the right tools for a guy who believed he could find a needle in a haystack. Varela, now 36 years old, is among a growing number of people of both known and unknown biological parentage, who are combining these tools to get the information they crave. Genetic testing can tell users what percentage of their DNA matches that of people from all over the world. It can provide information about disease risk — a boon for those who know nothing about family medical history. Testing companies also connect users with any relatives, close or distant, who happen to be in their database. Savvy users might pair this information with social media to find family they never knew. Continue reading

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When cancer runs in the family

Screen Shot 2016-03-30 at 7.44.40 AMGenetic testing can provide powerful insight into the risk for hereditary breast and ovarian cancer.

After Lucy Benton completed her breast cancer treatment 16 years ago, she thought she was done with cancer. Then last year, the 68-year-old Texas woman learned she had cancer again. This time it was in her ovaries, not her breast. Because these were two distinct cancers — rather than a recurrence of the same one — Benton’s oncologist recommended genetic testing.

“She said it could determine my current or future treatments. So I decided right away that I was going to do it,” Benton says. She tested positive for a mutation in the BRCA2 gene. Having the mutation increases a woman’s chance of developing breast cancer from 12 percent, which is the average risk any woman has, to about 45 percent. It increases ovarian cancer risk from less than 2 percent to as much as approximately 17 percent.

Having both breast and ovarian cancer, as Benton did, can be a sign of hereditary breast and ovarian cancer (HBOC) syndrome. HBOC syndrome is a genetic risk for breast, ovarian, and other gene mutations that are passed down from one generation to the next. Genetic testing can reveal whether women, as well as men, carry a gene mutation that increases the risk for these cancers. Knowledge of a gene mutation can help individuals and families optimize cancer prevention and treatment.

Researchers believe that about 5 to 10 percent of breast cancers are hereditary. This means the increased risk for cancer is a result of a flaw in a gene, also known as a mutation, inherited from a parent. If a parent has a gene mutation, each child has a 50 percent chance of inheriting it. Several known mutations can increase risk for breast cancer. Mutations in the BRCA1 and BRCA2 genes are currently the most common cause of HBOC. A number of other less common mutations, such as those found in the ATM, PALB2, and CHEK2 genes, among others, can also increase risk for breast and other cancers. Continue reading

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A place for e-cigarettes in smoking cessation

Screen Shot 2016-03-30 at 7.39.05 AMIn the field of tobacco control, Michael B. Siegel, M.D. ’90, is a lone wolf. The Boston University public health professor stands at odds with most of his public health colleagues on one matter: e-cigarettes.

“Why so many public health groups are trying to block them is beyond me,” said Siegel. “Cigarettes are highly toxic and kill 400,000 people a year, while e-cigarettes are not particularly harmful and they’re helping many people quit.”

During his medical internship at Berkshire Medical Center in Pittsfield, Mass., Siegel saw that most people are admitted to the hospital for preventable reasons: smoking, alcohol, drugs, poor diet, and lack of exercise. “We can counsel every patient who walks in the door about smoking,” he said, “but wouldn’t it be more effective to have mass public health campaigns that reduce smoking? You’ll have a much larger impact on the public’s health.” Continue reading

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More than skin deep

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Geneticists view “race” in a far more complex way than the average census taker.

For centuries, authors, researchers, and politicians have tried to use science to classify the “races.” Their attempts have resulted in divisive books, theories such as eugenics, and even genocide. One such book, Nicholas Wade’s 2014 tome A Troublesome Inheritance, inspired over 140 experts in population genetics and human evolution to speak out against it.

Wade, a journalist, used the work of leading geneticists to hypothesize that behavior and IQ, like some physical differences, vary by race as a result of natural selection. The 143 scientists signed a letter condemning the book and said their research did not support his claims that genetics, rather than culture, explains differences in global economies, political structures, and social norms.

Geneticists’ rejection of Wade’s book begs the question: How then did the races come to be? One challenge in addressing that question has to do with the term “race.” Genetically, “races” don’t fall into distinct categories or groups like those on a census survey. Geneticists recognize far more genetic variation among humans than we consciously recognize in the physical differences we see on the street. This diversity tells the story of migration, natural selection, and random chance.

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Holding pattern: Helicopter parenting in higher ed

 

Screen Shot 2016-03-29 at 10.27.04 PMWhen I was a kid, my mom would send me out to play after breakfast and I wouldn’t come home until dinner.

Scores of older Americans describe their childhoods this way. Kids today know little of this freedom to wander during unstructured Saturdays. Between organized play dates and soccer games coached by mom or dad, today’s kids grow up with a lot more parental supervision than their parents did.

One particular brand of supervision — where mom or dad is always hovering just a few feet away even after their children have grown — has become something of a cultural phenomenon. Last year alone, helicopter parents and their adult children were the subject of stories in Forbes, Time, U.S. News & World Report, Los Angeles Times, Washington Post, New York Times, New York Post and Psychology Today.

In these stories, parents called graduate school admissions offices on their children’s behalf and sat in on meetings with their grown son’s and daughter’s professional career coaches, among other jaw-dropping faux pas.

Studies show that the parenting style probably hasn’t reached the epidemic proportions the media suggest, but it is nevertheless a reality professors, administrators and students face at many universities.

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The new normal: The ethics of neuroenhancement

The new normal

Are we on the cusp of a future where we can just take a pill to work longer, learn faster and achieve more? Is that a world where we want to live?

“Jason,” a pre-med student at Georgia State, holds leadership roles in several clubs, has conducted research with doctors at a local hospital and still makes time for his girlfriend, who’s also a college student. And most recently, Jason has taken a weekend restaurant job to help pay his rent.

“I used to use weekends to catch up on my school work, but I don’t have that anymore,” he says. But these activities haven’t prevented Jason from taking a full load every semester. He recently learned he’ll graduate in the fall, a semester early. But how has he managed to study?

Jason clears entire days to hunker down and hit the books, and on those days, he takes a Vyvanse. The central nervous system stimulant, a type of amphetamine prescribed to people with attention deficit hyperactivity disorder (ADHD), can improve focus and concentration. It can also reduce hyperactive, impulsive behaviors, such as the impulse to check Facebook 12 times before you finish reading a single paragraph of your textbook. In some people, these effects improve learning, recall and working memory, the ability to temporarily hold information, such as a phone number, in your head.

“It gives you a hardcore motivation to sit down and study the most mundane topics for a really long time,” Jason says. “You can do work that you would otherwise procrastinate on. Procrastination is a serious issue in college.”

When Jason told his longtime family doctor that he couldn’t focus in school, the doctor skipped the standard ADHD testing and said, “You seem like a really motivated student, and I’ve been in your shoes before,” Jason recalls. Then the doctor wrote him a prescription for Vyvanse.

But many more pre-meds take ADHD medications than just those who have a prescription, Jason admits.

“Quite frankly,” he says, “they go around like candy. If you don’t have a friend who has it, you’ll have a friend who knows someone who has it.” Continue reading

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Immunotherapy brings new hope to cancer fight

Screen shot 2014-11-14 at 11.29.45 AMTwenty-year-old Milton Wright III’s life seemed to finally be on track. After a lifetime of interruptions to his education, his football career, and his plans to join the Marines, he found his way. He had launched a modeling career and appeared in ads for brands including Zumiez and Adidas. He had all but forgotten he’d ever had cancer.

Then Wright slipped on a sidewalk in 2013 and heard his ribs crack. He walked himself the few blocks to Seattle Children’s Hospital. The hospital was a familiar place. He had lived near it since at age 8, when he was diagnosed with leukemia. He had then spent several years there in treatment for two bouts of acute lymphoblastic leukemia (ALL), the second when he was 15.

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Will 3D printing revolutionize medicine?

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Sydney Kendall lost her right arm below the elbow in a boating accident when she was 6 years old. Now 13, Sydney has used several prosthetic arms. But none is as practical — nor as cool, shed argue — as her pink, plastic, 3-D-printed robotic arm.’

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The arm was custom-designed for her this spring, in pink at her request, by engineering students at Washington University in St. Louis through a partnership with Shriners Hospital. They printed it while Sydney and her parents watched.

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The Science of Fat

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“Introducing Diet Coke” was the commercial jingle in everyone’s head that announced the zero-calorie soft drink’s arrival on the market. And fitness celebrity Richard Simmons hosted a top-rated talk show. Fitness was in fashion, but Americans just kept getting fatter. In the 1980s, Americans underwent their greatest weight gain in recorded history. And we haven’t taken the weight off since.

For 20 years, from 1960 to 1980, the nation’s obesity rate held steady at 13 to 15 percent of the adult population, according to the Centers for Disease Control. But from 1980 to 1988, nearly 10 percent more American adults became obese to include 23 percent of the population. Ten more years added another nearly 10 percent. In 1999, 30 percent of American adults were obese. And the number has steadily risen since then. Today, more than one in three Americans over age 20 is obese. The weight-loss industry is valued at $20 billion. And 108 million Americans are on a diet at any given time.

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